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What is a Pre-Existing Condition and How It Applies to Insurance?

What is a Pre-Existing Condition

What is a Pre-Existing Condition and How It Applies to Insurance?

With the increasing health hazards, health insurance is no more a luxury but a necessity. However, when you enter the world of health insurance, you will be introduced to a new term known as a pre-existing condition.

Pre-existing conditions play a crucial role in determining whether you are eligible for a certain health insurance policy or not. Moreover, the coverage amount is also affected by pre-existing conditions.

To know more about these conditions and how they shape a health insurance policy, keep reading…!

What are Pre-Existing Conditions?

A health issue is treated as a pre-existing condition, if you have received treatment for it, you are taking medication for it, it had been diagnosed before you applied for health insurance or it exists at the time of application.

Insurance providers cannot deny you insurance coverage or charge you higher rates for an insurance policy if you have pre-existing conditions.

What are some of the common examples of pre-existing conditions?

A pre-existing condition could be any health issue it could be minor or chronic and extremely serious. Some of the common pre-existing conditions are Diabetes, COPD, Cancer, Sleep apnea, Asthama, High Blood Pressure, and many more. Also you must know about how Pre-Existing Conditions affect Visitor Insurance Policy.

Pregnancy before enrolment in health insurance is also considered a chronic pre-existing condition.

Some of these conditions may be covered in your health insurance policy under the acute onset of pre-existing condition benefit. But, the coverage or exclusion of pre-existing conditions varies from insurer to insurer and also the severity of your condition.

Can I get Health Insurance Coverage if I have Pre-existing conditions?

Yes! Individuals with pre-existing conditions are eligible to apply for a health insurance policy. As these plans do not go through Underwriting (no medical condition evaluation is done), anyone applying for coverage does get covered under the plan.

So, despite having one or multiple pre-existing conditions you can still get good health insurance for pre-existing conditions from reputed insurance providers like Visitor Guard®.

What is the Look-Back period and is it valid for Travel Health Insurance?

The two most important factors that determine a pre-existing condition and when to offer coverage are; Look Back Period and Waiting period.

Look Back Period.

To declare a certain health issue as a Pre-existing condition it needs to be treated or diagnosed in the look-back period. This time span varies for different insurance companies. It could be as short as a year or as long as 2 to 3 years. On average it is 18months to 2 years.

If your condition was treated or diagnosed before the look-back period specified by your insurer, then it might not be seen as a pre-existing condition. However, conditions like diabetes, high blood pressure, arthritis, cancer and other chronic conditions will always be treated as pre-existing conditions no matter how long ago it has been diagnosed.

Waiting Period.

A waiting period is a duration of time i.e.,6 months, 12 months, or more, after which a pre-existing condition can be covered under the policy.

There are student plans that sometimes have a waiting period for a pre-existing condition to be covered under the policy. Travel health insurance plans do not have a waiting period as the plans will not cover pre-existing conditions but may only cover an acute onset of a pre-existing condition.

Any medical expense for the treatment of the pre-existing condition during the waiting period is not compensated by the policy. Students seeking insurance coverage for  pre-existing conditions will have to wait till the waiting period has been met for any treatment for an existing condition to be covered .

The waiting period is different with each insurance company.

Things to Remember.

  • Never hide your pre-existing conditions from your insurance provider as it could result in claims denial.
  • Many plans offer coverage for an acute onset of any pre-existing condition
  • Always read the brochure and certificate wordings for benefits and exclusions.
  • If you do change your insurance provider after the waiting period is met, you will have to meet the waiting period again on the new policy. Hence, it is beneficial to stay on the same policy.

However, you don’t have to bother about these details if you pick a trusted insurance agency like Visitor Guard®. Visitor Guard® has been in the insurance industry for more than a decade and has  helped many students and visitors purchase health insurance, while they had pre-existing conditions.
If you wish to get a FREE quote for Health Insurance, connect with us TODAY!

Chiranth Nataraj

Chiranth Nataraj

Travel Insurance Expert

Chiranth Nataraj is a licensed insurance agent and the principal at, an independent insurance agency that provides visitor insurance to customers across the United States and the world. With over 20 years of experience, Chiranth has been instrumental in educating the travel community, new immigrants, the international student community, and foreign governments about visitor medical insurance to cover medical expense risks. He has built a team that strives to make the preferred choice for travelers, exchange visitor organizations, and international universities. His insights and expertise have made him a popular industry voice, and he is often featured in USA Today, Forbes, Washington Post, and many more.


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