In an effort to deter people from not buying insurance until they get sick, insurance companies have imposed “pre-existing condition” clauses into policies. Basically this means if you have a medical problem that you received treatment for or treatment was recommended for and it exists at the time you enroll in or purchase health insurance, then the insurance company will deny all claims pertaining to the medical problem for a certain amount of time.

If your coverage is job-based insurance then your pre-existing condition time period maxes out at 12 months and is only relevant to conditions that you sought treatment for in the 6 months prior to your enrollment in the insurance program. However, if you’ve had continuous coverage with another plan you can sometimes subtract from the waiting period. Continuous coverage is defined as coverage with less than 63 days of a gap in coverages.

Each state has its own rules for pre-existing condition exclusion periods. Generally they vary greatly, too. Check with consumer guides in your state to find out the specific information regarding pre-existing condition in job-based policies as well as individual policies.

This entry was posted on Friday, June 27th, 2008 at 9:00 am and is filed under Health Insurance. You can follow any responses to this entry through the RSS 2.0 feed. Both comments and pings are currently closed.