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Are preexisting conditions still a thing?

On Behalf of | Dec 19, 2022 | Insurance Disputes

For anyone over the age of 30, you likely remember the term, preexisting condition as it related to insurance coverage. In the past, health insurance coverage would deny coverage for these conditions when you switched health plans. However, with the passage of the 2010 health care law, preexisting conditions could no longer be used as a reason to deny coverage. However, some people are finding that they still pop up in some San Francisco, California, insurance contexts.

Grandfathered health insurance policies

Potentially, there are some pre-2010 health insurance policies that were grandfathered. This means that people were allowed to keep these older policies that exempted preexisting conditions. At this point, these should be exceedingly rare or non-existent.

Short-term health insurance

Preexisting condition denials can still occur in short-term health insurance policies as well. These are policies that are for 364 days or fewer. They can only be renewed for fewer than 3 consecutive years. However, they are only available in a very limited number of states, and since the elimination of the insurance penalty, these too have largely been phased out as the need is mostly gone.

Life insurance policies

Nonetheless, where preexisting condition language is more common is San Francisco, California, life insurance policies. In these policies, they are allowed to charge higher fees for preexisting conditions, like hypertension or being a cancer survivor. Some companies may even refuse to cover you based on these preexisting conditions.


If you find yourself facing a denial, ask why. Ask which treatments and prescriptions are normally covered and if there are alternative options if your claim is denied. Ask for pre-approvals and ask for the specific billing codes prior to getting services to get pre-approval. Do not be afraid to call your insurer to get approval prior to seeking treatment. And, if you feel like your insurer is treating you unfairly, remember, you can always seek out the assistance of a San Francisco, California, attorney.