Pre-Existing Conditions

Most pre-existing conditions exclusions to end in 2014

Beginning Sept. 23, 2010, group health plans cannot exclude enrollees (employees, spouses or dependents) under age 19 based on pre-existing conditions. For other plans, all pre-existing condition exclusions must be removed beginning in 2014.

Grandfathered group health plans receive no special protection and must comply once the provision becomes effective with respect to the plan. These rules apply equally to collectively bargained and non-collectively bargained plans.

A special rule applies to individual health insurance coverage. The pre-existing condition rules only apply to non-grandfathered individual health insurance plans.

A temporary high-risk health insurance pool provides coverage for eligible individuals who have been denied health care coverage.

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