Pre-existing condition insurance

Pre-existing condition insurance is a type of health coverage that pays for medical costs related to illnesses or injuries diagnosed before the start date of an insurance policy. The Affordable Care Act prohibits insurers, such as Aetna and Cigna, from denying coverage due to pre-existing conditions as of January 1, 2014.

Insurers like UnitedHealthcare and Blue Cross Blue Shield cannot charge higher premiums based on pre-existing conditions for individual or employer-sponsored plans. Short-term health plans, available from providers like National General, usually exclude coverage for pre-existing conditions by contract.

Marketplace plans under Healthcare.Gov must cover essential health benefits, including treatment for asthma, diabetes, or cancer diagnosed before enrollment. COBRA continuation coverage includes pre-existing condition protection if group health insurance was in force.

Medicare covers pre-existing conditions without charging higher rates during open enrollment periods. Medicaid eligibility does not restrict individuals with chronic or prior diagnoses such as hypertension or epilepsy.

Travel insurance policies rarely include pre-existing medical condition waivers unless purchased as an add-on rider within a specified time frame–typically 14-21 days after initial trip deposit, according to a report from YourInsurance.info. Denials based on pre-existing conditions have declined dramatically since the ACA mandate, dropping from over 18% of individual market applicants in 2010 to nearly zero today (Kaiser Family Foundation).