Generally, a pre-existing medical condition is limited to a physical or mental condition for which medical advice, diagnosis, care, or treatment was recommended or received within the six (6) month period prior to obtaining healthcare coverage.
When obtaining a ‘new’ policy, a preexisting condition limitation may not apply if an individual has maintained creditable coverage for the prior 12 months (18 months for late enrollees). Creditable coverage is continuous coverage without a lapse of more than sixty-three (63) days.
