Which statement best describes the usual treatment of a pre-existing condition when a policy is issued?

Which statement best describes the usual treatment of a pre-existing condition when a policy is issued?

• A. Covered with no waiting period
• B. May be excluded or postponed for a period
• C. Is always excluded
• D. Counts toward the deductible

Answer: (B)

When a policy is issued, the thing being tested is how pre-existing conditions are handled in the underwriting and benefit rules. The usual approach is to exclude or postpone coverage for those conditions for a specified period. This means that if a condition existed before the policy started, claims for that condition aren’t paid right away and may not be payable until after the waiting period ends, if at all, depending on the policy terms. This helps insurers manage risk from the outset. It’s not typically immediate coverage with no waiting period, since that would expose the insurer to paying for care for conditions that existed before coverage began. It isn’t always excluded forever, because many plans eventually provide coverage for those conditions after the waiting period. And it doesn’t inherently relate to the deductible in a way that would routinely count those expenses toward the deductible before any benefits apply.

When a policy is issued, the thing being tested is how pre-existing conditions are handled in the underwriting and benefit rules. The usual approach is to exclude or postpone coverage for those conditions for a specified period. This means that if a condition existed before the policy started, claims for that condition aren’t paid right away and may not be payable until after the waiting period ends, if at all, depending on the policy terms. This helps insurers manage risk from the outset.

It’s not typically immediate coverage with no waiting period, since that would expose the insurer to paying for care for conditions that existed before coverage began. It isn’t always excluded forever, because many plans eventually provide coverage for those conditions after the waiting period. And it doesn’t inherently relate to the deductible in a way that would routinely count those expenses toward the deductible before any benefits apply.