Health Insurance and Financial Assistance for the Cancer Patient

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The Health Insurance Portability and Accountability Act of 1996 (HIPAA)

HIPAA is a federal (US) law with many clauses that can help cancer patients. This older law applies only to “grandfathered” plans that were in existence when the new health law went into effect in March 2010. For most other plans, the new law doesn’t allow pre-existing condition exclusion waiting periods. It allows a person who has had a grandfathered health insurance for at least 12 months with no long loss of coverage (usually more than 63 days) to change jobs and be guaranteed other coverage with a new employer, as long as that new employer offers group insurance. In this case there may be no waiting period and the pre-existing condition exclusion may be reduced or not applied. Also, the employee and his or her partner cannot be denied coverage because of a pre-existing health problem. (See “Pre-existing condition exclusions” in the section “Other things to know about health insurance.”)

HIPAA requires insurers to renew coverage for all employers and individuals as long as premiums are paid on time. It also guarantees that group insurance coverage is available for employers with 2 to 50 employees. But it does not require these small employers to buy and offer the insurance to their employees.

For more information about HIPAA see our document What is HIPAA? or contact your state department or commission of insurance. See the section called “To learn more” for contact information.


Last Medical Review: 12/31/2013
Last Revised: 09/08/2014