The Health Insurance Portability and Accountability Act is a federal law passed in 1996 to protect consumers of health insurance policies. HIPAA laws also require health care providers to protect consumers' privacy and allow administrators to create documents that are easily read and translated by average citizens.
Privacy
The Health Insurance Portability and Accountability Act provides privacy rules for medical information. It gives patients the right to acknowledge or deny use of medical records by entities other than the treating health care provider. According to the Human Resources and Services Administration, patients must be granted access to their own medical records and be provided a copy when requested within 30 days. Patients can request that incorrect information be corrected in medical records. Providers must make corrections within 60 days. Additionally, patients must be asked for permission for health care providers to share their records with other providers.
Pre-existing Conditions
According to the U.S. Department of Labor, one of the most important requirements of HIPAA is that it protects consumers with pre-existing conditions from being excluded from health insurance coverage. Prior to the act, employers could deny new employees with pre-existing health conditions from joining in a group health care plan. Under HIPAA, coverage eligibility is based only on conditions that existed for the previous six months from when the employee applies for coverage. Additionally, the potential insured must have received treatment or seen a doctor for the condition in the six-month eligibility period. If an applicant has a qualified pre-existing condition that was diagnosed in the last six months, he can only be excluded from coverage for that condition for 12 months under HIPAA laws. Pregnancy and genetic conditions cannot be used as reasons to exclude someone from health coverage.
Eligibility
Individual health care policies cannot be refused to persons who have carried continuous health care coverage prior to applying for the new coverage. As long as a person was covered within 63 days of applying for a new policy, the insurance company cannot refuse coverage, nor apply any pre-existing condition clauses to the coverage. Those leaving one plan, whether it's an employee health care plan or an individual policy, should receive a certificate declaring the continuous coverage.
Discrimination
HIPAA forbids health insurance companies from discriminating against policyholders by denying coverage. HIPAA forbids insurance companies from charging customers additional premiums for certain health factors that include disability, genetic information, recent health care claims or medical history. People with physical and mental illnesses cannot be refused group health care coverage. Those who participate in high-risk behaviors such as skiing or motorcycling cannot be refused coverage, though benefits may be limited. Victims of domestic violence also cannot be discriminated against under HIPAA requirements.
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