What is a pre-existing condition and can it be excluded from my health coverage?
A pre-existing condition is any condition for which a person received treatment or treatment was recommended within the preceding six months. Any individual enrolling in a new health plan covered by NYS law may be subject to up to a 12 month waiting period (six months for Medicare Supplement policy holders) before expenses related to the pre-existing condition are covered. However, the plan must subtract from the waiting period the time that the person had continuous coverage in a previous plan. Continuous coverage means that the person had less than a sixty three day gap between coverages. The insurer shall count a period of creditable coverage for all benefits or may elect to credit coverage based on Catagories of Benefits specified in the policy or certificate.
Health Insurance Resource Center
Comprehensive health insurance information for consumers
Contact: Department of Financial Services Consumer Assistance Unit
Phone: (800) 342-3736