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    mdurkes's Avatar
    mdurkes Posts: 1, Reputation: 1
    New Member

    Nov 4, 2008, 01:03 PM
    Employer provided health insurance and preexisting conditions
    If an employee with a preexisting condition is terminated and selects to take COBRA coverage until he/she finds a new job, will there a be a problem getting coverage under the new employer's plan due to the preexisting condition?
    twinkiedooter's Avatar
    twinkiedooter Posts: 12,172, Reputation: 1054
    Uber Member

    Nov 4, 2008, 03:17 PM

    Yes. That employee will have to wait until the new company's health insurance has an open enrollment period and then get their coverage. I had a preexisting condition that was not covered by a new company's health insurance and had to wait until their open enrollment period came around. In the meantime have the employee keep the COBRA insurance coverage until then.
    Fr_Chuck's Avatar
    Fr_Chuck Posts: 81,301, Reputation: 7692

    Nov 4, 2008, 03:18 PM

    It will depend on the new employers plan,

    Past employer and cobra have nothing to do with the new company.

    The contract the new company has will make a difference,
    Some larger companies do accept you and covers pre existing coditions, but many of the smaller companies have plans that will not cover pre existing for a time.

    So you will have to ask the new company about their isurance plan
    jef1056's Avatar
    jef1056 Posts: 70, Reputation: 5
    Junior Member

    Nov 5, 2008, 11:37 AM
    Quote Originally Posted by mdurkes View Post
    If an employee with a preexisting condition is terminated and selects to take COBRA coverage until he/she finds a new job, will there a be a problem getting coverage under the new employer's plan due to the preexisting condition?
    No, there will not be a problem. As long as you don't have a lapse of more than 63 days and meet the new employers probationary period for new hires, typically 30 - 90 days. A new hire is a qualifying event and you don't have to wait for an open enrollment.

    Below is from the US Dept of Labor web site.

    Preexisting Condition Exclusions

    The law defines a preexisting condition as one for which medical advice, diagnosis, care, or treatment was recommended or received during the 6-month period prior to an individual’s enrollment date (which is the earlier of the first day of health coverage or the first day of any waiting period for coverage)

    Group health plans and issuers may not exclude an individual’s preexisting medical condition from coverage for more than 12 months (18 months for late enrollees) after an individual’s enrollment date

    Under HIPAA, a new employer’s plan must give individuals credit for the length of time they had prior continuous health coverage, without a break in coverage of 63 days or more, thereby reducing or eliminating the 12-month exclusion period (18 months for late enrollees)

    Creditable Coverage

    Includes prior coverage under another group health plan, an individual health insurance policy, COBRA, Medicaid, Medicare, CHAMPUS, the Indian Health Service, a state health benefits risk pool, FEHBP, the Peace Corps Act, or a public health plan

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