Any illness or health condition for which you have received medical advice or treatment during the six months prior to obtaining health insurance. Group healthcare policies cover pre-existing conditions after you have been insured for six months, and individual policies cover pre-existing conditions after you have been insured for one year.
Essentially, it is a medical condition, illness, or injury for which you just had treatment, are undergoing treatment, or have had treatment for. How an insurance company will look at pre-existing conditions depends on the type of insurance.
Individual and Family Health Insurance.
This type of coverage is medically underwritten which means that you need to qualify based on health, pre-existing conditions have the most impact here and this affects coverage in a couple of ways.
Mostly,
you must qualify for coverage based on health, a carrier can accept you, decline you, or increase your monthly premium based on your pre-existing conditions. Insurers have underwriting guidelines specifying how they may look at particular issues. Ultimately, the underwriter (person who decides to accept, decline, or rate up your health coverage) makes the final decision based on information found in the health application, medical records, prescription information or even a Medical Information Bureau database.
For some issues, the health insurance carrier may want a certain amount of time away from a give situation before offering coverage. A good rule of thumb is 6 months to one year for a more simple situation (simple broken bone, ingrown toenail, etc). Some issues are deemed uninsurable for which they will not offer coverage. If you are unable to qualify for Major Medical individual or family health insurance in Nevada, you can find options for the here.
If a carrier does not decline coverage based on pre-existing conditions, they can increase rates. Tier 1 is the best rate and you can find this rate when you quote individual Nevada health insurance. Tier 2 is typically 25% higher than this standard rate. Tier 3 is typically 50% higher and Tier 4 is typically 100% higher. Some carriers apply different increases. This tier increase is not locked in stone and you may be able to have it removed or lowered in the future once time has passed from a given situation (assuming you are in otherwise in good health). We recommend submitting the required change of coverage form every 3-4 months until this tier increase can be decreased.
It's important to look at a carrier's policies and restrictions regarding pre-existing conditions, waiting periods and exclusions as they can differ from company to company.
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