Preexisting Condition: FSA Eligibility
What is a preexisting medical condition?
Due to health care reform, most health insurance coverage plans won't have a preexisting condition limitation. However, if they do, the cost associated with a preexisting condition not covered by a primary insurance plan is eligible for reimbursement with a consumer-directed healthcare account.
A preexisting medical condition is normally defined as a medical condition that occurred before a program of health benefits went into effect. In the context of healthcare in the United States, health care expenses for preexisting medical conditions were generally not covered in health insurance plans. The primary reason for this was to protect the financial stability of health care insurance providers, who would otherwise be forced to reimburse the healthcare expenses of individuals who purchased health insurance knowing they would receive reimbursement for the expenses for their condition. As of January 1st, 2014, this is no longer legal in the United States. Instead, thanks to the Patient Protection and Affordable Care Act, also known as the ACA or Obamacare, new minimum requirements for accepting patients are in place for all health insurance providers. Preexisting medical conditions are one example of a cost factor that a health insurance provider must now cover expenses for (Consumer Reports).
If for any reason a health insurance provider has not covered expenses related to a preexisting medical condition, then those expenses are eligible for reimbursement with a consumer-directed healthcare account.