The term pre-existing condition refers to a physical or mental condition for which you obtained medical advice, care, or treatment before enrolling in a policy.

The level to which a condition affects your level and cost of coverage depends on whether you are getting health insurance through a group plan (through your employer) or if you’re trying to get individual health insurance coverage.

When it comes to group coverage, the Health Insurance Portability and Accountability Act (HIPAA) helps to assure continued coverage for employees and their dependents, regardless of preexisting conditions.

• Insurers can only impose a 12-month waiting period for any preexisting condition that has been diagnosed or treated within the previous 6 months.
• As long as you kept continuous coverage without a break of more than 63 days, your prior health insurance coverage will be credited toward the preexisting condition exclusion period.
• If you have had group health coverage for at least 1 year and you change jobs and health plans, your new plan can not impose another preexisting condition exclusion period.
• If you have never been covered by an employer’s group plan and you start a new job that offers such a plan, you may be subject to a 12-month preexisting condition waiting period.

However, when it comes to individual health insurance plans, a preexisting condition may not be covered at all, or only be covered after a specific waiting period. Even if accepted, a preexisting condition will surely raise your premiums.

Laws concerning pre-existing conditions vary by state so be sure to check your state insurance web site for specific information.