Preexisting condition


Also found in: Medical.

Preexisting Condition

In insurance, a medical condition that existed before one applied for and/or received a health insurance policy. Most private health insurance companies refuse to cover preexisting conditions, at least for a certain period of time. Depending on the severity of the preexisting condition, a provider may refuse to provide health insurance at all. However, employer-provided health insurance must cover preexisting conditions if an employee switches insurance plans as the result of a job change.

Preexisting condition.

A preexisting condition is a health problem that you already have when you apply for insurance.

If you have a preexisting condition, an insurer can refuse to cover treatment connected to that problem for a period of time. That period is often the first six months, but may be for the entire term of your policy.

Insurers can also deny you coverage entirely because of a preexisting condition. And they can end a policy if they discover a preexisting condition that you did not report, provided you knew it existed when you applied for your policy.

However, if you're insured through your employer's plan and switch to a job that also provides health insurance, the new plan must cover you regardless of a preexisting condition.

References in periodicals archive ?
But the preexisting condition provision is less generous than the one outlined by PPACA as it protects only consumers who maintain continuous health coverage.
Argos insisted a preexisting condition was to blame for the allergies he was suffering and rejected the claim.
Huw had su ered a brain haemorrhage from a preexisting condition no-one could have known about.
1/You can't be turned down for health insurance--even if you have a preexisting condition.
As such, the court determined that the causation question involved separate loss due to a covered event from a property's preexisting condition.
Only 1 of these patients had a preexisting condition.
Specifically, we explored (a) the number of years of Medicare claims history necessary to find a preexisting condition and (b) the proportion of preexisting versus newly diagnosed conditions identified by the Medicare claims using the CCW algorithm.
Health insurers have used genetic test results to try to prove that a newly diagnosed genetic disease was a preexisting condition.
told the New York Times that the IOM report brought the US "one step closer to saying goodbye to an era when simply being a woman is treated as a preexisting condition.
As noted earlier, health insurance companies will not be able to exclude anyone from coverage for a preexisting condition or set a cap for the amount of coverage.
Under the concept of "apportionment," when part or all of a compensable injury or disability is connected to a preexisting condition, compensation for the injury will be divided (or "apportioned") so that compensation for the preexisting injury is deducted from the amount for which the current employer or carrier is liable.