Serious question - how is pre-existing defined?

[Paula Sims]

My friend in Michigan said pre ACA it was prior 5 years. In this new bill, does anyone know how pre-existing is defined?

[angstlessk]

1. It is however the person on the phone at the time declares it...

it is arbitrary and whatever saves the insurance company money...make no mistake!

[ck4829]

2. See: Moving the goalposts

https://en.wikipedia.org/wiki/Moving_the_goalposts

[Sparkly]

3. I think it's more a question of "what is a condition?"

Being a normal woman of a certain age was a "condition" that kicked me off my insurance (prior to ACA)! The insurance company cited tests I'd had, including a biopsy that was BENIGN. They even said my height/weight ratio was not to their standard -- my weight is on the low side, but I am NOT underweight. The company referred me to a state high-risk pool, but by the state standards I wasn't high-risk. I'm healthy!!

Fortunately I was able to get a work-around to keep coverage (at a high cost, but oh well).

[Ms. Toad]

4. Pre ACA it was no limited to the prior 5 years.

Insurance companies were free to classify pretty much as they wanted. Some things were very short duration - some were "any time in your life."

[theglammistress]

5. This seems significant...

I've thought the GOP claim on covering pre-existing conditions was a fraud all along. Looks like I was right:


Andy Slavitt?Verified account
@ASlavitt

The number of times the words "pre-existing conditions" are used in the bill . . . Is ZERO.

Link to tweet

[duncang]

6. I have had letters from insurance copanies

Asking me a long list of what, when, where. It is primarily used when something like a er treated injury comes up. Trying to find out if it car wreck related or similar. But I have also had others that ask stuff like when did you first have problems with your back? They could pretty much decide on their own prior to ACA. As brought up here even taking a baby aspirin every day could put you in that category.

[Cicada]

7. Any condition requiring higher insurance premiums than normal

The ban on considering preexisting conditions is achieved by requiring the same price for every one, with a few minor exceptions such as somewhat more for the elderly. If insurers will not sell to you at the same price as others in your community then you have a preexisting condition, the condition leading insurers to insist you pay more.