What Is a “Pre-Existing Condition,” and How Will It Effect My Health Insurance?

The term “preexisting condition” is defined as any medical issue (i.e. illness, or injury) of yours that required treatment 3 to 6 months or more prior to your health insurance plan’s effective date. From time to time, a particular insurance carrier will expand the definition of a preexisting condition to include any medical condition that you were aware of during that 3 to 6 month period, even if you didn’t receive treatment for it.

If you have a preexisting conditions clause in your health plan contract, it excludes coverage for the conditions named therein for as long as 12 months after your health coverage takes effect. Since the definition of what precisely constitutes a preexisting condition and the requirements of each individual clause will vary from one health policy to another, it’s recommended that if you’re either newly insured or currently shopping for insurance, you should take the time to do some preexisting conditions homework.

You want to make sure your new health plan will cover you as fully and as quickly as possible, depending on your current health conditions. Knowing the ins and outs of your health plan can be the best medicine you’ll ever have.