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All You Need To Know About Pre Existing Conditions

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All You Need To Know About Pre Existing Conditions

All You Need To Know About Pre Existing Conditions

Preexisting conditions is one term you will be familiar with when you are dealing with health insurance plans. These are basically those illnesses or health conditions you may have before you enroll for a new plan or join one. The insurance company may use a pre existing clause to deny you cover or exclude you from certain benefits. The laws that determine how an insurance company will deal with a pre existing condition are included in the Health Insurance Portability and Accountability Act of 1996(HIPAA).

The basic ground of this law states that a person may not be denied covers for a pre existing illness, if that person has had covers for at least six months prior to his applying for this new cover. If the person has had such a cover in the preceding period, it is to be included in the waiting period that the person has to go through before his covers kick in. However, these laws vary between states. You can find out more about HIPAA regulations in your state through your state insurance department.

You should also remember that it does not mean that the insurance company has to offer you the normal covers for an individual insurance or a standard issue. Most states permit the carriers to deny an individual insurance to the person who has a pre existing illness. Most of the group health plans you find, are under guaranteed issue. Hence, the applicability of the HIPAA regulations pertain more to a person who is getting a new employer sponsored group health plan.

Some insurance companies may also place a few ‘riders’ on you. These state that the company need not pay you any benefits for a pre existing cause that you get treatment for. The company will only accept your application, if you accept this precondition. However, some states like California do not permit such riders to be placed on the applicants. People in states like these will usually be declined insurance covers if they have a serious pre existing condition.

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