UNDERSTANDING INSURANCE - PRE-EXISTING CONDITIONS

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PRE-EXISTING CONDITIONS

When purchasing insurance read the fine print relating to "Pre-Existing Conditions." This may determine whether or not the insurance will meet your needs.

Each company has their own definition of a pre-existing condition. Here is the definition of "Pre-Existing Conditions" taken from a policy that gives medical coverage for foreign nationals visiting the USA:

A pre-existing condition is defined as an injury or illness which was contracted or which first manifested itself; or for which manifestations of symptoms would have caused a prudent person to seek medical advice or treatment; or for which a licensed physician was consulted; or for which treatment or medication was prescribed within the five years prior to the effective date of the insured person's coverage.

The following is a “Pre-Existing Conditions” definition for a domestic policy offered in the USA:

Any injury or sickness, or any complications there from which is present or manifest itself, or for which medical care, treatment, advice or consultation was rendered to a Covered Person with the 12 months period prior to the Effective Date of Coverage. Any injury or sickness shall be considered to be present or manifest if the condition or symptoms exist prior to the Effective Date of coverage, even though no diagnosis, care or treatment were sought or received.

Different companies put a time limit on what is considered a pre-existing condition. The first company above gives a five-year look-back as the time span for determining a pre-existing condition. Among the various policies we handle the following time limits are given: 6 months, 12 months, 24 months, 5 years, 24 months, 60 months, etc.

Having pre-existing conditions does not mean that your insurance rates will be higher. But, if the pre-existing conditions fits into a company's definition for such, it may mean that those conditions will not be covered by your insurance.

Before you buy insurance get information on the "Pre-Existing Condition” clause. Otherwise, you may think some medical problem will be taken care of even though it is clearly excluded from coverage because it is a pre-existing condition.