How do I calculate the length of a preexisting condition exclusion in a new employers health plan?
Suppose an employee had coverage for 2 years, followed by a break of 70 days. The employee then resumes coverage for 8 months before moving to a new job, with no time off between jobs. He enrolls in the health plan at the new job as soon as possible. A preexisting condition exclusion can last 12 months at most, if the person enrolls when first eligible. This employee has 8 months of creditable coverage. His earlier 2 years of health coverage are not creditable because he had a break in coverage that was more than the 63 days allowed under the law. His preexisting condition exclusion will last 4 months after he enrolls in the employer’s health plan. If the same employee had a break in coverage of only 60 days, his story would be different. This would not be a significant break and he could use the earlier 2 years of coverage to completely offset the preexisting condition exclusion period.
Related Questions
- I changed employment and my new group health plan imposes a preexisting condition exclusion period. How does my new plan determine the length of my preexisting condition exclusion period?
- How does the preexisting condition exclusion apply if an applicant has had prior coverage with another Blue plan?
- How do I calculate the length of a preexisting condition exclusion in a new employers health plan?
