HIPAA

HIPAA2018-12-23T20:48:05+00:00

HIPAA is the acronym for the Health Insurance Portability and Accountability Act that was passed by Congress in 1996.  Here are a few of the protections HIPAA provides:

  • Pregnancy is no longer considered a preexisting condition:  If you’re pregnant and want to switch group health plans, you can do so without risking a break in your coverage.
  • Protections for newborns and adopted children:  Health plans and insurers can’t apply the preexisting condition exclusion to newborns or to children younger than 18 who are adopted or who are put up for adoption so long as the newborn or the child entered the health plan within 30 days of birth, adoption, or placement for adoption.
  • Genetic information can’t be treated as a preexisting condition in the absence of a diagnosis:  If your coverage is through an insurance company or offered through a health maintenance organization, state law may provide additional protections.
  • Shorter preexisting condition exclusion periods: If you do have a preexisting condition and you have group health insurance, you face shorter preexisting condition exclusion periods than you would have faced prior to HIPAA. In other words, you can get covered for your condition faster than before. The maximum exclusion period is generally 12 months from the date on which you enrolled in the plan.
  • Protection if you change jobs:  If you switch from one group health plan to another as the result of a job change, you will not face new preexisting condition exclusions so long as there is no more than a 63-day break in your health coverage. This enables you to switch jobs despite your health status without fear that you will lose coverage for certain conditions.

In addition to protecting you from exclusions based on preexisting conditions, HIPAA also protects you from discrimination based on health-related characteristics. The Act prohibits health plans and insurers from excluding you from coverage or charging you more for coverage because of your health status.

Finally, HIPAA requires health care providers, including doctors and hospitals, to improve their efforts to keep your medical records and health information confidential.