Definitions

Pre-existing Condition

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define: Pre-existing Condition

Group and individual health plans differ on what they deem is a pre-existing condition. Group plans often consider a pre-existing condition to be any sickness or injury medically treated in the previous 3 months prior to the inception date of coverage. Individual health plans often consider any sickness or injury that appeared in the previous 1 or 2 years to be a pre-existing condition.

Specific times vary by company, and coverage for specific conditions also depends on each policy and whether the applicant disclosed the information.




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