About pre-existing conditions and waiting periods
Until January 2014, individual health plans may require a nine-month waiting period for pre-existing conditions. This waiting period applies to:
- Any health condition you had during the previous six months (whether or not you received medical advice or treatment)
But, you may receive credit toward the waiting period if:
- You submit your application for the new insurance within 63 days of ending your old plan
- Your prior coverage was not a catastrophic plan
A plan is catastrophic if it has a deductible amount of:
- $1,970 or more for a single person
- $3,940 or more for two or more people (family)
Currently, health insurers can also deny eligibility for an individual health plan if you have a pre-existing condition with a score of 325 or higher on the Standard Health Questionnaire, unless you are exempt (PDF, 747KB) (www.wship.org).
Pre-existing conditions, waiting periods and health reform
Starting Jan. 1, 2014, under health reform, health insurers cannot limit or deny benefits or coverage if you have a pre-existing health condition. Everyone (64 years or younger) will be able to buy health insurance through an agent, broker, or insurance company, or through the Washington Healthplanfinder (www.wahbexchange.org).