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?
The maximum length of a preexisting condition exclusion period is 12 months after your enrollment date (18 months in the case of a late enrollee). A late enrollee is an individual who enrolls in a plan other than on the earliest date on which coverage can become effective under the terms of the plan and other than on a special enrollment date. A plan must reduce an individual’s preexisting condition exclusion period by the number of days of an individual’s creditable coverage. However, a plan is not required to take into account any days of creditable coverage that precede a break in coverage of 63 days or more (significant break in coverage). A plan generally receives information about an individual’s creditable coverage from a certificate furnished by a prior plan or health insurance issuer (e.g., an insurance company or HMO). A certificate of creditable coverage must be provided automatically to you by the plan or issuer when you lose coverage under the plan or become entitled to el
Related Questions
- I changed jobs and my new group health plan imposes a pre-existing condition exclusion period. How does my new plan decide how long my pre-existing condition exclusion period will be under HIPAA?
- 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?
- I had a pre-existing condition exclusion period at my prior employment. Can another exclusion period be applied by my new group health plan?
