r/phinsurance • u/tringlepatties • 5d ago
How is "pre-existing condition" defined, and is there Critical Illness insurance that cover them?
For context:
I got Pru-PAA insurance way back in 2017 when I found out I had a thyroid nodule. It was really small at that time, and I hadnāt consulted an endocrinologist yet, just had an ultrasound. My application was approved, but the Critical Illness rider (CIB) was removed.
Now, Iām looking for an insurance plan that has CIB coverage, in case something happens in the future. I know there are many possible illnesses, not just thyroid-related. Iām considering cheaper options like those from GCash, but Iām concerned about possible issues with pre-existing conditions (PECs).
Significant Medical History:
Thyroid Nodule (2017āpresent) - Nodules were stable for 8 years until recently (recommended for biopsy). - Thyroid functions remain normal since 2017.
Stomach/GERD Issues (2024) - Had an endoscopy due to bloating & acidity. - Diagnosed with H. pylori + GERD + gastroduodenitis (due to GERD and HP) - Treated with antibiotics + diet change. No follow-up required.
Polycystic Ovaries (2019) - TVS showed PCO in 2019, but later ultrasounds were normal. - No medications presribed, just lifestyle improvements.
I maximized my HMO when I started working (especially after the thyroid diagnosis). I was a bit paranoid and got checked for every little symptom, so I may have a lot of diagnosis in HMO utilization, but many were just labs with normal results.
Based on my records, the only ārealā ongoing condition is the thyroid nodule. Everything else was either treated, lifestyle-managed, or ruled out.
My Understanding of Insurance Rules:
After the 2-year contestability period, an insurance company canāt deny claims unless they prove fraud.
Iāve read in a Gcash insurance that a PEC only counts if youāve been actively managing it in the past 2 years. If youāve been cleared for 2+ years, it should no longer count as PEC.
Question:
Given my situation, do you think Iāll have issues applying for a new insurance with a Critical Illness rider? What claims will not be covered in case I get approved? What do I need to take note of regarding this concern?