A health condition or ailment that an individual has before applying for or enrolling in a health insurance plan.
The process by which insurance companies assess an individual’s health status, medical history, and associated risks when determining coverage eligibility and premium rates.
Coverage that pays for medical and surgical expenses incurred by the insured individual, providing financial protection against the high costs of healthcare.
The amount paid by an individual or their employer to an insurance company for health coverage, typically on a monthly basis.
The refusal by an insurance company to provide coverage for a specific health condition or treatment due to it being classified as a pre-existing condition.
A policy or law that prohibits insurance companies from denying coverage to individuals based on pre-existing conditions.
A policy provision ensuring that an insurance company cannot refuse to renew a policy or increase premiums based on changes in the insured individual’s health.
The specified period after enrolling in a health insurance plan during which coverage for pre-existing conditions may be limited or excluded.
A state-sponsored or federally funded insurance program designed to provide coverage for individuals with pre-existing conditions who might be deemed high-risk by private insurers.
A requirement, often enforced through tax penalties, for individuals to obtain health insurance coverage, intended to encourage broad participation in insurance markets and reduce adverse selection.
The tendency for individuals with higher health risks to seek or maintain insurance coverage more often than those with lower risks, potentially leading to increased costs for insurers.
A set of benefits that health insurance plans are required to cover under the Affordable Care Act (ACA), ensuring a baseline level of coverage for all individuals, regardless of pre-existing conditions.
A federal law that provides protections for individuals with pre-existing conditions by limiting exclusions and ensuring portability of health insurance coverage when transitioning between jobs.
A timeframe during which certain pre-existing conditions are not covered by an insurance plan, typically occurring at the beginning of coverage.
The maximum dollar amount that an insurance plan will pay for covered services over the course of an individual’s lifetime.
The maximum dollar amount that an insurance plan will pay for covered services within a specific policy year.