Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
Under the Affordable Care Act, an individual health plan may impose a pre-existing condition exclusion period:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
Before the ACA, insurers could refuse to pay for conditions that existed before enrollment, sometimes for 12 months or longer. The ACA bans pre-existing condition exclusions outright in both the individual and group markets, including the small group market. Combined with guaranteed issue, this means an applicant cannot be denied benefits for a condition that existed before the policy took effect. Nondisclosure is separately handled by rescission rules limited to fraud or intentional misrepresentation.
Why the other options are wrong
- B) The old 12-month exclusion period was eliminated by the ACA and no longer applies to individual or group plans.
- C) No six-month waiting period for pre-existing conditions exists; all pre-existing condition exclusions are prohibited.
- D) Nondisclosure does not create a pre-existing exclusion; only fraud or intentional misrepresentation can support retroactive rescission.
Memory hook
Pre-existing exclusions are dead under the ACA. Prior conditions cannot delay or reduce your benefits.