Understanding Pre-Existing Conditions & Health Insurance: What You Need to Know

The Truth About Pre-Existing Conditions & Your Coverage

There’s a lot of confusion surrounding pre-existing conditions and health insurance, so let’s clear things up. Many people assume that all insurance plans must cover pre-existing conditions—but that’s not always true.

What is a Pre-Existing Condition?

A pre-existing condition is any health issue you’ve had before enrolling in a new insurance plan, even if it’s resolved. Examples include:

✔ A past stroke or heart attack (even if you’re fine now)

✔ Diabetes (especially if you take insulin)

✔ High blood pressure (if you take medication for it)

✔ ADD/ADHD (if you’re on medication)

✔ Cancer (even if you’re in remission)

What Type of Plans Cover Pre-Existing Conditions?

✅ Major Medical Insurance (ACA Plans) → Covers pre-existing conditions (required by law under the Affordable Care Act).

🚫 Other Plans (May Not Cover Pre-Existing Conditions):

❌ Short-term health plans

❌ Self-employed insurance plans

❌ Indemnity plans

❌ Supplemental plans (cancer, accident, or life insurance)

These plans can:

🔹 Deny coverage for certain conditions

🔹 Exclude pre-existing conditions from coverage

🔹 Require a waiting period (often 12+ months)

Why This Matters

Many people assume all health plans must cover pre-existing conditions. That’s only true for ACA-compliant major medical insurance. If you’re considering a different type of plan, always check the fine print.

For example:

📌 If you have ADD, some plans may not cover doctor visits or medication for 12 months.

📌 If you’re in cancer remission, some plans require 5-10 years before offering coverage.

📌 If you take heart medication, you may not qualify for some plans at all.

The Best Insurance Strategy? Stay Healthy!

While you can’t prevent everything, prioritizing good health can give you more insurance options later.

✔ Regular exercise

✔ Healthy eating

✔ The right supplements

✔ Preventative checkups

Yes, these things can be expensive, but not as expensive as a major illness. My husband and I invest in our health now to avoid costly medical bills later.

Need help understanding your health insurance options? Schedule an appointment, let’s chat! www.jkappconsulting.com