How will my pre-existing conditions affect my ability to obtain health insurance in Colorado?

If you are applying for individual health insurance, pre-existing conditions can have a major impact on the rates quoted by health care providers. Healthquotes.com president Michael Horvat has 30 years of experience in helping people get the best deal, given their pre-existing conditions. That's the advantage of contacting us or filling out our online quote form. Our expert and friendly staff can help you compare plans from multiple companies and help you get effective and affordable coverage in spite of pre-existing conditions.

If you are applying for group health insurance, the Health Insurance Portability & Accountability Act of 1996 (HIPAA), sometimes referred to as “Kennedy Kassenbaum,” is a federal law that impacts group health plans and health insurance issuers. The HIPAA provisions are designed to improve the availability and portability of health coverage. HIPAA places limitations on the exclusions that a health carrier may make due to an individual’s preexisting condition(s).

For example, say you began employment with your current employer 45 days after your previous group health plan coverage terminated. You had coverage under your previous employer's plan for 24 continuous months prior to the termination. You had no other coverage before your enrollment date in your new plan. Will you be subject to the 12-month preexisting condition exclusion period imposed by your new employer?

Not if you enroll when you are first eligible, according to the Department of Labor's interpretation of HIPPA. The 45-day break in coverage does not count as a significant break in coverage under HIPAA. Under federal law, a significant break in coverage is a break in coverage of at least 63 consecutive days. Since you had over 12 months of creditable coverage from your previous group plan without a significant break, you would not be subject to the preexisting condition exclusion period imposed by your new employer's plan if you enroll when you are first eligible.

Click here for more information on HIPPA, pre-existing conditions, and creditable coverage. Or contact us and our staff will be happy to help you with your questions.