HIPAA

[lauralee77]

My husband recently got a new job and with his new insurance plan, it has one of those pre-existing condition clauses for 12 months. However, I just read up on HIPAA and my question is, does this law apply to this situation or only if I am trying to get insurance through my OWN company? Because I am currently covered through my own employer and have been for 4 years, but I've been out of work for awhile and in my last month of FMLA and it may be safer to put myself on his insurance plan. Any advice would be very much appreciated!
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[barefut]

Good question. I don't know but wait for Raggedyann.......you can bet she'll know or at least know where you can find out. style_emoticons/<#EMO_DIR#>/flowers.gif

[dudley]

Hi,

I can only tell you how it works in my state (but I believe the 12 month pre-existing condidtion is across the US).


The pre-existing condition clause for 12 months kicks in if you have had a break in issurance and had a pre-existing condition. Hence, if there is a break the insurance company will not cover you for that condition for 12 months.

If your husbands new job has a waiting period to pick up company insurance (as most do) you must continue on an insurance plan until he is eligble. In the State of NJ there is a list of companies that must give you health insurance (as long as no break in insurance has occured) that will treat existing conditions.

Also if your husband is all ready in roled in the company issurance plan you will have to find out if you can be added right away or do you have to wait for open enrollment.

Elaine

[raggedyann1]

I wrote an entire post discussing cobra and Hippa. It is pinned at the top of this forum.

Elaine is mostly right. HIPPA is a federal law and therefore trumps state laws. The break in insurance cannot be longer than 63 days. If you have a break of less than 63 days then they cannot use the preexisting clause. HIPPA is for people who have had company sponsored insurance. it helps them to have continuous coverage from job to job or to get private insurance if they no longer have access to employer sponsored health insurance.

Since you are talking about employer sponsored I will leave the other part alone, I addressed it in my post.
What you need to double check since I am not a lawyer or any sort of legal professional is to call the HR department at your husbands job and get clarification on the pre-existing clause - Tell them the outline of insurance that they gave your husband is not detailed enough to answer your question. You need to know if HIPPA law applies and if you have certificate of coverage will that remove the pre-existing clause condition.

Take care,
Karen

[lauralee77]

Thanks for the info everyone! I am going to get my husband to ask HR tomorrow about the clause. style_emoticons/<#EMO_DIR#>/smile.gif