Pre-Existing Conditions

A pre-existing condition in insurance refers to any medical condition, injury, or illness that a person has before they enroll in a health insurance plan. Pre-existing conditions can range from chronic conditions such as diabetes, asthma, or heart disease, to more acute conditions such as a recent surgery or injury.

In the past, insurance companies could exclude coverage for pre-existing conditions or charge higher premiums for individuals with such conditions. However, under the Affordable Care Act (ACA), insurance companies are prohibited from denying coverage or charging higher premiums based on pre-existing conditions. This means that insurance plans must cover treatment for pre-existing conditions, and insurers cannot charge individuals more for their insurance coverage due to a pre-existing condition.

Here are some key features of pre-existing conditions in insurance:

• Pre-existing conditions are medical conditions that existed prior to the start of a health insurance policy.

• The Affordable Care Act (ACA) prohibits insurance companies from denying coverage or charging higher premiums based on pre-existing conditions.

• Insurance plans must cover treatment for pre-existing conditions, and insurers cannot charge individuals more for their insurance coverage due to a pre-existing condition.

• The ACA also requires all health insurance plans to cover certain essential health benefits, including treatment for pre-existing conditions.

Next Up

‍Each month, Mployer Advisor collects and presents some of the most relevant and most pressing recent changes in law, compliance, and policy in areas related to employee benefits, health care, and human resources. 
The average US employee costs their employer about $45.42 per hour in total compensation expenses with a little more than 30% of that expense going toward employee benefits and perks.
Each month, Mployer Advisor breaks down the Bureau of Labor Statistics’ most recent State Employment and Unemployment Summary to highlight some employment trends across various markets. This is an overview of April’s report.