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In the context of healthcare in the United States, a pre-existing condition is a medical condition that started before a person's health insurance went into effect. Before 2014, some insurance policies would not cover expenses due to pre-existing conditions. These exclusions by the insurance industry were meant to cope with adverse selection by ...
After that, though, Medigap plans in most states can flat-out reject you if you have a pre-existing condition, such as diabetes. The exceptions are New York, Connecticut, Maine, and Massachusetts.
Creditable coverage" is defined quite broadly and includes nearly all group and individual health plans, Medicare, and Medicaid. [12] A "significant break" in coverage is defined as any 63-day period without any creditable coverage. [13] Along with an exception, it allows employers to tie premiums or co-payments to tobacco use, or body mass index.
Adults with existing conditions became eligible to join a temporary high-risk pool, which will be superseded by the health care exchange in 2014. [4] [18] To qualify for coverage, applicants must have a pre-existing health condition and have been uninsured for at least the past six months. [19] There is no age requirement. [19]
The Medicare Advantage open enrollment period is a time period during which a person with a Medicare Advantage plan can make changes to their plan. This period runs from January 1 through March 31 ...
Special enrollment periods. Medicare allows SEPs under certain circumstances. The type of changes a person can make, and the rules surrounding the changes, are different for the various parts of ...
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