Pre-existing conditions: what they are and how they affect your insurance
It's the most common question when buying major medical insurance, and also the one that causes the most problems when it isn't cleared up from the start.
What is a pre-existing condition?
It's a condition that already existed before you took out your policy: because you already had a diagnosis, because you were already being treated or because you'd already had clear symptoms.
For example, diabetes diagnosed two years ago, a hernia a doctor had already found or a previous knee injury.
Does insurance cover them?
It depends on each insurance company and each plan. In general, one of these three things happens:
- It's excluded: that specific condition isn't covered, but the rest of your health is.
- It's covered after a waiting period, once you've had the policy for a certain amount of time.
- It's covered with conditions, for example with a different deductible or premium.
Why is it so important to tell the truth?
When you apply, you fill out a health questionnaire. If you leave out something you already knew about, the insurance company can deny payment when you need it or even cancel your policy.
Disclosing everything may feel like it works against you, but it's what makes sure your coverage will actually work when you use it.
Waiting periods
Besides pre-existing conditions, some conditions have a waiting period even if they show up after you buy the policy: for example, certain surgeries or pregnancy. Accidents, on the other hand, are usually covered from day one.
That's why it pays to get coverage before you need it: the sooner you have your policy, the sooner those waiting periods end.