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 ?
On the preexisting condition, background, and autopsy, the family has not released any statement,' the DOTr said.
With just one preexisting condition, a case can be twice as costly as a typical claim; with two pre-existing conditions, a case is five times more costly.
Yet others argue that the problem is with the truth itself: The other side lies, and because the good guys are always too honest, they always lose, a preexisting condition they can undo only if they learn to fib boldly.
A well-targeted and adequately funded high-risk-pool approach would provide a fair and efficient way to ensure insurance coverage without preexisting condition exclusions, reduce premiums in the rest of the individual market, and help expand overall coverage.
While the former would pose few difficulties, it would probably be impossible to retain the preexisting condition ban without also keeping the mandate to buy insurance and the subsidies to low- and middle-income families; in short, most of the ACA's essential components.
Workers' Comp: A group of female workers and the Service Employees International Union California State Council has filed a class-action lawsuit against California's acting administrative director of the division of workers' compensation for alleged systemic gender discrimination, claiming the system treats women's gender as a preexisting condition.
1994), stating "[A]bsent sufficient evidence of a preexisting condition, cases involving alleged workplace cardiovascular injuries generally should be analyzed like any other workplace injury.
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.
1/You can't be turned down for health insurance--even if you have a preexisting condition.
Department of Health and Human Services (HHS) presented its program, the Preexisting Condition Insurance Plan (PCIP), that will lower premiums and ease eligibility standards for preexisting conditions for those denied coverage.
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.