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Learn About the Health Insurance Portability & Accountability Act
The Health Insurance Portability and Accountability Act, or HIPAA, as it’s more commonly known by its acronym, is a federal law that was enacted in 1996. It offers limited protections to ensure continuity of health care coverage. For example, under HIPAA, insured individuals who have a health condition cannot be denied benefits when they change jobs.
H.i.p.p.a. also prevents health plans from refusing coverage on the basis of pre-existing conditions. This means becoming employed somewhere with a group health plan is a huge benefit to many people. Group health plans are also limited on the restrictions it can place on benefits for pre-existing conditions.
As a rule of thumb, most health insurance companies define pre-existing conditions as any condition an individual received advice for, received advice to have treatment for or received treatment for in the last 12 calendar months. These “pre-existing” conditions can adversely affect your ability to get coverage or how much you will have to pay for an individual plan.
HIPAA covers those bases because it “prohibits any group health plan from creating eligibility rules or assessing premiums for individuals in the plan based on health status, medical history, genetic information or disability.” If you have private individual insurance, HIPAA is not applicable.
Keep in mind while HIPAA says insurance companies cannot deny coverage based on certain factors and cannot establish premiums on an individual basis, it puts no limits on premiums that may be charged for the group.
In summation, the basic tenet of HIPAA is the establishment of national standards for the portability of insurance as well as the regulation of employer provided group health plans. HIPAA, according to the law, “regulates the availability and breadth of group and individual health insurance plans, amending both the Employee Retirement Income Security Act and the Public Health Service Act.”
HIPAA also sets the standards for the use and dissemination of health care information. This rule assures the physical and electronic confidentiality of the health information for covered entities. This put into simpler terms means that if an insurance provider uses your personal information in any manner except for insurance purposes they are liable.
Health Insurance Portability & Accountability Act
H.I.P.A.A., as some might assume, is not plural for multiple female hippo. HIPAA is synonymous with health care privacy and group health plan regulation. Unfortunately far too many people do not understand the actual concept behind this law.
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