Does anybody know anything about the law Bill Clinton passed about people with pre existing conditions?

Question

My insurance company claims they will not cover my fiance's diabetes when we get married because he has had a lapse in insurance that is greater than 61 days. His diabetes educator thinks Bill Clinton passed a law saying it must be greater than 90 days. Does anybody know anything about this?

Answer 1

the 90 day reference doesn't apply to the coverage gap. The 62 day break in coverage is correct. It will be covered 12 months from the effective date.

Answer 2

The law in question is HIPAA, the Health Insurance Portability and Accountability Act of 1996. In accordance with HIPAA,an insurance company cannot apply a pre-existing condition limitation clause if an individual has not had a lapse in cover that lasted longer than 63 days. If the lapse in cover lasts 64 days or longer, than the insurance company is entitled to apply the pre-existing condition limitation clause, which is the case of diabetes would generally mean no costs related to the treatment will be covered for a period of one year. Find out exactly when the insurance company will begin covering your fiance's diabetes. As I said, the pre-existing waiting period is usually one year. He will have coverage for all other medical conditions.

Best wishes to you.

Answer 3

No, the break must be 63 days or less in order that a condition not be considered pre-existing. However, this 63-day break period may be extended under state law if your coverage is insured through an insurance company or offered through an HMO.  Check with your State Insurance Commissioner's Office to see whether a longer break period applies to you.Here is a link that explains it:

http://www.dol.gov/ebsa/faqs/faq_consume...