Minnesota laws dictate how health insurance companies must do business in the state.
Companies in Minnesota that offer health insurance are subject to the laws in that state that regulate how insurance can be sold and how policies must be designed. Some of the strongest protections that Minnesota offers are related to pre-existing conditions, specifically, what constitutes a pre-existing condition and how long health conditions can be excluded. However, not all laws are designed to protect the consumer. Some laws favor the insurance industry.
Denial Of Coverage
Health insurance companies selling individual policies are free to turn you down because of health or other reasons, like age. This applies only to health insurance you purchase yourself, and not through a group insurance plan offered by your employer. This differs from states like Massachusetts that do not allow insurers to turn down individuals because of poor health. This means that when you apply for health insurance in Minnesota, you should be aware that it is in your best interest to apply for coverage when you are young and healthy.
Automatic Coverage
Newborns and adopted children are covered automatically on their parents' policy. This provision is only valid if your health insurance policy already covers dependent children. However, a health insurance company can withhold benefit payments until you pay the updated premiums that reflect the new subscriber on the policy.
Coverage for Disabled Children
Disabled children are normally covered up to the maximum age specified in the policy. However, if you can show that your child is incapable of supporting himself because of his mental or physical disability and that the child relies primarily on you for financial support, you can keep your child on your health insurance policy.
Pre-Existing Conditions
Minnesota does not allow exclusion riders, which can permanently exclude health conditions. They do, however, allow exclusions. An exclusion rider is a supplement added to a health insurance policy which modifies the terms and conditions of the policy so that a health condition, such as diabetes or a specified injury, can be excluded from coverage under the policy. All other conditions would be treatable under the policy. Allowing exclusions differs from an exclusion rider because the company will only be allowed to exclude health conditions that the insured person had before obtaining the health insurance policy. Once a person develops an illness or injury, the insurance company won't be able to add a rider to the policy when the policy renews at the end of the year to exclude the new condition.
For group health insurance plans, allowable excluded conditions can only be conditions for which you were either diagnosed or treated for up to six months before your acceptance into the new plan. If you were not treated or diagnosed, then the insurance company cannot exclude this condition. The actual exclusion period, however, can be up to 12 months for those conditions. The exclusion period is a period when your pre-existing health condition will not be treated by the insurance company. After the exclusion period is over, you can be treated for that condition. If you join the group health plan after you are hired, but not during the open enrollment period in January or a special enrollment period specified by the employer, then you are entering the plan late. If you enter the plan late, you might face an exclusion period of up to 18 months.
This exclusion period works the same way for individual policies.
Pre-existing condition exclusions cannot apply to pregnancy, newborns, adopted children or children placed up for adoption. Also, insurance companies are not allowed to impose an exclusion period because of genetic information. Group health insurance plans also must give you credit toward your new policy for any exclusion periods. For example, if your old policy has an exclusion period of five months, this time must be credited to your new policy.
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