Georgia Navigator Practice Exam

How is a pre-existing condition defined in health insurance?

1. A condition treated or diagnosed in the last year

2. Any medical condition treated within a specified period before coverage starts

3. A general health assessment before enrollment

4. An ongoing treatment within the past five years

The correct answer is: Any medical condition treated within a specified period before coverage starts

A pre-existing condition in health insurance refers to any medical condition that exists prior to the start of an individual's health insurance coverage. This means that if a person has been diagnosed or received treatment for a medical issue before they enroll in a new health insurance plan, that issue is considered pre-existing. The specific focus on any medical condition treated within a specified period before coverage begins ensures that it encompasses a range of issues that might not be apparent right at the moment of enrollment but were present prior to it. Other options describe different scenarios that do not align with the standard definition of a pre-existing condition. For example, a treatment within the last year or ongoing treatment in the past five years focuses on time frames that might not capture all relevant pre-existing conditions as defined by insurance policies. Additionally, a general health assessment typically refers to a preventive measure rather than a classification relating to coverage.