Can a Group Health Plan Limit My Coverage for Pre-existing Health Conditions?
When you first enroll in a group health plan, the employer or insurance company may ask if you have any pre-existing conditions. Or, if you make a claim during the first year of coverage, the plan may look back to see whether it was for such a condition. If so, it may try to exclude coverage for services related to that condition for a certain length of time. However, federal and state laws protect you by placing limits on these pre-existing condition exclusion periods under group health plans. In some cases your protections will vary, depending on the type of group health plan you belong to. · A group health plan can count as pre-existing conditions only those conditions for which you actually received (or were recommended to receive) a diagnosis, treatment or medical advice within the 6 months immediately before you joined that plan. This period is known as the look back period. · Group health plans cannot apply a pre-existing condition exclusion period for pregnancy, newborns, newly
Related Questions
- I am changing from one type of coverage to another, but staying within the same employers group health plan. Can a pre-existing condition exclusion be applied to my new coverage?
- How can I sign up for health coverage in the new Pre-Existing Conditions Insurance Plan and when will it be available?
- Can a Group Health Plan Limit My Coverage for Pre-existing Health Conditions?
