38.2-3514.1 - Preexisting conditions provisions. - Virginia Statutes

§ 38.2-3514.1. Preexisting conditions provisions.

A. In determining whether a preexisting conditions provision applies to aninsured, all coverage shall credit the time the person was covered underprevious individual or group policies providing hospital, medical andsurgical or major medical coverage on an expense incurred basis if theprevious coverage was continuous to a date not more than thirty days prior tothe effective date of the new coverage, exclusive of any applicable waitingperiod under such coverage.

B. As used herein, a "preexisting conditions provision" means a policyprovision that limits, denies, or excludes coverage for charges or expensesincurred during a twelve-month period following the insured's effective dateof coverage, for a condition that, during a twelve-month period immediatelypreceding the effective date of coverage, had manifested itself in such amanner as would cause an ordinarily prudent person to seek diagnosis, care,or treatment, or for which medical advice, diagnosis, care, or treatment wasrecommended or received within twelve months immediately preceding theeffective date of coverage or as to pregnancy existing on the effective dateof coverage.

C. This section shall not apply to the following insurance policies orcontracts:

1. Short-term travel;

2. Accident-only;

3. Limited or specified disease contracts;

4. Long-term care insurance;

5. Short-term nonrenewable policies or contracts of not more than six months'duration which are subject to no medical underwriting or minimal underwriting;

6. Policies subject to Article 4.1 (§ 38.2-3430.1 et seq.) of Chapter 34 ofthis title;

7. Policies or contracts designed for issuance to persons eligible forcoverage under Title XVIII of the Social Security Act, known as Medicare, orany other similar coverage under state or federal government plans; and

8. Disability income.

(1995, c. 522; 1997, c. 291; 1999, c. 1004.)