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Can I still get health insurance if I have a pre-existing condition?

Guidance on pre-existing condition protections under the Affordable Care Act (ACA), including coverage rules, examples of qualifying conditions, and details on what Marketplace plans must cover from the start of enrollment.

Sam avatar
Written by Sam
Updated over 2 weeks ago

Yes. Under the Affordable Care Act (ACA), health insurance companies cannot deny you coverage or charge you more because of a pre-existing condition. This rule applies to all Marketplace plans and most individual and employer-based plans. HealthSherpa applications will not ask questions about pre-existing conditions during the application process.

What counts as a pre-existing condition?

Any health issue you had before your coverage starts, such as asthma, diabetes, cancer, pregnancy, or mental health conditions.

What Marketplace plans must cover

  • Marketplace plans must cover treatment for pre-existing conditions from the day your coverage starts.

  • Preventive services (like check-ups, vaccines, and screenings) are covered with no cost to you, even if you already have a condition.

  • You cannot be charged more or have benefits limited just because of your health history.

  • Pregnancy is always covered, even if you were pregnant before applying.

Quick tip

Only ACA-compliant plans are available through HealthSherpa.

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