Question:
HIPPA Law
My Cobra coverage ended 04/30/03. My new insurance went into effect 06/28/03. Will I be denied for pre-existing? — Tiffany C. (posted on August 10, 2003)
August 10, 2003
It more than likely will be considered pre-existing because it has to be
consecutive...no gaps...sometimes if you are on an HMO or join during open
enrollment they forgo the pre-existing condition clause. Good Luck!
— chris S.
August 10, 2003
What did your policy say when you signed it? If you got it through an
employer you might have a 6 month wait. If you bought it on your own then
I don't know, but it should be clearly spelled out in your policy book.
— zoedogcbr
August 10, 2003
In the state of Alabama if you don't go more than 60 days without coverage
then there's no pre-existing clause. You have to provide your new
insurance company a certificate of creditable coverage from your old
company. I'd sure give it a try. As far as the HIPPA Law - that is simply
a law designed to protect patient privacy and does not have anything to do
with insurance. Best wishes to you!
— ronascott
August 10, 2003
My understanding of the HIPPA law is that you have to have a lapse in
coverage of greater than 60 days, I am thinking 63 but I could be wrong.
Insurance companies can not hold pre-existing conditions against you as
long as you dont have a lapse greater than that. They may require a
certificate of credible coverage which your previous insurance co. can give
you to prove that you had insurance.
— maryburton
August 10, 2003
There are several parts to HIPPA--one part has to do with privacy, another
with portability. Other posters are correct that as long as your break in
coverage is less than 63 days, the new carrier has to give you credit for
the time you were covered under the previous policy (or policies, if you
had still previous relevant coverage) towards the pre-existing condition
limitation. However, this does not automatically erase the pre-exisitng
condition limitation; they simply have to apply the time under the previous
policy to their policy time limit. For example, if you have to have
coverage for at least 12 months before pre-exsiting conditions are covered,
then the new company has to count your period under the previous
insurance(s) towards that 12 months. So, if you've had at least 12 months
of coverage under the previous policy (or policies) and had less than a 63
day break in coverage, then there would be no pre-existing condition
limitation. However, suppose you had only 9 months of coverage under your
previous policy (or policies). Then the new company can still make you
wait the remaining three months to get to 12 months of coverage for the
pre-exisitng conditions. Do get a certificate of creditable coverage from
your previous carrier if they didn't already send you one (they often give
you one when your coverage ends). It's your official proof that you had
eligible coverage.
— Vespa R.
August 11, 2003
http://www.cms.hhs.gov/hipaa/hipaa1/default.asp
— RebeccaP
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