I had individual health insurance. Can my group coverage health insurance deny pre-ex conditions?
Will I be excluded from pre-existing conditions even if I had continuously previous coverage on my own instead through employer? Can I be denied coverage for visits, medical procedures/diagnostics related to pre-existing conditions? I have COBRA group health insurance through my previous employer. I did not have employment for too long (2 months). I have also individual health insurance that I had since 2006 and the condition was detected more than year ago (hypertension). Because I always had coverage should not I be eligible for pre-existing exclusion waiver? I hate insurance companies. I still have individual health insurance
Public Comments
- As long as you have had creditable coverage with no break longer than 63 days you will not have a pre-existing condition exclusion. Here is the government website with more information on the regulations: http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html
- Being preexisting will not cause them to be denied. In other words, they cannot be denied as a result of being preexisting. There may be some conditions that are not covered for other reasons, but only if they would not have been covered even if they were not preexisting. As long as you have had coverage continuously for 18 months, they cannot use the preexisting nature of the condition to deny coverage. They can deny it only for other reasons.
- If you have prior credible coverage with a lapse in coverage less than 63 days, the new group insurer cannot exclude coverage for preexisting conditions. It doesn't matter if the prior policy was individual or group, as long as it's "credible coverage", and THAT policy didn't exclude coverage for your condition. Typically, short term medical coverage is NOT "credible coverage".
- It's not "credible coverage." It's called "CREDITable coverage." Please stick to answering homeowners and car insurance questions.
- ~~Once you are accepted into a group coverage, there is no preexisting conditions that can change that. An employers "group coverage" has to cover all eligible employees. This may differ by state laws, or the others don't understand group health insurance. But at least in CA, doesn't matter at all if you have a preexisting or not or if you were previously insured or not, all eligible employees are covered under the group plan.~~
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