What Pre-Existing Conditions Mean Under COBRA
A pre-existing condition is a health condition you had before enrolling in a new health insurance plan. Many short-term individual medical plans do not cover pre-existing conditions, which means treatment and prescriptions may not be included. COBRA is different because it continues your employer-sponsored group health plan, and all pre-existing conditions remain covered.
If you have ongoing medical needs or take prescription drugs, staying on your employer plan through COBRA or enrolling in an Affordable Care Act Marketplace plan may be the best option until you secure new coverage.
Pregnancy Is a Pre-Existing Condition
Pregnancy is considered a pre-existing condition because it begins before enrollment in a new health insurance plan. Before the Affordable Care Act, some individual health plans could deny coverage or exclude maternity care if a woman was already pregnant when she applied. Today, COBRA covers pregnancy as part of your employer-sponsored group health plan, so maternity care continues without interruption.
Examples of Preexisting Conditions
The following list of Preexisting Conditions are covered under the Affordable Care Act.
- Acquired Immune Deficiency Syndrome (AIDS)
- AIDS Related Complex (ARC)
- Alcohol or drug abuse
- Bipolar disorder or schizophrenia
- Blood disorders
- Brain disorders
- Cancer or tumor (except basal cell skin cancer)
- Chronic obstructive pulmonary disease (COPD)
- Crohn’s disease
- Cystic fibrosis
- Eating disorder
- Emphysema
- Heart or circulatory conditions (including heart attack or catheterization)
- Hepatitis C
- Hospitalization for mental disorder
- Human Immunodeficiency Virus (HIV)
- Insulin or medication dependent diabetes (except gestational)
- Kidney disease
- Liver disease
- Lung disease
- Multiple sclerosis
- Muscular dystrophy
- Pancreas disease
- Pregnancy
- Rheumatoid arthritis
- Stroke
- Systemic lupus
- Transient ischemic attack (TIA)
- Ulcerative colitis
Frequently Asked Questions
A pre-existing condition is any health issue you had before enrolling in a new health insurance plan, such as asthma, diabetes, heart disease, or pregnancy.
Yes. COBRA continues the same employer-sponsored health plan you already had, and all pre-existing conditions remain covered without waiting periods.
Yes. Marketplace plans are required by law to cover pre-existing conditions and cannot deny you coverage or charge higher premiums because of them.
Usually not. Most short-term medical plans exclude pre-existing conditions and may deny claims related to ongoing or prior health issues.
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