Like what you're reading?
Get weekly money news & money moves delivered to your inbox
Insurance companies can no longer deny you coverage based on health problems.
Pre-existing conditions are protected under the Affordable Care Act
Insurers cannot deny health coverage for people for pre-existing conditions
Insurers cannot charge higher costs for people with pre-existing conditions
Insurers cannot subject people with pre-existing conditions to a waiting period
Pre-existing conditions are medical conditions and health problems that occurred before the start date of your health insurance coverage. Examples of pre-existing conditions include cancer, asthma, diabetes or even being pregnant.
Under the Affordable Care Act (Obamacare), health insurance companies cannot refuse to cover you because of any pre-existing conditions nor can they charge you for more money for the coverage or subject you to a waiting period. This went into effect for plans that begin on and after January 1, 2014.
In this article:
Any health problems that you have prior to getting an insurance plan qualifies as a pre-existing condition. Health insurance companies decide what is considered a pre-existing condition. In theory, it could be any condition that might be costly for the health provider to cover.
According to the Kaiser Family Foundation, common examples of pre-existing conditions that affected coverage before the ACA are:
Even a more minor medical condition — like acne, tonsillitis, high blood pressure or menstrual irregularities — could be deemed a health issue, depending on the provider.
Easy Money by Policygenius
Sign up for Easy Money by Policygenius, a free weekly newsletter with exclusive content, personal finance advice, and bonus offers.
Insurance companies cannot deny you health coverage based on a pre-existing condition. It is also illegal for them to charge more money for your plan because of the pre-existing issue or refuse to cover the 10 essential health benefits that must be included in every insurance policy.
Passed in 2010, the Affordable Care Act helps make health insurance more affordable for Americans. Guaranteed coverage of pre-existing conditions applies to all health plans that people enrolled in beginning on or after January 1, 2014.
Prior to Obamacare, insurance companies could reject people for any number of pre-existing health conditions – including something minor as mentioned before – or increase the costs of their coverage. People had to enroll in a pre-existing condition insurance plan (PCIP) — a health program specifically designed for individuals who had been rejected on the basis of a medical condition. PCIP coverage ended in 2014 when the Obamacare protections went into effect.
Health insurance plans that started on or before March 23, 2010 – called grandfathered plans — are not subject to the rules of Obamacare. That means if you enrolled in a health plan prior to this date, your insurer can choose to cancel your policy or increase your premiums for pre-existing medical conditions.
Health insurance and life insurance work together to offer financial protection.
Health insurance can pay your medical expenses. Life insurance keeps your loved ones whole after you die.
About the author
Elissa is a personal finance editor at Policygenius in New York City. She writes about estate planning, mortgages, and occasionally health insurance. In the past she has written about film and music.
Policygenius’ editorial content is not written by an insurance agent. It’s intended for informational purposes and should not be considered legal or financial advice. Consult a professional to learn what financial products are right for you.
Was this article helpful?
We make it easy to compare and buy insurance.
Security you can trust
Yes, we have to include some legalese down here. Policygenius Inc. (DBA Policygenius Insurance Services in California) (“Policygenius”), a Delaware corporation, is a licensed independent insurance broker. Policygenius does not underwrite any insurance policy described on this website. The information provided on this site has been developed by Policygenius for general informational and educational purposes. We do our best to ensure that this information is up-to-date and accurate. Any insurance policy premium quotes or ranges displayed are non-binding. The final insurance policy premium for any policy is determined by the underwriting insurance company following application.
Copyright Policygenius © 2014-2020