September 21, 2023

Protection for pre-existing situations

All Market plans should cowl therapy for pre-existing medical situations.

  • No insurance coverage plan can reject you, cost you extra, or refuse to pay for important well being advantages for any situation you had earlier than your protection began.
  • When you’re enrolled, the plan can’t deny you protection or increase your charges based mostly solely in your well being.
  • Medicaid and the Kids’s Well being Insurance coverage Program (CHIP) can also’t refuse to cowl you or cost you extra due to your pre-existing situation.

Being pregnant is roofed from the day your plan begins

  • If you happen to’re pregnant once you apply, an insurance coverage plan can’t reject you or cost you extra due to your being pregnant.
  • When you’re enrolled, your being pregnant and childbirth are lined from the day your plan begins.
    • If you happen to give delivery or undertake after enrolling in your Market plan for the 12 months:
      • Your baby’s delivery or adoption qualifies you for a . This implies you may enroll in or change plans outdoors the annual Open Enrollment Interval.
      • Your protection can begin from the date of delivery or adoption, even when you enroll as much as 60 days afterward.

Exception: grandfathered plans don’t must cowl pre-existing situations

don’t must cowl pre-existing situations or preventive care. When you have a grandfathered plan and wish pre-existing situations lined, you have got 2 choices:
  • You possibly can swap to a Market plan that can cowl them throughout Open Enrollment.
  • You should purchase a Market plan outdoors Open Enrollment when your grandfathered plan 12 months ends, and also you’ll qualify for a Particular Enrollment Interval.