What is a pre-existing condition, as defined under HIPAA?What is a pre-existing condition, as defined under HIPAA?
A pre-existing condition is anything for which medical advice, diagnosis, care, or treatment was recommended or received within six months before the effective start date of enrollment in a group healthcare plan. Under the law, group health plans may not impose an exclusionary wait period for pre-existing conditions longer than 12 months (or 18 months for late enrollees). *This is not applicable to individual health insurance policies.Permalink • HideDon’t sue us! Fractured Atlas is not an insurance company. We’re also not lawyers, brokers, agents, doctors, or anyone else qualified to give professional advice. We try our best to be helpful, but take anything written here with a handful of salt.