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What Is HIPAA?

HIPAA is an acronym for Health Insurance Promotion and Accountability Act. This act, which was passed in the 1980's by President Kennedy, is aimed at helping workers who have recently become unemployed with health insurance benefits. It provides help with health insurance problems, particularly to hose who have been identified by insurance companies as uninsurable due to their having serious health issues.

  

While it may sound confusing at first, this program is simply something aimed at providing benefits for regular workers. In particular, this act is supposed to provide aid to those workers who have just secured a new job or to those workers who have serious health problems and thus face difficulties keeping their health insurance coverage. It also helps to provide an avenue of assistance for workers whose health insurance coverage was previously funded by an employer but was interrupted due to a change in jobs. Finally, it also concerns workers who wish to purchase health insurance coverage without the aid of their employers.

The HIPAA provides an addendum to health insurance policies preventing insurance companies from denying workers health coverage due to per-existing condition exclusions. The HIPAA also prevents insurance companies from increasing health insurance premiums due to the health risks of an individual or his or her dependents. Insurance companies are therefore not allowed to refuse anyone renewal of their insurance coverage on the grounds of previously submitted insurance claims.

For individuals who either have serious health problems or are in the process of changing their jobs, the HIPAA provides a large amount of benefit and protection, ensuring that they remain covered by health insurance. However, while the HIPAA helps increase the chances that a person will receive health insurance coverage, it is not fool-proof and does not guarantee coverage for everyone. It also regulates the amount that insurance companies may charge as premiums for insurance coverage.

The HIPAA does stipulate various requirements regarding pre-existing conditions, although it is not specific about the exact benefits that insurance companies must offer to those affected. While the number of pre-existing conditions has decreased, exclusions due to pre-existing conditions still exist. For example, if someone whose coverage comes under a specific insurance carrier decides to change insurance plans or carriers, it is possible that he or she will be denied coverage. The policy may require twelve consecutive months of coverage and this requirement may have been met under the previous policy or carrier.

The biggest advantage offered by the HIPAA is that pregnancy is excluded from consideration as a pre-existing condition, ensuring that pregnant women will always continue to receive insurance coverage. However, if there are long breaks of 60 days or more in coverage in the insurance history of a particular worker, then he or she will lose their insurance coverage. In such a situation, the best course for a worker would be to opt for COBRA coverage if he or she is eligible to do so. A worker who is eligible for COBRA coverage should choose to take it as HIPAA coverage will not be available to him or her until all the benefits offered by COBRA are exhausted.


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