Moving from One Employer-Sponsored Group Health Plan to Another Employer-Sponsored Group Health Plan
I have had at least 12 months of health insurance coverage without a gap lasting 63 days or more (a significant gap in coverage):
Can a plan refuse to enroll me just because I am sick?
No. Employer-sponsored health plans may not refuse to enroll you just because you are sick. (There are exceptions to these protections for some church and state or local government plans.)
Can a plan charge me more based on my health?
No. Employer-sponsored health plans may not charge you or your family a higher premium than other employees who have a similar position in the company due to your health status.
Can a plan refuse to cover my illness for a period of time just because my illness was preexisting?
No. Employer-sponsored health plans may not refuse to cover an illness you had before you enrolled in the plan, since you had 12 months of previous creditable coverage. However, your new insurance plan may not offer coverage for all of the same benefits covered by your former plan. Check your policy to see what benefits your plan will cover.
I have had fewer than 12 months of health insurance coverage:
Can a plan refuse to enroll me just because I am sick?
No. Employer-sponsored health plans may not refuse to enroll you just because you are sick. (There are exceptions to these protections for some church and state or local government plans.)
Can a plan charge me more based on my health?
No. Employer-sponsored health plans may not charge you or your family a higher premium than other employees who have a similar position in the company due to your health status.
Can a plan refuse to cover my illness for a period of time just because my illness was preexisting?
Yes. An employer-sponsored health plan may refuse to cover a preexisting illness for a period of up to 12 months. The length of time the plan may refuse to cover the illness will be reduced depending on how much creditable coverage you had when you enrolled in the new plan.
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