I Will Be Leaving My Job Where I Have Health Coverage, But I Have A Pre-Existing Condition. What Are My Options?

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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UPDATED: Jul 16, 2021

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Probably the largest single worry that many have is coverage for pre-existing conditions, especially when you switch jobs. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) helps assure continued health insurance coverage for employees and their dependents.

That law imposes limitations on exclusion of coverage for pre-existing conditions, provides credit for prior health insurance coverage and a method to provide certificates regarding such prior health coverage to a new group health plan, prohibits discrimination in enrollment and the premiums paid by employees and their dependents based on health factors, and other protections for obtaining health insurance – both as to employees and to employers sponsoring a health insurance plan.

The major benefit of this legislation for most employees is that when they have been covered by a group health insurance plan for more than 12 months (or an individual policy, by Medicaid, Medicare, or a public health plan), there will be no pre-existing conditions exclusion of new group health insurance when the employee enrolls as a participant in a new group health insurance plan. If, for example, you obtained medical advice, care or treatment for a condition 3 months ago, and had an individual or group insurance plan for the past year, your new group health insurance plan must not exclude coverage for that condition (pre-existing conditions exclusion not enforceable due to HIPAA).

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