What is a Pre-Existing Condition?

A pre-existing condition is a health problem that existed before the start date of new health insurance coverage. Examples include diabetes, cancer, heart disease, asthma, and pregnancy. Under the Affordable Care Act, health insurance companies cannot refuse coverage, charge higher premiums, or deny benefits based on pre-existing conditions for most health plans.

Why pre-existing conditions matter

• Affects coverage access: Historically limited ability to obtain health insurance
• Impacts healthcare costs: Previously resulted in higher premiums or coverage exclusions
• Influences plan choice: Important consideration when evaluating coverage options and benefits

How Solace can help

A Solace advocate can help you understand your rights regarding pre-existing conditions, ensure insurers comply with ACA protections, and find plans that best cover your specific health needs. Advocates can also assist with appeals if coverage is inappropriately denied.