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  •  What if you are long-term unemployed (1+ / 0-)
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    and then get hired by a company that has insurance benefits and you use them and the doctor finds, say, cancer.

    Will they keep you from being covered on something that hasn't been discovered by a doctor because you haven't BEEN to a doctor for so long?

    "The difference between the right word and the almost-right word is like the difference between lightning and the lightning bug." -- Mark Twain

    by Brooke In Seattle on Fri Jan 30, 2009 at 06:33:52 PM PST

    [ Parent ]

    •  Excluded if diagnosis, care, treatment w/in 6 mth (2+ / 0-)
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      etherapy, kurious

      I think this is the relevant section. Excluding pre-existing conditions isn't forever. It's for 12 months unless you didn't enroll when you were first eligible. Then it's 18 months. Some companies don't exclude at all. My experience is that large employers generally do not exclude pre-existing conditions but the law says they could. Exclusion may become more prevalent as costs continue to escalate.

      Under HIPAA, a plan is allowed to look back only 6 months for a condition that was present before the start of coverage in a group health plan. Specifically, the law says that a preexisting condition exclusion can be imposed on a condition only if medical advice, diagnosis, care, or treatment was recommended or received during the 6 months prior to your enrollment date in the plan. As an example, you may have had arthritis for many years before you came to your current job. If you did not have medical advice, diagnosis, care, or treatment – recommended or received – in the 6 months before you enrolled in the plan, then the prior condition cannot be subject to a preexisting condition exclusion. If you did receive medical advice, diagnosis, care, or treatment within the past 6 months, then the plan may impose a preexisting condition exclusion for that condition (arthritis). In addition, HIPAA prohibits plans from applying a preexisting condition exclusion to pregnancy, genetic information, and certain children.

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