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Health Insurance Portability and Accountability Act (HIPAA)
In 1997, Congress passed the Health Portability and Accountability Act (HIPAA), which provided for a number of reforms within the health provider system. Among other things, it guarantees the continuation and availability of coverage when transferring from one company to another, or if you should lose your job. Here are some details of the HIPAA provisions.
Provides Group Coverage To All In The Group
When you are an employee and your company buys group insurance, then you must be included in the coverage. No individual can be singled out because of health, genetics, disability, or for any medical history reason. It simply must be made available to everyone in the group. Larger companies (more than 50) still can, however, choose to cover only certain groups within that company. For instance, they may choose to insure only the office personnel, and leave the floor personnel out.
Guarantees Continued Coverage
One of the things that HIPAA made possible is the coverage that you can get if you should change health insurance companies, or lose your insurance altogether. Things that you have been diagnosed with and treated before the change of policies may only have limited exclusion rights by the new insurer.
Pre-existing Conditions
When you have a pre-existing condition, which is something that is determined by a diagnosis and treatment within the past six months, then the new insurer may give you an exclusion period of up to 12 months. When the insurance coverage is extended to you, you need to take it as quickly as possible. By waiting for a longer period of time, you allow the new insurer to possibly extend the exclusion period up to 18 months. If you are seeking to get an individual health insurance policy, then an insurer may refuse to insure you if they feel that the risk is too high. But if you are being employed where there is a group policy, then they cannot refuse to insure you, but may give you an exclusion because of the pre-existing condition.
Exclusion Period Altered By Previous Insurance
As long as you can prove that you were carried by another insurer, and did not let the policy lapse for more than 62 days, then this exclusion period can be reduced, according to the HIPAA plan. The amount of time it can be reduced by is the amount of time that the other insurance company was paying for that particular health problem. For instance, if the other company was treating you for a problem for eight months, then they must subtract the eight months from the 12 months - which means that they can exclude you from payments for any treatment of that problem for up to four months.
You Need Continual Coverage
HIPAA demands that in order for your coverage to be carried over to another insurer, then you need to have continual health insurance coverage. There cannot be any more than a 62-day period of not having any medical coverage. If you let this happen, then the new insurer does not have to count any previous coverage into the exclusion factor - thus extending it to a possible 18-month period. If there should be some reason you lose your health insurance, then you will want to get some kind of temporary insurance to meet this need.
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Free Health Insurance Quotes
By comparing health plans with other rates, you should be able to find the right plan. You can get your free health insurance quotes at the following sites:
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