Small Group Health Insurance pre exisiting conditions periods
Small group is defined as health insurance plans 2 to 50 employees. Health insurance is a risk management business. In the insurer customer relationship, one party has to come out ahead and one behind. Use the info below to calculate if you should elect COBRA. If your waiting period until your new job is less than 63 days, don't worry about electing COBRA unless you have a sudden or chronic illness.
You will sere from teh info beow that states have different time periods concerning pre exisiting conditions. A pre-existing condition is a health or medical problem an individual has before applying to be accepted into a health insurance plan.
Most insurance plans will deny insurance to someone who is already incurring medical expenses since they do not knowingly buy claims. Even if you "forget" to disclose a health problem on the health insurance application, the insurer may find it through your doctor's health records and MIB or Medical Information Bureau report. They can also do a retroactive underwriting and get very specific.
to make sure you did not have the issue before you applied. There are even two kinds of pre existing conditions, diagnosed and undiagnosed. Undiagnosed is if a reasonable person would have known or should have known, pregnacy is a good example. Diagnosed is if a doctor has already diclosed your health problem or you are taking medication for something.
Some insurers may accept you follwing an exclusion period. You may be accepted, and pay for the insurance, but no care related to your pre-existing condition will be covered for a period of time which may range from six months to 18 months, depending on the policy and state regulations.
Alabama: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Alaska: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 90
Arizona: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Arkansas: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
California: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 6
Maximum Lapse Period Allowed in days: 62-180
Connecticut: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 120-150
Colorado: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 6
Maximum Lapse Period Allowed in days: 90
Delaware: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Florida: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Georgia: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 90
Hawaii: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Idaho: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Illinois: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Indiana: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 9
Maximum Lapse Period Allowed in days: 63
Iowa: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Kansas: Maximum Look-Back Period in months: 3
Maximum Exclusion Period in months: 3
Maximum Lapse Period Allowed in days: 63
Kentucky: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Louisiana: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Maine: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 90-180
Maryland: Maximum Look-Back Period in months: 12
Maximum Exclusion Period in months: 12
Massachusetts: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 6
Maximum Lapse Period Allowed in days: 63
Michigan: Maximum Look-Back Period in months: 0
Maximum Exclusion Period in months: 0
Minnesota: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Mississippi: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Missouri: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Montana: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Nebraska: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Nevada: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
New Hampshire: Maximum Look-Back Period in months: 3
Maximum Exclusion Period in months: 9
Maximum Lapse Period Allowed in days: 63
New Jersey: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 0-6 For health insurance groups of 2-5, max exclusion period is 6 months. For health insurance groups of 6-50, insurance carriers cannot require a pre-existing exclusion period.
Maximum Lapse Period Allowed in days: 90.
New Mexico: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 6
Maximum Lapse Period Allowed in days: 63
New York:Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
North Carolina: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
North Dakota: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Ohio: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Oklahoma: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Oregon: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 6
Maximum Lapse Period Allowed in days: 63
Pennsylvania:: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Rhode Island: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 6
Maximum Lapse Period Allowed in days: 90
South Carolina: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
South Dakota: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Tennessee: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Texas: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: Insurers must credit all prior coverage within last 12 months.
Utah: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Vermont: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 90
Virginia: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Washington DC: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Washington State: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 9
Maximum Lapse Period Allowed in days: 90
West Virginia: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Wisconsin: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 63
Wyoming: Maximum Look-Back Period in months: 6
Maximum Exclusion Period in months: 12
Maximum Lapse Period Allowed in days: 90
*Georgetown Health Policy Institute, January 2010.
Small group health insurance market pre-existing condition exclusion rules, January 2010 Washington, D.C. Kaiser Family Foundation
Written by Craig J. Casey
Craig Casey is an Writer, Coach, Blogger, Husband, and Former Health Insurance Agent helping people on the web since 1999 with their health insurance problems.
