Medical Insurance Coverage of Preexisting Conditions
A preexisting condition is any health issue treated prior to obtaining a new medical insurance. Exclusions for these conditions will be prohibited in all plans by Jan. 1, 2014.
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Small Groups
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In small group insurance, any illness for which you sought treatment 6 months prior to application is considered a preexisting condition. Coverage for these can be excluded for a period of no more than 18 months. If you have had insurance for 18 months with no lapse in coverage greater than 63 days, you have "creditable coverage" and will not be subject to any exclusion. Effective Sep. 23, 2010, children under 19 with preexisting conditions will no longer be denied coverage under their parents' health plan.
Individuals
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With individual coverage, insurance companies are more selective and go back as far as 10 years in your medical history. Diagnosis with certain conditions can make you an unacceptable risk. Some companies will increase the monthly premium to include coverage options, exclude coverage for certain conditions, or deny coverage altogether.
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Alternate Plans
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The government implemented a national high-risk health pool on June 21, 2010. This plan guarantees coverage for anyone with preexisting conditions. A less expensive insurance alternative is a limited liability plan. While it does not offer extensive coverage, it is an option until exclusions for preexisting conditions are prohibited.
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