Moratorium underwriting sets a waiting period for pre-existing medical conditions to limit risk to the insurer. This way insurers can do their utmost to keep premiums affordable for plan members. A moratorium will therefore exclude all pre-existing medical conditions for a set period, often two years, but may then cover the conditions after that. Many health insurance providers, including Aetna, use moratorium underwriting.
In Aetna's case, we underwrite plans on a 24-month moratorium basis. This means that any medical conditions, or related medical conditions, that have existed in the 24 months before your plan starts, will not be covered until you have been free of symptoms and treatment for 24 months after the start date of your plan. Pre-existing medical conditions and related medical conditions are those that have one or more of the following characteristics:
- was foreseeable;
- clearly showed itself;
- you had signs or symptoms of;
- you asked for advice about;
- you received treatment for;
- to the best of your knowledge, you were aware you had.
Pre-existing medical conditions or related medical conditions may be covered after you have had 24 months' continuous cover under the plan and within that time you have not
- experienced symptoms;
- asked for advice; or
- needed or received treatment, medication, or a special diet.
On the other hand if you have experienced symptoms; asked for advice; or needed or received treatment, medication, or a special diet; then you will have to wait until you have completed a continuous 24-month period when none of these apply to you. Pre-existing medical conditions or related medical conditions may then be covered. This is the rolling part of the moratorium.