Pennsylvania General Notice of Preexisting Condition Exclusion
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FAQ
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.
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.
If you had a pre-existing condition exclusion period, you didn't have coverage for any care or services related to your pre-existing condition for a predetermined amount of time, despite paying your monthly premiums.
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.
existing condition exclusion can not be longer than 12 months from your enrollment date (18 months for a late enrollee). existing condition exclusion that is applied to you must be reduced by the prior creditable coverage you have that was not interrupted by a significant break in coverage.
What Is the Pre-existing Condition Exclusion Period? The pre-existing condition exclusion period is a health insurance provision that limits or excludes benefits for a period of time. The determination is based on the policyholder having a medical condition prior to enrolling in a health plan.
Employer-based plans and individual health plans cannot deny coverage to people with pre-existing conditions. People under individual health plans that existed before September 23, 2010 known as grandfathered plans, are allowed to use pre-existing condition exclusions.
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.
