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preexisting condition and hipaa

i have been in my current job for over 1.5 years w/ group insurance the entire time. i want to find a new employer as my current one has been cutting jobs and closing locations, making it somewhat unsteady. about a year ago i rolled my ankle several times and didn't do anything about it. as it turns out, i did some damage that will require surgery (ligament repair and bone spur removal). i have gone to the dr. 3 times and this week have an appt to discuss surgery.

regarding the hipaa laws and regulations, what could happen if i change jobs? from the pasted part below, it seems that if i change jobs then i may have to wait for 12 months to have my ankle worked on. i can walk but i do have pain. what sort of waiting or grace periods to most group plans have?



"Today, HIPAA helps to assure continued coverage for employees and their dependents, regardless of preexisting conditions. Insurers can impose only a 12-month waiting period for any preexisting condition that has been diagnosed or treated within the preceding 6 months. As long as you have maintained continuous coverage without a break of more than 63 days, your prior health insurance coverage will be credited toward the preexisting condition exclusion period.
If you have had group health coverage for at least 1 year and you change jobs and health plans, your new plan can't impose another preexisting condition exclusion period. If you have never been covered by an employer's group plan and you start a new job that offers such a plan, you may be subject to a 12-month preexisting condition waiting period. Federal law also makes it easier for you to get individual insurance under certain situations. You may, however, have to pay a higher premium for individual insurance if you have a preexisting condition."
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replied February 20th, 2009
break in coverage
bandit350-

The key to your question is break in coverage. As long as you don't have a break in coverage of more than 63 days between jobs, then your new group insurance typically cannot exclude your ankle. Otherwise, anything you have been treated for in the last 6 months can be excluded by your new company's insurance for a year.

If you think there will be a break of longer than 63 days before your new group coverage kicks in, you can buy a short-term policy in the meantime. Your short term policy probably won't cover your pre-existing, but at least you won't have to wait 12 months to get your ankle treated when your new group coverage kicks in. You can usually get high deductible short term insurance for up to 6 months at relatively low cost.

Hope this helps.

Joe
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