In a health insurance policy, what is meant by a pre-existing condition?

In the context of health insurance, a pre-existing condition refers to a medical condition or health issue that exists prior to the submission of an insurance application. This means that if an individual has been diagnosed with or has been receiving treatment for a particular condition before they purchase their insurance policy, that condition is classified as pre-existing.

This designation is significant in the insurance industry because it often affects coverage. Traditionally, many insurance policies impose waiting periods or exclusions for pre-existing conditions, meaning that the insurer may not cover expenses related to that specific condition for a certain duration or it may require an individual to wait before those benefits kick in.

Recognizing pre-existing conditions helps insurers assess the risk and manage costs associated with providing coverage.