Pre-existing conditions were addressed as significant problems Michael Moore’s recent documentary, Sicko. While pre-existing conditions can present some challenges to patients, in the past decade Federal laws have been passed to limit the amount of latitude that health insurers have in denying care based upon a pre-existing condition.
A pre-existing condition is a medical condition diagnosed or treated before joining a new plan. In the past, health care given for a pre-existing condition often has not been covered for someone who joins a new plan until after a waiting period. However, the Health Insurance Portability and Accountability Act (HIPAA), changed the rules.
Under the law, effective July 1, 1997, a pre-existing condition is covered without a waiting period when you join a new group plan if you have been insured the previous 12 months. This means that if you remain insured for 12 months or more, you will be able to go from one job to another, and your pre-existing condition will be covered—without additional waiting periods—even if you have a chronic illness. If you have a pre-existing condition and have not been insured the previous 12 months before joining a new plan, the longest you will have to wait before you are covered for that condition is 12 months.
Ruthann Russo, PhD, JD, MPH, RHIT, is a healthcare expert with more than 20 years of experience working in and advising healthcare organizations.
