HIPAA - 63 DAY PERIOD OF NONCOVERAGE AND PRE-EXISTING CONDITIONS

[Guest AngelaCro]

I am trying to understand the rules in HIPAA to see if I will be affected by pre-existing conditions. I lost COBRA insurance on Nov 1 and will be enrolled in my employer insurance on Jan 1st. Is it correct that since I have had coverage for years and will only have this 61 day break in coverage that I will not have a pre-existing condition in my new plan with my new employer?

[Sandra Pearce]

The 63 day period allowable begins when your coverage is lost and ends when the waiting period for new group coverage begins. Uusually a 30, 60 or 90 day waiting period for group coverage is imposed on new hires. The date of hire in these cases would be the date that the 63 day clock stops ticking. In the case cited no matter when the waiting period began, the period from November 1 - January 1 would be less than 63 days and would not cause your previous creditable coverage to be excluded. There would be no exclusion of pre-existing conditions in the new group coverage. Be sure to get the certificate of creditable coverage from your prior carrier or carriers and present that to your new carrier.