A disproportionate number of these people seek new insurance when they have cause to suspect that their upcoming medical expenses will be substantial. is designed and priced to cover unforeseen medical expenses for the majority of plan members.
This is referred to as a "pre-existing medical condition". Most policies restrict or exclude coverage for pre-existing medical conditions.
Title II of HIPAA, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers.
Title I of HIPAA regulates the availability and breadth of group health plans and certain individual health insurance policies.
Americans are not required to maintain health insurance so about one in ten people goes without coverage for a period of more than six months.
Gaps in coverage are triggered by changing jobs, layoffs, leaving parents' coverage, graduation from college, relocation, immigration, or starting a business.
Some health care plans are exempted from Title I requirements, such as long-term health plans and limited-scope plans such as dental or vision plans that are offered separately from the general health plan.