Pre-existing Conditions
Related FAQs
Why do health insurance companies need to know about my pre-existing conditions?
Disclosing your pre-existing conditions is most relevant for Medically Underwritten health care plans.
With Medically Underwritten plans, by getting the opportunity to review your health history, the insurance company can potentially offer you a more comprehensive plan at a lower relative cost (i.e., better value).
The caveat to Medically Underwritten plans is that while they will offer better value to those who qualify medically, they will exclude (i.e., not cover) health conditions that you are already being treated for or taking medication for. These health conditions are referred to as 'pre-existing conditions'.
Pre-existing conditions are disclosed on a simple questionnaire. Medical tests such as blood or urine samples are not required when applying for health care plans.
For those who do not qualify medically for a Medically Underwritten plan, there are Guaranteed Acceptance plans available that will cover pre-existing conditions without need for a medical questionnaire.
With Medically Underwritten plans, by getting the opportunity to review your health history, the insurance company can potentially offer you a more comprehensive plan at a lower relative cost (i.e., better value).
The caveat to Medically Underwritten plans is that while they will offer better value to those who qualify medically, they will exclude (i.e., not cover) health conditions that you are already being treated for or taking medication for. These health conditions are referred to as 'pre-existing conditions'.
Pre-existing conditions are disclosed on a simple questionnaire. Medical tests such as blood or urine samples are not required when applying for health care plans.
For those who do not qualify medically for a Medically Underwritten plan, there are Guaranteed Acceptance plans available that will cover pre-existing conditions without need for a medical questionnaire.
Can I be denied health insurance coverage?
As long as you are covered by provincial healthcare, you will always be offered coverage when you apply for a health insurance plan through Aeva.
It is possible to be declined for a Medically Underwritten plan due to your medical history.
You can always apply for a Guaranteed Acceptance plan, regardless of whether you have pre-existing conditions or have been declined for coverage (e.g., declined for a Medically Underwritten plan).
It is possible to be declined for a Medically Underwritten plan due to your medical history.
You can always apply for a Guaranteed Acceptance plan, regardless of whether you have pre-existing conditions or have been declined for coverage (e.g., declined for a Medically Underwritten plan).
Do health insurance plans cover pre-existing conditions and medications I am already taking?
There are three types of plans available, each treating pre-existing conditions and medications differently.
Guaranteed Acceptance plans will cover pre-existing conditions and medications without requiring a medical questionnaire.
Guaranteed Issue plans cater to those leaving an employee group benefits plan, covering pre-existing conditions and medications without a medical questionnaire if you transition within 60-90 days of your group benefits terminating.
Medically Underwritten plans exclude pre-existing conditions and medications, only covering new conditions and medications after the coverage starts.
Guaranteed Acceptance plans will cover pre-existing conditions and medications without requiring a medical questionnaire.
Guaranteed Issue plans cater to those leaving an employee group benefits plan, covering pre-existing conditions and medications without a medical questionnaire if you transition within 60-90 days of your group benefits terminating.
Medically Underwritten plans exclude pre-existing conditions and medications, only covering new conditions and medications after the coverage starts.
Which health insurance plans cover pre-existing conditions?
There are three different types of health care plans:
Each type of plan has a different approach to 'pre-existing conditions'.
Medically Underwritten Plans:
Will exclude pre-existing conditions. Conditions that are considered chronic in nature will generally be excluded on a permanent basis, while conditions that are acute in nature may be excluded initially with the potential to be reconsidered after a period of time (e.g., 12, 24, 36, 48 months).
Guaranteed Issue Plans:
Will cover pre-existing conditions, so long as you apply within 60-90 days of your employee group benefits terminating (some insurance companies offer 60 days to make this transition, while others 90 days).
Guaranteed Acceptance Plans:
Will always cover pre-existing conditions. An in-depth blog post article can be found here: https://aeva.ca/blog/what-are-exclusions-for-pre-existing-conditions-how-do-they-work
- Medically Underwritten
- Guaranteed Issue
- Guaranteed Acceptance
Each type of plan has a different approach to 'pre-existing conditions'.
Medically Underwritten Plans:
Will exclude pre-existing conditions. Conditions that are considered chronic in nature will generally be excluded on a permanent basis, while conditions that are acute in nature may be excluded initially with the potential to be reconsidered after a period of time (e.g., 12, 24, 36, 48 months).
Guaranteed Issue Plans:
Will cover pre-existing conditions, so long as you apply within 60-90 days of your employee group benefits terminating (some insurance companies offer 60 days to make this transition, while others 90 days).
Guaranteed Acceptance Plans:
Will always cover pre-existing conditions. An in-depth blog post article can be found here: https://aeva.ca/blog/what-are-exclusions-for-pre-existing-conditions-how-do-they-work
What is a pre-existing condition in health insurance?
A 'pre-existing condition' means any condition that existed prior to the effective date of your health care plan.
Pre-Existing Condition means any disease or physical condition, whether diagnosed or not, for which symptoms occurred or medical treatment was sought, recommended, required, or obtained, from or by a Physician (medical treatment including any medical advice, consultation, care, diagnosis, treatment or service provided by a Physician), or for which drugs were prescribed by a Physician or taken by an Insured Person, during the 24-month period immediately preceding the Effective Date of Coverage.
An in-depth blog post article can be found here: https://aeva.ca/blog/what-are-exclusions-for-pre-existing-conditions-how-do-they-work
Pre-Existing Condition means any disease or physical condition, whether diagnosed or not, for which symptoms occurred or medical treatment was sought, recommended, required, or obtained, from or by a Physician (medical treatment including any medical advice, consultation, care, diagnosis, treatment or service provided by a Physician), or for which drugs were prescribed by a Physician or taken by an Insured Person, during the 24-month period immediately preceding the Effective Date of Coverage.
An in-depth blog post article can be found here: https://aeva.ca/blog/what-are-exclusions-for-pre-existing-conditions-how-do-they-work