HEALTH TERM - PRE-EXISTING CONDITION
Definition: A medical condition developed prior to issuance of a health insurance policy that may result in the limitation in the contract on coverage or benefits.
Normally this is defined as a health problem for which the new enrollee received health care services before the date that the new health plan benefit begins.
Some policies exclude coverage of
such conditions and the exclusion may continue for a specific period of
time or indefinitely. Federally qualified HMOs cannot limit coverage
for pre-existing conditions.
New statutes in 1997 and 1998 altered the freedom other health plans have enjoyed in setting preexisting time limits.
Certification of prior coverage may mean new insurers would need to waive preexisting clauses for some subscribers.
August 28, 2009 | Permalink | Comments ( 0 )
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