No, a medical examination is not required to purchase the policy. The plan can start from the next day.
UC&R (or Usual, Customary & Reasonable) Charges represent the average or most common amount charged by providers for a particular service, treatment, or supplies in the same geographic area. Typically information on rates for procedures is compiled into a data bank and updated periodically. So when a claim is submitted for a plan with UC&R benefits, the insurance company reviews the UC&R rate to verify that hospitals and doctors are not billing excessively for the particular service or procedure. Most well respected plans from Blue Cross, Aetna, Lloyds, Unicare etc. follow the UC&R schedule.
Pre existing conditions are defined slightly differently by each insurance company. Please check the brochure of the plan you wish to apply to get the most correct definition. In general pre-existing conditions are defined as injuries or sickness first manifesting itself before the start of the policy.
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