Kentucky General Notice of Preexisting Condition Exclusion

State:
Multi-State
Control #:
US-AHI-012
Format:
Word
Instant download

Description

This AHI form is a general notice regarding preexisting condition exclusions under the group health plan.

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FAQ

The time period during which an individual policy won't pay for care relating to a pre-existing condition. Under an individual policy, conditions may be excluded permanently (known as an "exclusionary rider").

A health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts. Insurance companies can't refuse to cover treatment for your pre-existing condition or charge you more.

However, a feature of a travel insurance policy known as a pre-existing medical condition exclusion waiver could let you, for instance, cancel a trip due to a flare up of an existing condition and then be reimbursed for nonrefundable travel costs.

Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either.

The time period during which a health plan won't pay for care relating to a pre-existing condition. Under a job-based plan, this cannot exceed 12 months for a regular enrollee or 18 months for a late-enrollee.

It limits the time a new employer plan can exclude the pre-existing condition from being covered. An employer health plan can avoid covering costs of medical care for a pre-existing condition for no more than 12 months after the person is accepted into the plan.

I. What is an Exclusion Waiver? Waivers permit certain excluded individuals or entities to be eligible for payment by Medicare, Medicaid, and all other Federal health care programs for specific items and services defined in the scope of the waiver.

Yes. Under the Affordable Care Act, health insurance companies can't refuse to cover you or charge you more just because you have a pre-existing condition that is, a health problem you had before the date that new health coverage starts. They also can't charge women more than men.

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Kentucky General Notice of Preexisting Condition Exclusion