Articles on: Carriers Questions

How does my plan handle pre-existing conditions?

Under the Affordable Care Act (ACA), your health insurance plan cannot deny you coverage or charge you more based solely on a pre-existing condition. This means that if you have a health condition before you enroll in your ACA plan, your insurance company cannot refuse to cover you or charge you higher premiums because of it.

Key points to remember:
No pre-existing condition exclusions: Your plan must cover all essential health benefits, including treatment for your pre-existing condition.
No lifetime limits: There are no lifetime limits on the amount of coverage you can receive for a pre-existing condition.
No waiting periods: You don't have to wait for a certain period before your coverage kicks in for a pre-existing condition.

However, there are a few exceptions:
Grandfathered plans: If you have a grandfathered health insurance plan purchased before March 23, 2010, it may not cover pre-existing conditions.
Individual market plans before the ACA: If you purchased an individual health insurance plan before the ACA was implemented, it may not cover pre-existing conditions.

Updated on: 07/10/2024

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