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HIPAA defines a pre-existing condition as "a condition (whether physical or mental), for which medical advice, diagnosis, care or treatment were recommended or received within the six-month period ending on the enrollment date." Simply stated, it is any health condition for which you saw or consulted a health
Health insurance companies cannot refuse coverage 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.
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.
Section 1201 of the Affordable Care Act (ACA) adds a new section to the Public Health Service Act, Section 2704, which amends the HIPAA portability rules relating to preexisting condition exclusions.
A. An outline of coverage shall be delivered to an applicant for a long-term care insurance policy at the time of initial solicitation through means that prominently direct the recipient's attention to the document and its purpose.
Conditions for Exclusion HIPAA did allow insurers to refuse to cover pre-existing medical conditions for up to the first 12 months after enrollment, or 18 months in the case of late enrollment.
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.
Health insurance companies cannot refuse coverage 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.
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.