How Pre-existing Condition Coverage works?
Pre-existing Condition is any injury, illness, sickness, disease, or other physical, medical, mental or nervous condition, disorder or ailment that, with reasonable medical certainty, existed at the time of application or at any time during
the three years prior to the effective date of the insurance, including any subsequent, chronic or recurring complications or consequences related thereto or arising therefrom, whether or not previously manifested or known, diagnosed, treated, or disclosed.
There are two ways how the insurance company covers Pre-existing condition coverage. Some insurance carriers cover if anything happens related to preexisting condition as long as the condition is controlled through the taking of prescription drugs or medication and remains controlled throughout the 12 month period and No medical treatment with in last 12 months, where as other plans cover only Acute onset of a preexisting condition. The restriction on how acute onset of a preexisting condition coverage is based on the insurance carrier which we choose. But the common definition of Acute onset is - A sudden and unexpected outbreak or recurrence of a Pre-existing Condition which occurs 1) spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent medical care; 2) after the Effective Date; and 3) prior to the age shown in the Schedule of Benefits/Limits. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence.