Pre-existing condition coverage and its benefits

October 25, 2019


Pre existing conditions, Student Health Insurance

Before Affordable Care Act (ACA) came into being, health insurance companies could refuse or deny insurance to those who were ill or were suffering from a pre-existing condition. However, since 2010 onwards, ACA (also known as ObamaCare Act) prevents health insurers from denying coverage to such persons.

Therefore, in this blog, Student Cover tries to explain what Pre-Existing Condition is and how it benefits insurance buyers. It also provides a list of those plans that provide coverage for pre-existing conditions.

What is a Pre-existing Condition?

In simple words, pre-existing conditions are those injuries, diseases, physical or mental conditions that already exist in a person’s body and in certain cases regular medication is being taken for the same at the time of purchase of a health insurance plan. Student Cover Basic and Essential Plans define Pre-Existing Condition as:

The existence of symptoms which would cause an ordinarily prudent person to seek diagnosis, care or treatment within the 6 months immediately prior to the Insured’s Effective Date under the policy.


Any condition which is diagnosed, treated or recommended for treatment within 6 months immediately prior to the Insured’s Effective Date under the policy’

Pre-existing coverage benefits

Fearing possible loss arising out of insuring persons who are already ill and are very likely to undergo treatment in near future, health insurance companies use to refuse insurance cover or charged a high premium from such persons. However, with the implementation of ObamaCare Act, the ACA plans sold at healthcare marketplace: –

  • • Cannot refuse insurance coverage to a person with pre-existing medical condition,
  • • Cannot charge higher premium in lieu of pre-existing condition or
  • • Cannot refuse to pay for essential health benefits for any condition a person had before his or her coverage started.
  • • Once a person is enrolled, the plan can’t deny coverage or raise premium rates based only on the person’s health.
  • • Medicaid and the Children’s Health Insurance Program (CHIP) also can’t refuse to cover or charge more because of your pre-existing condition.

Diseases that fall under pre-existing conditions

Some common diseases and medical conditions that fall under the category of Pre-existing diseases, include

  • – Epilepsy
  • – Cancer
  • – Diabetes
  • – Lupus
  • – Sleep apnea,
  • – Pregnancy
  • – Kidney and Gall Bladder Stone

Note: The list is not exhaustive

Student Cover health insurance Plans that cover pre-existing medical conditions

Student Cover offers student health insurance plans to those students going to the US for higher studies but have pre-existing medical condition. Although not available in Healthcare marketplace, its flagship SC Plus and SC Elite plans are Affordable Care Act comparable providing same coverage for pre-existing medical conditions to students as any other ACA plan available at healthcare marketplace provides.

International Students studying in US Universities can purchase Student Cover’s student health insurance plans online at

Let’s Wrap Up!

Pre-existing conditions are those diseases, injury or sickness that a person already suffers from at the time of purchase of health insurance. As per ACA regulation, health insurance plans sold at healthcare marketplace in the US cannot refuse or charge more for health insurance to those suffering from pre-existing medical condition. Student Cover plans such as SC Plus and SC Elite provide cover for pre-existing medical conditions.

Disclaimer: The content of the following article is based on the personal research of the writer. Readers are advised to go through the policy documents of health insurance plans and exercise discretion while purchasing them. Student Cover will not be held liable for any wrongful interpretation of the content of this article.

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