What is a Pre-Existing Condition

This is an irrelevant question when we’re talking about Obamacare-compliant health insurance plans. The Affordable Care Act guarantees coverage that includes pre-existing conditions (at the same price).

But if Obamacare isn’t an option because you missed Open Enrollment, you’ll need to look at alternatives like short-term health insurance.  And a short-term health plan isn’t going to cover pre-existing conditions.

The technical definition of a pre-existing condition will vary a little bit from company to company. Typically you can use common sense: It’s any medical condition that you’ve experienced symptoms of, sought treatment for, or been prescribed medication for in the last 5 or 10 years. (Note: That’s not a technical definition.)

As a typical example, here’s how BlueCross BlueShield of SC defines a pre-existing condition as it pertains to their short-term health plans:

  • Symptoms existed that would cause a person to seek diagnosis, care or treatment with the previous year prior to coverage or
  • Medical advice or treatment was recommended by or received from a doctor within a 5- year period prior to coverage.

On a short-term health insurance plan, you’re not going to get coverage for pre-existing conditions. In fact, some pre-existing conditions could make you not eligible to get covered on most short-term health plans. (There is at least one exception we can show you if this is a problem for you).

Why would anyone want to buy a plan that didn’t cover pre-existing conditions?

  • Obamacare plans aren’t available outside of Open Enrollment unless you have a major life event that qualifies you for a Special Enrollment Period.
  • You can enroll in a short-term health insurance plan at anytime.
  • Short-term health plans are FAR cheaper than non-subsidized Obamacare plans.

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