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The Daily Insight Hub

How do insurance companies investigate pre-existing conditions?

Author

Sarah Martinez

Updated on January 10, 2026

Insurers then use your permission to snoop through old records to look for anything that they might be able to use against you. If you have a pre-existing condition, they’ll try to deny your claim on the grounds that you were already injured and their insured had nothing to do with it.

How long can a pre-existing condition be excluded?

Conditions for Exclusion HIPAA allows insurers to refuse to cover pre-existing medical conditions for up to the first twelve months after enrollment, or eighteen months in the case of late enrollment.

How far back do insurance companies look for pre-existing conditions?

Each category of care is then subject to the six-month look-back period. If you have not had healthcare coverage in the past 12 months, your new employer’s healthcare plan can refuse treatment for pre-existing conditions for up to one year.

Can insurance companies deny health insurance due to preexisting conditions?

Yes, health insurance policy for pre-existing diseases is definitely possible; however it may lead to an increase in premium or denial in some cases. Once you honestly disclose the pre-existing condition while applying for insurance, there are 3 ways how this condition will affect your policy and premiums.

Do I have to disclose pre-existing conditions?

Under the Affordable Care Act, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts. They don’t have to cover pre-existing conditions.

Does GeoBlue cover pre-existing conditions?

The GeoBlue Voyager Choice plan is available to those who have primary insurance inside the U.S. and will cover medical treatments for pre-existing conditions.

Is back pain considered a pre-existing condition?

Some of the commonly understandable “pre-existing conditions” can be chronic illnesses like diabetes, high blood pressure, asthma etc. The “pre-existing conditions” can include chronic injuries like back pain too.

What qualifies as pre-existing condition?

A health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts. Insurance companies can’t refuse to cover treatment for your pre-existing condition or charge you more.

Which insurance company covers pre-existing diseases?

Health Insurance for Parents with Pre-Existing Diseases. One can buy health insurance for his/her parents with pre-existing illnesses. Some of these plans include Bajaj Allianz Silver Health, Oriental Insurance Hope, New India Assurance Senior Citizen Mediclaim Policy, etc.

Which insurance is best for pre-existing medical conditions?

Can a health insurance company refuse to cover you because of a pre-existing condition?

Under current law, health insurance companies can’t refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.

When did the pre-existing Condition Insurance Program end?

Pre-Existing Condition Insurance Plan (PCIP) Coverage. The Pre-existing Condition Insurance Plan (PCIP) ended on April 30, 2014. The PCIP program provided health coverage options to individuals who were uninsured for at least six months, had a pre-existing condition, and had been denied coverage…

What do you need to know about pre-existing conditions?

A pre-existing condition is a health problem you had before the date that your new health coverage starts. Pre-existing conditions include epilepsy, cancer, diabetes, lupus, sleep apnea, and many more. Can a health insurance company deny me or charge me more for my pre-existing condition?

Can you still have PCIP if you have a pre-existing condition?

Now, thanks to the Affordable Care Act, health insurance plans can no longer deny anyone coverage for their pre-existing condition, and so PCIP enrollees can transition to a new plan outside of the PCIP program.