Health Insurance Articles
How Waiting Periods Affect What Your Health Insurance Covers And When
2010-05-11
Many people often have difficulty determining how their health insurance coverage may be affected by waiting periods imposed by their new employers. When there is also a pre-existing condition exclusion period, it can become even more confusing. While they may try to make things clear, the fact is, unless you understand the jargon associated with the industry, it can be complicated. Regardless, for the best interest of you and your family, you must understand how waiting periods affects what your health insurance covers and when.
Most employers will have an established waiting period before a new employee can enroll in their insurance plan. Some may be a relatively short period of one-month, while others will be three-months. During this time period, you will not be covered by this insurance at all. If there is a pre-existing condition exclusion period, the federal HIPAA laws require that it starts at the same time as the employee's waiting period. So if you were to start work on April 1 and there is a one-month waiting period and a six-month pre-existing condition exclusion period, you would be covered under the policy on May 1, but still have five-months left on the pre-existing condition clause.
The time period of your pre-existing condition exclusion period can, however, be shortened if you have had prior coverage. Basically, if you were covered previously by another provider from previous employment and had less than sixty-three days of a break in your coverage, the new insurance company can not even instill a pre-existing condition in your policy. It becomes null and void. If it has been more than sixty-three days, your previous coverage can be credited toward this and lessen the amount of time left on your pre-existing condition exclusion. The key is to make certain to provide them proof of prior coverage to benefit from this exception.
Thankfully, there are also laws on what your health insurance coverage can consider a pre-existing condition. If, for example, you were treated for carpal tunnel syndrome nine-months prior to enrolling in this insurance and have not been treated since, the insurance company can not consider this a pre-existing condition, as the law only allows the company to only look back at the medical history for six months. They also can not consider certain conditions as pre-existing, such as pregnancy, even if the individual was not previously covered by insurance. If you are a new employee and in the process of enrolling in a new insurance policy, do not be afraid to ask questions and make certain that you completely understand what will and will not be covered by your new policy.
