Practical Law Glossary Item w-001-4470 (Approx. 3 pages)
Glossary
Preexisting Condition
A medical condition that was present before the effective date of an individual's health plan coverage. Prior to the Affordable Care Act (ACA), health plans could exclude coverage for preexisting conditions for a certain period of time (or for the duration of an individual's coverage).
Health plans generally defined a preexisting condition as either a condition:
For which an individual had received medical advice or treatment.
With symptoms for which an average person would have sought treatment.
State laws varied regarding which definition of preexisting condition was used, and how long the exclusion period applied.