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What is considered a preexisting condition?
A pre-existing condition is a medical condition that existed before
you obtained health insurance. It is significant because the
insurer may not cover the pre-existing condition for the duration
of the pre-existing condition period. The policy will provide for a
stated time period within which it will not provide benefits for
the condition.
The pre-existing condition exclusion period varies by insurance company, and also by the State in which the policy is issued. Currently, State law regulates the terms and conditions of insurance policies. For example, some States have disallowed certain types of provisions, including mcertain medical conditions to which they might otherwise apply.
All of that may change if there occurs greater Federal involvement in the regulation of health insurance, but the odds are that new laws will apply only upon the expiration of existing insurance contracts and for the issuance of new contracts after such laws are implemented.
The rationale for pre-existing condition exclusions is that medical insurance works the same way other insurances do: that insurance covers fortuitous occurrences, nor ones that are planned, intentional, or predictable. Stated otherwise, you need to have coverage in place before something adverse happens. An analogy is that just like you can't buy auto insurance after an accident to cover the cost of the accident, medical insurance only covers issues that arise unexpectedly after coverage has begun.
Pre-existing conditions are usually chronic and often costly conditions such as:
If you think you may have a condition that might be pre-existing you can ask the insurance company if there are exceptions and if your physician can confirm you have not suffered or been treated for the problem during the time period designated by the insurance company. Some companies may decide they cannot cover you if you are seeking individual coverage (rather than group coverage).
The pre-existing condition exclusion period varies by insurance company, and also by the State in which the policy is issued. Currently, State law regulates the terms and conditions of insurance policies. For example, some States have disallowed certain types of provisions, including mcertain medical conditions to which they might otherwise apply.
All of that may change if there occurs greater Federal involvement in the regulation of health insurance, but the odds are that new laws will apply only upon the expiration of existing insurance contracts and for the issuance of new contracts after such laws are implemented.
The rationale for pre-existing condition exclusions is that medical insurance works the same way other insurances do: that insurance covers fortuitous occurrences, nor ones that are planned, intentional, or predictable. Stated otherwise, you need to have coverage in place before something adverse happens. An analogy is that just like you can't buy auto insurance after an accident to cover the cost of the accident, medical insurance only covers issues that arise unexpectedly after coverage has begun.
Pre-existing conditions are usually chronic and often costly conditions such as:
- diabetes
- heart problems
- mental illness
- asthma
- COPD
- Hemophilia
- Epilepsy
- Chronic Infections
- a pregnancy prior to coverage
- an injury which occurred prior to coverage.
- multiple sclerosis, etc.
- certain allergies
- certain skin conditions
If you think you may have a condition that might be pre-existing you can ask the insurance company if there are exceptions and if your physician can confirm you have not suffered or been treated for the problem during the time period designated by the insurance company. Some companies may decide they cannot cover you if you are seeking individual coverage (rather than group coverage).
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What are Preexisting Conditions?
Any personal illness or health condition that was known and existed prior to the writing and signing of an insurance contract is known as pre-existing conditions. It inclu…des any and every health issue ranging from the usual suspects like cancer and diabetes to high blood pressure, asthma and even acne.
Would a complete knee replacement be preexisting condition?
Yes. In order to have a knee replacement done you must first have a significant amount of damage to the knee joint. That is your preexisting condition. The knee replacement it…self was done to replace the damaged joint and may or may not be considered a preexisting condition.
Are uterine fibroids a preexisting condition?
According to any insurance company the answer is "YES", and they will that to their advantage to deny coverage. Regardless, if there is an existing problem or condition that w…arrants treatment or if whether you've gone your whole life with them without any medical implication. If they were discovered under routine exam and noted in your medical history, even though never treated, you can be guaranteed a black check by your name and instant denial to insurance coverage. What is deeply disturbing is that doctors have incentive from insurance companies to perform fibroid surgeries, so treatment/surgery is encouraged, even if not necessary. And, simply due to the resulting high volumes of fibroid treatment/surgeries that places them in the high risk category. So, thank you Ob-gyn next time through for contributing to blocking your access to health insurance. But you may want to wait until you're off the exam table!
Would a condition be considered preexisting if you have never been treated for it but you may have had it without knowing?
Answer A condition is considered pre-existing only if confirmed and diagnosed by a Medical provider. You may think you have high blood pressure for example, and yo…u may have, but until diagnosed by a doctor it's not considered a fact.
You have preexisting condition can i make a claim due to a car accident?
In the UK - you can claim for an acceleration of symptoms of a pre existing medical condition. For example in car accidents - whiplash is common which affects the cervical spi…ne. If your spine has a pre existing degenerative condition you may be suffering no pain. But the car crash could lead to whiplash symptoms which last permanently into the future. A medical expert can scan your spine and see if it is degenerative and that expert will approximate how long the symptoms of pain have been brought forward. The amount you would claim would simply depend on the time period of acceleration. See the related link entitled "car accident compensation" to see examples of how much compensation you can claim for the time period your neck symptoms are accelerated by.
Does insurance cover preexisting conditions?
Medical Insurance policies will typically deal with pre-existing conditions in one of three ways: # Exclude the pre-existing condition from coverage, but offer ot…her benefits as usual. # Place a 24 month moratorium (or waiting period) on the coverage of the condition. If the policyholder receives no treatment during the moratorium, the condition may be reconsidered for coverage. # Cover the condition by increasing the plan premium. This may not be applicable for all pre-existing conditions. # Cover the condition under a Medical History Disregarded benefit (MHD), which is typically only available to group coverage where 20 or more members are enrolled. There are no industry wide standards for dealing with pre-existing conditions, and each insurance company will provide coverage, or not, in their own way.
Is premature birth a preexisting condition?
No, premature birth is not at all a preexisting condition. Premature birth becomes imminent when the doctor thinks the condition of both mother and child would be safe to allo…w premature birth. In this way it will not be considered as a preexisting condition while applying for Medical insurance.
Are gallstones a preexisting condition?
If you were diagnosed with gallstones prior to applying for insurance, or if you knew you had gallstones during the underwritng process, then it is considered pre-existi…ng. This rule applies to most medical conditions which existed before the application process.
Is a genetic condition considered a preexisting condition?
Yes, if it was known prior to coverage. If you have had continuous insurance since the genetic condition was known and there was no lapse in coverage (or the lapse was short e…nough), care for that condition will be covered by your new insurer, per HIPAA.
Shawanda Taylor
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Is diabetes a preexisting condition?
Answer .
Diabetes isn't a preexisting condition in terms of health or life insurance, but generally results in a rate-up or a decline, depending on whether or not you are …taking oral medications or getting an insulin shot.
How do you determine a preexisting condition?
A preexisting condition refers to a medical condition that you had before you applied for new medical health care. Let's say you got a new job that had health care benefits …that you would receive after thirty days on the job. For example, if you had already been diagnosed with Diabetes, high blood pressure, back injuries, ulcers or Cancer and they didn't find these out during your pre-job physical (in which case, they probably wouldn't have hired you), these are considered preexisting illnesses, and the insurance company can refuse to treat these diseases or they can make you pay full price for you prescriptions and they can make you wait up to nine months before they will pay for the treatments of these illnesses. This is the case also if you are disabled and unemployed and you apply for health insurance and you don't qualify for SSI, they can make you wait for up to nine months before paying for the treatments for your major illnesses.
What is not considered a visibility condition?
Narrow road
Answered
How do you determine if you have a 'preexisting condition'?
According to BCBS, if you are still under a doctor's care for a condition and have not been released, it counts as a pre-existing condition. That is what I have found …out during my search. What insurance company do you go through? Most places won't cover pre-existing conditions for 12 months! More accurately, look at the definition of pre-existing conditions in the policy disclousures. Typical language will say some like: any condition for which you received care or treatment for the past (generally 6 or 12 months) will not be covered for the first (generally 6 or 12 months). So if you had cancer but have been treatment free for several years, in many cases it will not be considered a pre-ex. The language in most plans is pretty specific so please read it carefully.
Answered
Is degenerative disc disorder a preexisting condition?
Degenerative disc disorder is a pre-exisiting condition that most insurance companies would likely place a "rider" on. The rider basically says that the insurance compan…y will not pay any claims related to the degenerative disc. Some companies may still cover any medication prescribed for the problem.
Answered
What is a preexisting condition?
A pre-existing condition any medical condition that your have been diagnosed with, prior to the time of application. Some pre-existing conditions can cause an applicant …to be declined coverage. Other conditions may cause the insurance company to place a "rider" on the condition, meaning they would not cover the condition itslef but will still offer coverage to you.
Answered
Is an ovarian cyst considered a preexisting condition if it has dissolved on its own months prior to being enrolled in an insurance plan?
An ovarian cyst would not be considered a pre existing condition. You should have no problem getting an insurance plan.
Answered
What happens if you cannot get health insurance due to a preexisting health condition?
there are some companies that will let you have insurance with preexisting health issues; (globe life, aarp, and mutual of Omaha--to list a few). most companies charge more fo…r premiuns--but these have a set rate. check them out first. then if tou're not satisfied; get on medicad or medicare. you can sign up at your loca ssi-d office to get started. if this don't work;, then find a insurance company that will work wit you on a monthly payment plan. just keep looking--you will find one. i know there is a way to do this. don't give up. my older sister was turned down for a insurance policy--for burial benefits. she found a place where she could pay funeral expense payments--in advance, at a funeral home. her health is also too bad for burial insurance.don't give up;, they are a lot of options left for you to check out yet. sincerely Julia parmer