Some of you have been asking us about this feature of the HCR (Health Care Reform) bill. I’m going to share with you a clarification that I received from Anthem Blue Cross. This one aspect of the massive HCR law, which will take effect on Sept. 23 applies only to the following:
1) If an overage dependent has been dropped from a health plan in the past due to having attained age 23, this dependent will be allowed to enroll, guarantee-issue, back onto the parent’s plan after Sept. 23rd, as long as they are not yet age 26.
2) The no pre-existing condition rule for children means that children (under age 18) will no longer have to be subject to the 6 month pre-existing condition waiting period (which currently applies to all PPO plans for individuals who did not have continuous coverage, or did not have prior creditable coverage making them eligible for the 6 month pre-existing condition waiting period waiver.)
3) Rule #2 above does not bar insurers from still denying coverage or ‘rating up premiums’ for dependents (with pre-existing conditions) who do not satisfy Rule #1 above.
4) Rule #4 above has since been revised by the regulators after further discussions and negotiations with insurance companies.  The rules now mandate Guarantee Issue as well as the elimination of Pre-Existing Condition waiting periods for children.

© Philip W Lee, www.health-insurance.com, www.healthplantalk.com