What Is A Pre-Existing Condition?

woman hospital patient sitting upright on stretcher

A pre-existing condition is a medical illness, condition and/or disease that someone has prior to attempting to obtain healthcare coverage.

Starting in 2014, being sick won’t keep you from getting health coverage. An insurance company can’t turn you down or charge you more because of your condition. It can’t refuse to cover treatment for pre-existing conditions. This is true even if you have been turned down or refused coverage due to a pre-existing condition in the past.

The only exception is for grandfathered individual health insurance plans–the kind you buy yourself, not through an employer. If you have one of these plans you can switch to a Marketplace plan during open enrollment and get coverage for your pre-existing condition.

You can apply for Health Insurance Marketplace insurance when open enrollment starts on October 1, 2013. Coverage starts as soon as January 1, 2014. Open enrollment ends on March 31, 2014. Medicaid and the Children’s Health Insurance Program(CHIP) also can’t refuse to cover you or charge you more because of a health condition.

For more information, visit HealthCare.gov.

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