Does testing positive for asymptomatic hepatitis B qualify as a pre-existing condition?

Answer

Yes.

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Pre-Existing Condition

Answer

Maybe but not always. You need to review the definition of pre-existing conditions. Here are two actual definitions: (a) A condition that would have caused an ordinary prudent person to seek medical advice, diagnosis, care or treatment during the twelve (12) months immediately preceding the effective date of coverage; (b) A condition for which medical advice, diagnosis, care or treatment was recommended or received during the twelve (12) months immediately preceding the effective date of coverage;

The key here is the timing issue. If two years ago you were diagnosed and were told you needed no treatment and did not need to see the doctor in the previous 12 months then it would not qualify as a pre-ex under these definitions. Remember though, it is not your word that is important; it is what your medical records say. If your doctor advised you have it checked every year, even though it may have been 18 months since you sought any treatment, it would still apply (see the wording of the first definition ‘…A condition that would have caused an ordinary prudent person to seek medical advice…’). The recommendation to have it checked annually would generally meet the standard for a prudent person to seek medical attention.

First answer by steve shorr. Last edit by Critmark. Contributor trust: 266 [recommend contributor]. Question popularity: 62 [recommend question]