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March 4, 2001

Insurance/Costs

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Question from Brooklyn, New York, USA:

What is the law in the state of New York concerning a pre-existing condition in children with type�1 diabetes?

Answer:

From: DTeam Staff

I am not a lawyer, but I do not believe there is any specific state law regarding “pre-existing medical conditions” in New York. Some insurance carriers, however, may have individual policies regarding when and if they will take on new individuals to insure if they have pre-existing illnesses.

TGL
Additional comments from David S. Holtzman, Esq.:

The State of New York does have laws on the books regarding the length of pre-existing or waiting periods for health insurance and HMOs. There is no special category determined by the type of medical condition or disease. The law in New York regarding how health plans can assess waiting periods for pre-existing conditions is rather complicated. Some of the variables include:

Is it an HMO or indemnity plan?
Was there prior health insurance coverage?
Is the person going directly from one policy to another?
Has there been more than 63 days without coverage by some insurance policy?
Is the coverage being taken as a part of a group plan of more than 25 people or is it an individual [or 1 family] contract?

DSH

[Editor’s comment: The American Diabetes Association keeps track of this sort of information. I suggest contacting your local chapter or your state’s insurance commission.

SS]