Definition of pre-existed conditions

Hi,
    I am filling an application for individual health insurance and am not sure what the true definition of pre-existed conditions is:

(1) If certain condition was diagnosed more than 6 months ago.  Suppose the condition is such that it is chronic, not easy to cure and generally not life threatening, and I have not seen a doctor in the past 6 months for that condition, does that constitute as pre-existed condition that I need to fill in the application form?

(2) This question is different: I am applying for individual health insurance after my COBRA coverage expires next month (after 18 months in group health plan).  I think under the HIPAA & COBRA rules, the individual health insurance provider cannot impose any payment waiting period for the pre-existing conditions?

Thanks a lot in advance.

[Amir Mostafaie]

Dear pc126,

Respond to your 1st question;
Please keep in mind that Pre-existing condition clause doesn’t only apply to life threatening health conditions & may include a condition as simple as Acne!
The 6 months (look back) rule applies to the HIPAA eligible plans & a chronic condition can be deemed pre-existing especially if you take (or are supposed to take) maintenance medication for to treat it.

Respond to your 2nd question;
Once you have exhausted the 18 months of COBRA, you are eligible for HIPAA rights which means depending on your State laws there will be some guaranteed issue plans which will not have any waiting period on your pre-existing conditions.

I am hoping you are working with a licensed agent & your agent can tell you the rules in your State. Another good resource to find out your options is www.coverageforall.org .

Sincerely,

Amir Mostafaie