Pre-existing Conditions
Many people worry about coverage for
preexisting
conditions, especially when
they change jobs or seek new coverage.
The Health Insurance Portability
and Accountability Act (HIPAA)
helps assure continued health insurance
coverage for employees and their dependents.
Starting July 1, 1997, insurers could
impose only one 12-month waiting period
for any preexisting condition treated
or diagnosed in the previous six months.
Your prior health insurance coverage
will be credited toward the preexisting
condition exclusion period as long
as you have maintained continuous
coverage without a break of more than
62 days. Pregnancy is not considered
a preexisting condition, and newborns
and adopted children who are covered
within 30 days are not subject to
the 12-month waiting period.
If
you have had group health coverage
for two years, then switch jobs and/or
go to another plan, that new healthcare
plan cannot impose another preexisting
condition exclusion period. If, for
example, you have had prior coverage
of only eight months, you may be subject
to a four-month, preexisting condition
exclusion period when you switch jobs.
If you’ve never been covered
by an employer’s group plan,
and you get a job that offers such
coverage, you may be subject to a
12-month, preexisting condition waiting
period.
Federal
law also makes it easier for you to
get individual insurance under certain
situations, including if you have
left a job where you had group health
insurance, or had another plan for
more than 18 months without a break
of more than 62 days.
If
you have not been covered under a
group plan and have found it difficult
to get insurance on your own, check
with your state insurance department
to see if your state has a risk pool.
Similar to risk pools for automobile
insurance, these can provide health
insurance for people who cannot get
it elsewhere.
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