Healthcare Reform

When do the changes to pre-existing condition limits go into effect?

A Answers (1)

  • For enrollees under age 19, the pre-existing condition rules went into effect for plan/policy years beginning on or after Sept. 23, 2010. The rules will apply to all enrollees beginning in 2014.

    A special rule applies to individual health insurance coverage. The pre-existing condition rules only apply to non-grandfathered individual health insurance plans.

    Pre-existing condition exclusions (consistent with HIPAA rules) may continue to apply for enrollees age 19 and older until the 2014 plan year. Beginning in 2014, no pre-existing condition exclusions will be permitted.

    To learn more about the pre-existing condition exclusion provision or health care reform, go to or

    This communication is not intended as legal or tax advice. Please contact a competent legal or tax professional for personal advice on eligibility, tax treatment and restrictions. Federal and state laws and regulations are subject to change.
Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.
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What are the rules for pre-existing condition exclusions?