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Last Updated
Thursday, August 05, 1999 

Pre-Existing Condition

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Overview

A preexisting condition is defined as an illness or injury for which the person has been under the care of a physician and has received medical care or advice or a condition for which a reasonable person should have sought treatment.

Many individual carriers are now offering a waiver of the pre-existing condition clause for anything disclosed on an application and not specifically excluded.  It is important to honestly disclose any preexisting conditions to your insurer. Failure to do so allows an insurance company the right to recind your policy at a later date. 

New health insurance laws have not eliminated the ability of individual carriers to deny policy issue or exclude medical conditions.  The only new guanratee issue provisions are the State sponsored, insurance company funded, plans.  ( See below for more info about Illinois’ plan.)

Group medical plans offer a waiver of the pre-existing condition clause if you have previous uninterupted coverage.  Temporary insurance plans are eligible for “time-served” coverage with group plans.

.  More serious situations may be excluded or may cause a person to be declined. Controlled high blood pressure or cholesterol are routinely accepted by many carriers.  Let your agent know your conditions up front.  Good agents are in contact with underwriters and  will only recommend policies that are most likely to accept you.

There are many conditions that make someone uninsurable.  The biggest factor in making someone uninsurable is the time factor.  Recent hospitalizations and diagnosed conditions usually make insurance carriers nervous. 

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If you have severe health problems, we can still help.

 We represent several "risk" carriers that can help.  We have quality health plans available for diabetics and/or heart patients, with a recent stable history, that might otherwise be uninsurable.

Since August 1, 1997 Illinois has been in compliance with federal mandates for guaranteed access coverage without a pre-ex clause for those with 18 months of qualifying previous coverage.  Indiana residents should check with the local Deptartement of Insurance for information about state provided guaranteed issue medical plans.

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The inHealth Insurance Quotesformation contained in this web may contain generalities or inaccuracies. Please read the brochures and policies for specific limitations and exclusions and applicable rules.