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Pre-existing Condition Exclusions

Effective for plan years beginning on or after January 1, 2014, group health plans and health insurance issuers may not impose pre-existing condition exclusions on any covered individual, regardless of the individual’s age. Pre-existing condition exclusions are already prohibited for individual’s under age 19.

A pre-existing condition exclusion is a limitation or exclusion of benefits related to a condition based on the fact that the condition was present before the individual’s date of enrollment in the employer’s plan.