Health & Medical Health & Medical Insurance

Health Insurance Portability Rights

    Preexisting Condition

    • HIPAA defines a preexisting condition as one for which you received (or a healthcare provider recommended) medical advice, diagnosis, care or treatment during the six months before your enrollment date in a new health insurance plan.

    Portability

    • If you had creditable health insurance coverage that ended less than 63 days ago, and enroll in a new health insurance plan, the new plan cannot impose a new waiting period for preexisting conditions. However, if you were still in a waiting period under your previous plan, the new plan can require that you complete that waiting period.

    Creditable Coverage

    • According to the U.S. Department of Labor, creditable health insurance coverage includes previous coverage under another group health plan, an individual health insurance policy, COBRA, Medicaid, Medicare, CHAMPUS, the Indian Health Service, a state health benefits risk pool, FEHBP, the Peace Corps Act or a public health plan. Health insurers must automatically provide you with a certificate of creditable coverage free of charge when you lose coverage under a health insurance plan.

    Considerations

    • The passage of the Affordable Care Act in March of 2010 changes rules concerning preexisting conditions effective in 2014. Insurance plans will no longer be permitted to exclude preexisting conditions from coverage.

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