Is an Amputation Considered a Pre-Existing Condition?

Amputation is often a doctor’s last resort to save a limb in case other methods of treatment don’t work. Amputation is the removal of any body parts, in most cases a leg, finger or arm due to conditions or diseases which inflict great pain and suffering to a person.

Health insurance primarily exists to safeguard a person’s health and protect the person from financial distress in the event that the person insured gets ill and needs proper medical attention by means of doctor consultation, hospital admission or surgery. Insurance companies follow procedures to determine whether a person is qualified for the health insurance he or she is applying for. The procedures include medical check-up and verifications on the person’s medical history or previous health problem. A pre-existing condition is defined as a medical condition that exists before application of, or the effectivity of the health insurance policy. Amputation is a medical procedure performed to save someone’s life or commonly from greater physical agony. But is an amputation considered a pre-existing condition?

Amputation is considered a pre-existing condition and is covered by health insurance coverage from an operation associated with diabetes. An amputation caused by diabetes normally involves removal of toes or any body part which contains diseased tissues. Health insurance companies cover diseases developed or acquired by the person prior to enrollment of the insurance policy. The most common disease that we can associate a pre-existing condition to amputation is diabetes. In cases where diabetes is deemed a pre-existing condition, any surgery needed in the future which is caused by the disease is also covered by the insurance policy.

If for example you were diagnosed as a diabetic prior to any enrollment of health insurance and during insurance application you also declared having the disease, your insurer will definitely verify it from your medical records. However, non-disclosure or lack of medical records pertaining to previous illnesses can be a ground for cancellation of the insurance policy. So if diabetes is officially considered by the health insurance company as a pre-existing condition, the insurer will cover the charges of any surgery such as toe amputation, which is performed with diabetes as the main cause. Diabetes is a type of disease that is curable but can also be a long term illness which can lead to many possibilities such as disabilities or even death. A large number of the population suffers from financial burdens caused by diabetes and amputation is often resorted to for the purpose of not just relieving diabetics from physical pain but also of preventing costly medical bills which is inevitable in the series of medical treatments.

The charges of amputation or any surgery which is performed as a result of a disease that is considered as a pre-existing condition is definitely covered by the health insurance policy. This is obviously because the disease is, in the first place the main reason why an operation or surgery takes place. However, amputations which are caused by accidents or medical malpractice can also be covered by health insurance but obviously not on the basis of pre-existing condition.