The Affordable Care Act eliminated pre-existing conditions starting 2014. Insurance companies are no longer able to deny coverage, charge more, impose waiting periods, or deny treatment for anyone with pre-existing conditions. The only exceptions are procedures like cosmetic surgery that aren’t considered medically necessary. Show The only medical question an insurance company asks that may affect your rates is your tobacco use. If you have used tobacco 4 or more days a week for the past 6 months, an insurance company is allowed to charge you 50% more than a non-tobacco user. This page is included as a reference; pre-existing condition clauses still apply to grandfathered or group/company plans from before 2014; as well as short-term insurance plans. Blue Cross Blue Shield of TexasPre-Existing Condition ExclusionsPre-existing Conditions are those
health conditions which were diagnosed or treated by a provider during the 12 months prior to the coverage effective date, or for which symptoms existed which would cause an ordinarily prudent person to seek diagnosis or treatment. Exception for Prior BCBSTX Group Plan CoverageFor applicants with continuous prior coverage (no more than a 31 day gap) under a Blue Cross and Blue Shield of Texas
employer-sponsored plan, For example, if you enroll in a Blue Cross and Blue Shield of Texas “individual” plan after being continuously covered for 6 months under a Blue Cross and Blue Shield of Texas employer group health plan, you’ll be considered to have satisfied 6 months of the 12 month pre-existing condition exclusion waiting period. This exception works for maternity as well. If you were insured under an employer’s BCBSTX group health plan for a year or more, and you immediately enroll in a BCBSTX individual plan with the maternity option, you’ll have no waiting period for the maternity benefits. Medical Condition-Specific WaiversIf you have a condition, illness, or injury that can be identified as one that does not necessarily affect your overall good health but could affect the risk balance of all insureds, Blue
Cross and Blue Shield of Texas may exclude that condition from coverage. Blue Cross and Blue Shield of Texas will place a maximum of two coverage exclusion riders on any one applicant. Mental Health Counseling GuidelinesBCBSTX is extremely strict (and in our opinion, often unfair) on how they underwrite individuals whom have had mental health counseling. Individuals currently in counseling with a licensed therapist or psychologist will be automatically declined, regardless of the reason they are in counseling. Medical Condition Rejection ListIf you have a condition, illness, or injury that is listed on the Medical Condition Rejection List below, you will most likely be declined for individual coverage with Blue Cross Blue Shield of Texas. These conditions include, but are not limited to:
Is there a waiting period for preNo. There are no waiting periods for medical plans, including for pre-existing conditions. When choosing a health plan, consider your medical needs.
What type of insurance can be denied due to preHealth insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either.
What is considered a preA health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts. Insurance companies can't refuse to cover treatment for your pre-existing condition or charge you more.
Which policy covers preThe PED insurance would cover the costly treatments of such diseases. Some of the most common pre-existing conditions include thyroid, high blood pressure, diabetes, asthma, cholesterol, etc.
What are preThe time period during which a health plan won't pay for care relating to a pre-existing condition. Under a job-based plan, this cannot exceed 12 months for a regular enrollee or 18 months for a late-enrollee.
Does Blue Cross Blue Shield of Texas cover prePre-existing Conditions
Beginning Jan. 1, 2014, individuals cannot be denied coverage because of a pre-existing condition. ACA protects these individuals from having to pay higher rates or having benefits limited to exclude these conditions.
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