What is a pre-existing condition?
The more easily defined and recognized type of pre-existing medical conditions are the ones for which you have showed symptoms prior to the effective date of your coverage. It is definitely possible to show symptoms without diagnosing the exact medical condition. For instance, perhaps you have been suffering from migraines, but you have no idea what is causing them. You need to disclose this symptom on your application and let the insurance company decide if they are concerned about it. They may request a diagnosis prior to approving your application, since they are only able to exclude a specific medical condition, and not an undiagnosed symptom. The clearest type of pre-existing medical condition is the one for which you have received diagnosis and treatment. A medical condition that was diagnosed and treated successfully 20 years ago would not be considered a pre-existing condition by most insurance companies. There are set time frames that are determined by insurance carrier policy and state regulations that define the look-back period for a pre-existing medical condition. 1 CommentLeave a comment |
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What is a pre-existing condition?
In short, a pre-existing medical condition is a medical condition that existed before your insurance policy was purchased and became effective. Depending on the state in which you reside and the type of insurance you are purchasing, the definition could have a more specific meaning. It may apply to any condition that manifested before your policy effective date, any condition for which you showed symptoms, any condition for which you sought medical treatment, or a combination of one or more of these. Most insurance policy types and states do not allow recognition of manifest pre-existing conditions when reviewing your claims eligibility. A manifest condition is one that may have originated without your being aware of it. An example of this would be an internal tumor or cancer. Both of these ailments can be present in your body for a length of time without you showing any signs or symptoms of this condition. Certain types of insurance, such as a travel insurance plan, may be allowed to consider manifest conditions, but this it not the case with most domestic individual and group health plans. It is very difficult for an insurance company to determine the exact date of origin of a manifest condition, so rarely will they pursue this avenue when denying a claim as pre-existing.
Hi, I am a female, 47 years old and I suffer from a disease called Psoriatic Arthritis. I am now changing jobs from my current job in real estate to a teaching position at a local community college. The salary package includes health insurance plans for the employees. I have had health insurance with my former company for the last 6 years. Now I am wondering what will happen to my health situation when I change jobs. I need medicine for my condition that is very expensive and I would hardly be able to afford it on my own without health insurance. Will I be denied for coverage with the new health insurance plans because of a pre-existing condition?
Comment by Kelly — June 29, 2009 @ 2:12 am