Pre-existing conditions: which plans cover them
A health problem you already have is covered on every Marketplace plan. That isn’t true of every plan you can buy.
Last checked October 15, 2026 · Written by licensed advisors · Sources are numbered and listed under Notes and sources
The short answer
A pre-existing condition is a health problem you had before your coverage starts, such as diabetes, asthma, cancer or a pregnancy. Marketplace plans and job-based plans can’t refuse you, charge you more, or refuse to pay for care for it.1
- Diabetes
- Asthma
- Cancer
- Pregnancy
Plans that can still say no
Short-term plans and some private plans are not ACA-compliant. They can ask health questions, decline you, charge more, or exclude a condition you already have. That is why they can cost less for healthy people, and why they are a risk if your health changes.2
- Can’t refuse you
- Can’t charge you more
- Must pay for care for the condition
- Can ask health questions
- Can decline you or charge more
- Can exclude a condition you already have
What that means when you choose
If anyone in your household has an ongoing condition, a Marketplace plan is usually the safe choice. You can enroll during open enrollment, or within 60 days of a life event such as losing other coverage.3
What to do: Tell us about the condition and the doctors involved. We check which plans cover them and what your share would be.
Related guides
Obamacare Hotline and/or Medicare Po Polsku are private companies not affiliated with any local, state, or federal government agency. This guide is general information, not tax or legal advice.