Are pre-existing conditions considered when going from group health insurance to individual health insurance?
Yes, they can be, although it varies by state. Most states have a rule that if you are moving from one group program to another–say, as a result of changing jobs—you will not be subjected to a pre-existence clause as long as you do not go more than 63 days without coverage. However, when you go to private insurance, that rule may not apply. Consequently, if you have a pre-existing condition, you may have to wait for a year or more before that condition will be covered. Can coverage be refused? Yes, it can. Unlike group health in which coverage is guaranteed, companies providing individual health can refuse to provide coverage if you have certain medical conditions. They can also give you an exclusion for coverage of certain conditions. For example, if you have EVER had any kind of coronary procedure, a company may put an exclusion for coronary artery disease in the policy. This would mean that if you ever had a hospitalization or new procedure involving or necessitated by coronary dis
