Why is there a six-month waiting period before pre-existing medical conditions are treated the same as other medical conditions?
Like traditional, commercial individual health insurance plans, a limitation on pre-existing conditions reduces premium rates and helps make an insurance program financially stable for its members. The AccessTN Board of Directors determined that not having a pre-existing condition waiting period made premiums too expensive and decided on a six-month waiting period. However, AccessTN will pay a 50 percent benefit for treatment of pre-existing conditions, rather than exclude coverage altogether. Prescription drug coverage is not subject to the pre-existing waiting period. Also, outpatient behavioral health services and outpatient drugs used for the treatment of cancer are not subject to either the pre-existing conditions exclusion or a deductible. The AccessTN Board approved this to help participants afford medications for chronic conditions and chemotherapy or radiation treatment.
