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Health Insurance Glossary

Definitions for common health insurance terms

pre-existing condition

DEFINITION: A pre-existing condition is a medical condition that is excluded from coverage by an insurance company because the condition was believed to exist prior to the individual obtaining a policy from the particular insurance company.

In the individual market, starting in 2014, pre-existing conditions could no longer be excluded, factored into premium calculations, or cause an application to be declined.

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