What Is a Pre-Existing Condition?
In the healthcare industry, a pre-existing condition refers to any medical condition you have that started before your health insurance benefits go into effect. Prior to 2014, before Obamacare went into effect, some health insurance plans did not cover medical expenses associated with pre-existing conditions.
Some health insurance companies use an objective standard to define this term, which means that a pre-existing condition is any condition that you have already received medical advice about or had treatment for before enrolling in a new health insurance plan.
Historically, other health insurance companies considered you to have one of these conditions if you reported that symptoms began before your coverage did, no matter if you sought medical care or not.
What Is Considered a Pre-Existing Condition?
There is a long list of conditions from simple acne to the complications of cancer. Among many conditions, the list usually includes chronic issues, such as:
- Parkinson's disease
- Renal failure
- Heart disease
- Alzheimer's disease
- Crohn's disease
This is not a comprehensive list, so make sure to check with your health insurance provider to see if you have anything that can be considered a pre-existing condition.
Health Insurance With Pre-Existing Conditions
Are You Able to Get Insurance With a Pre-Existing Condition?
Prior to the Affordable Care Act, also known as Obamacare, some insurance companies would completely refuse to insure you if you had certain pre-existing conditions, while others would insure you at higher rates than people in the same demographic without pre-existing conditions. The result of this was that as many as 25% of the United States population went without healthcare coverage because it was not affordable.
Under Obamacare, all plans sold and purchased through the Health Insurance Marketplace must cover pre-existing conditions. This means that a health insurance company cannot refuse or deny you coverage, or charge you more for premiums if you have a pre-existing condition. In addition, once you have already enrolled in a plan, you cannot be denied coverage or have your rates raised based on your health.
Does Having a Pre-Existing Condition Affect Medical Costs?
Under the current healthcare coverage laws, you will not pay more for your medical care because you have one of these conditions. Your premiums will be the same as if you did not have one, and you will pay according to your plan's policies for any diagnostic tests, doctor visits and treatments you have.
However, it is important to note that in general, pre-existing conditions do increase healthcare costs for both you as the consumer and your insurance company because you will likely require more health-related services and medical treatment than someone without a similar condition.
Get health insurance quotes for your pre-existing condition by talking to one of our experienced agents 858-771-4087 or by entering your zip code here!