What is considered a preexisting condition?

Answer 1:
To me the answer is simple: Preexisting condition is whatever the insurance you are looking at says it is. There are some regulation
available nationwide but that is basically it. If you don't like the
definition given in the policy, you can buy another. More important
question seems to be: Say you have been denied coverage because
of pre-existing conditions. What to do next!? That of course is a whole new question. I have some ideas, so email me if you want to discuss.

Answer 2:
My personal opinion (I am trying to settle this issue in my own situation) is a pre-existing condition is one that you have knowledge of. It could be quite possible to have prostate cancer and not know about it because it is slow growing.

On the question about changing policies. The key is to go from one GROUP policy to another GROUP policy. If you go to an individual policy you get hit with pre-existing condition requirements. The HIPPA law takes care of you group to group but not individual policies.

Answer 3:
A pre-existing condition is an active condition that has been treated within the last year to five years (depending on the condition) **** and there is a gap in medical insurance. So if you were diagnosed with some disease eleven years ago, but have not been treated for five years, even with a gap in insurance, you do not have a pre-existing condition.

Answer 4:
When insurance companies refer to pre-existing conditions what they are talking about is any serious, irreversible and/or terminal illness that won't go away and will cost them hundreds of thousands of dollars increasing toward the end of the insured's life. Examples include Advanced Emphyseyma/COPD, Major Cancers, Viral Cardiomyopathy, Massive heart damage or having been installed a pacemaker, AIDS, viral menengitis, Type A Diabetes, cirrhosis of the liver, or Acute Asthma in patients older than age 65. Almost any type of serious brain abnormality such as an AVM, Chronic Brain Tumors regardlesss if it is mallignant, benign, or terminated will almost always constitute a pre-existing condition, naturally.

Unfortunately in the last several years any and all of your decent health insurance companies will not even talk to you if there's any reason to believe you're suffering from or a substantial candidate for these diseases. In fact Blue Cross Blue Sheild's direct application has a list of most of the above diseases on the front with little check boxes and says if any are checked STOP HERE.

Answer 5:
A pre-existing condition is any condition that you are currently being treated for. If you already have prior insurance and wish to change then the pre-exisiting condition rule does not apply. If you are without insurance then you are either put on a waiting period or the company will exclude any type of coverage for that condition. Unless, your going on group, then most insurance companies have to take you on their plan. It all depends on what state you live in and what rules apply. Check with your insurance agent or contact an insurance broker.

Answer 6:
There are really TWO parts to this question.
1. Will you get coverage in the FIRST place.
2. If you do get coverage will the condition be excluded forever or for a period of time.

Answer 7:
It depends if you belong to an employer group or as an individual.
If an employer group of 2 or more in California, you are guaranteed to get coverage under AB 1672 - Insurance Code 10700 etc.
As an Individual, you can get the Major Risk Plan.
As far as the definition of pre-x goes you really have to look at the specific policy and the specific application you are filling out.
When filling out an application - be honest and read the question. Ask your agent what the company underwriting guidelines are to see if you have a chance to get coverage.
If you've been on a group plan, then your entitled to COBRA and HIPAA.

Answer :
From About.com.
Pre-existing conditions can vary between plans from being excluded to being covered fully and sometimes somewhere in-between like being covered after a specific amount of time. The Health Insurance Portability and Accountability Act ensures coverage for pre-existing conditions if you are joining a new group plan from your employer and you were insured the previous twelve months

No comments: