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Medical underwriting is a process that was widely used by individual market insurance companies prior to 2014 to evaluate whether to accept an applicant for health coverage and/or to determine the premium rate for the policy. Medical underwriting was also used in many states to determine premiums for small group plans, with the overall medical history of the group factoring into the premiums.
Since 2014, however, medical underwriting is no longer used in the individual or small group markets, due to Affordable Care Act rules. Instead, all individual and small group plans are guaranteed issue.