MEDICARE GLOSSARY

Pre-existing medical condition

1

A pre-existing condition is a health condition or illness that exists before a person enrolls in a health insurance plan. Pre-existing conditions can range from minor to chronic conditions, such as asthma, diabetes, cancer, and heart disease. Some examples of pre-existing medical conditions include:

  • Diabetes
  • Heart disease
  • Cancer
  • High blood pressure
  • Asthma
  • Arthritis
  • Depression
  • Chronic obstructive pulmonary disease (COPD)
  • HIV/AIDS
  • Multiple sclerosis (MS)
Pre-existing medical conditions can affect an individual's ability to obtain health insurance or receive coverage for their medical care. In some cases, insurance companies may charge higher premiums or deny coverage altogether to individuals with pre-existing conditions. However, under the Affordable Care Act (ACA), insurance companies are required to cover pre-existing conditions without charging higher premiums or denying coverage.

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