What is a pre-existing condition when applying for health insurance?

You can still get comprehensive, affordable health insurance even with pre-existing conditions

If you’re living with high blood pressure, anxiety, diabetes or any other ongoing medical condition, you’re not alone. More than four in 10 Canadians over the age of 20 have at least one of 10 common chronic conditions.

Fortunately, many conditions can be managed effectively with medication or other therapies. The downside is that government healthcare plans cover prescription drugs only for certain at-need groups, such as seniors and those living on social assistance. So unless you have sufficient coverage through workplace benefits or individual health insurance, you have to pay for them out of your own pocket.

Perhaps you’ve tried to get individual health insurance in the past and been turned dow because of your “pre-existing condition.” So what is the meaning of pre-existing conditions?

What is a pre-existing condition?

In the health insurance world, a pre-existing condition is any injury, sickness or condition that exists before the date an insurance policy takes effect. Examples include asthma, diabetes, anxiety, depression, high blood pressure, high cholesterol and so on.

You might be asking, does any health insurance cover pre-existing conditions? The good news is yes, you can still get comprehensive, affordable health insurance. All you have to do is look for an insurance plan that offers guaranteed acceptance, such as CoverMe Guaranteed Issue Enhanced

Acceptance guaranteed

With guaranteed-issue insurance, your acceptance at the time of application is guaranteed, even if you have a pre-existing condition.

Applying for coverage is easy. You won’t have to answer any medical questions or undergo any medical tests at the time of application. Coverage starts on the first day of the month following receipt of your first premium payment. And most policies include a 30-day “free look” period, so if you change your mind in the first 30 days, you can cancel your policy and get a refund of any premiums you’ve paid (less any benefits you’ve received).

What does it cover?

In addition to prescription drugs, individual health insurance may cover:

  • Dental care, including exams, cleaning, fillings and oral surgery
  • Registered therapists such as massage, chiropractic and acupuncture
  • Vision care, including prescription eyeglasses, contact lenses and laser eye surgery
  • Mental health and therapy
  • Nursing
  • Ambulance
  • Medical equipment and supplies
  • Emergency medical travel

Fill the gaps

Individual health insurance can be a great way to fill in the gaps in government coverage or top up the benefits you get through a group insurance plan at work. And choosing a guaranteed-issue policy makes it super easy and convenient to apply, even if you have a pre-existing condition.



Public Health Agency of Canada