Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
Which statement about pre-existing condition exclusions is correct?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
Under the Affordable Care Act, comprehensive individual and group health plans that are ACA-compliant may not impose pre-existing condition exclusions on any enrollee. However, limited benefit policies such as hospital indemnity, specified disease, and other policies sold as excepted benefits are not subject to the same market reforms, so they may still apply pre-existing condition limitations and waiting periods. Agents must understand which products are ACA-compliant comprehensive coverage and which are limited in scope.
Why the other options are wrong
- A) Comprehensive ACA-compliant plans cannot impose pre-existing exclusions at all, so this statement is false as written.
- C) The ACA ban applies to both group and individual comprehensive plans, so saying exclusions apply only to group plans is wrong.
- D) Pre-existing exclusions are not tied to the child's age; the ban covers all enrollees in comprehensive plans, and limited policies may apply exclusions to adults and children alike.
Memory hook
Comprehensive = no pre-existing gate. Limited policies = old rules still apply. Know which product you are selling.