Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 1/5
Under the Affordable Care Act, a health plan's application of a pre-existing condition exclusion to an individual applicant is:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
The ACA prohibits health insurers in the individual and group markets from imposing pre-existing condition exclusions or waiting periods on any applicant. Combined with guaranteed issue, this means coverage cannot be denied, limited, or priced based on health status. Before the ACA, pre-existing exclusions were common; their prohibition is one of the law's core consumer protections and a frequent examination point.
Why the other options are wrong
- B) There is no six-month exclusion window; the ACA ban on pre-existing condition exclusions applies from the start of coverage.
- C) The prohibition is universal across individual and group markets; self-employed applicants receive the same protection as everyone else.
- D) Coverage cannot be excluded for a pre-existing condition even if it was disclosed, because health status may not be a basis for exclusion.
Memory hook
Pre-existing exclusions were banned by the ACA — health history no longer blocks coverage.