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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.

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Written by Nick Perry

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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