Health Ins. Question: Didn't Clinton get something passed that

[Amy6627]

prohibited Health Ins. Co from denying claims based on pre-existing conditions for group policies?

My sister is having her claims denied for PECs, she has a group plan through school.

Thanks, Amy

PS--We live in CA.

[MNDemNY]

1. Nope.

Many states have I am not sure about CA.

[Freddie Stubbs]

2. Yes, but she must have been previously covered by another group plan

Obtaining Health Insurance Coverage with Preexisting Conditions

Frequently health insurance companies will require new insureds to undergo a waiting period before having their preexisting conditions covered under the health insurance policy. Many insurance companies which offer individual health insurance policies require a waiting period of 12-18 months before they will pay medical bills related to preexisting conditions. The good news is that there are certain protections allotted to those with preexisting medical conditions. Under HIPAA, the Health Insurance Portability and Accountability Act. you are entitled to have your preexisting medical condition treatments paid for by the new company. Under this act, those who have previously been insured under a group health insurance plan and are obtaining a new type of health insurance may be able to have their preexisting conditions covered so long as they meet certain criteria.

It is important to note that HIPAA relates to individuals who have been previously insured under a group health plan and not an individual health insurance policy. With that said, should you fall into this category, take advantage of HIPAA when switching from a group policy to another group policy. This will prevent you from having to pay for costly insurance due to a preexisting condition or having a hard time obtaining health insurance altogether.

http://www.medhealthinsurance.com/preexisting-conditions.htm

[truedelphi]

3. There is a state insurance commission

Or some such regulatory commission.

She can call info for their number. if that doesn't work, she can contact her local state legislator
and ask for their help.

[Warpy]

4. They can't refuse to insure someone within a group

when that group is available through the job. However, they still routinely deny claims related to the illness.

In other words, she's covered if she totals her car and breaks a leg unless she's ever had a rash on that leg.