What defines a pre-existing condition and its coverage in an organizational or institutional group health insurance plan?
Generally, a pre-existing condition is any medical condition, injury or illness that manifested itself, for which a licensed physician was consulted or for which treatment of medication was prescribed, prior to the effective date of the insurance policy. The length of time before the effective date during which a condition would be considered to be pre-existing varies, and can be anywhere from 30 days to 6 months or longer. A pre-existing condition exclusion waiting period is the length of time after the effective date of an insurance policy that a person must wait before any pre-existing conditions are covered. Once a person is enrolled, these policies can only have a 6-month maximum waiting period for pre-existing condition exclusions, which is reduced or waived if the individual had prior credible coverage that did not lapse in the last 63 days. However, the waiver only applies to fully licensed products, so may not be included in accident and sickness supplemental insurance policie
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?
- What defines a pre-existing condition and its coverage in an organizational or institutional group health insurance plan?
- How does HIPAA limit the pre-existing condition exclusion of group or employer health insurance coverage?
