South Carolina General Notice of Preexisting Condition Exclusion

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

Description

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

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FAQ

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.

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.

No. There are no waiting periods for medical plans, including for pre-existing conditions. When choosing a health plan, consider your medical needs.

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.

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.

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.

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.

Under Federal law, a "pre-existing condition" is any condition (either physical or mental) for which medical advice, diagnoses, care, or treatment was recommended or received within a six month period immediately preceding enrollment in a health plan.

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.

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.

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South Carolina General Notice of Preexisting Condition Exclusion