CARD Q076
An applicant with diabetes seeks ACA-compliant individual major medical coverage. Which statement is correct?
- The plan must postpone diabetes coverage for twelve months
- The plan may permanently exclude diabetes treatment
- The insurer may charge more solely because of the diabetes
- The plan cannot deny coverage or charge more because of that condition
The plan cannot deny coverage or charge more because of that condition
The preexisting-condition protection applies to this specified coverage. It does not eliminate underwriting for all life, disability, or other products.
Why each choice is right or wrong
A. The plan must postpone diabetes coverage for twelve months
Incorrect. The specified ACA-compliant coverage cannot impose that condition-based waiting period.
B. The plan may permanently exclude diabetes treatment
Incorrect. It cannot permanently exclude the stated condition on that basis.
C. The insurer may charge more solely because of the diabetes
Incorrect. It cannot increase the premium solely because of diabetes in this specified market.
D. The plan cannot deny coverage or charge more because of that condition
Correct. The preexisting-condition protection applies to this specified coverage. It does not eliminate underwriting for all life, disability, or other products.
Review the related terms
Use these lessons to revisit the concepts and try additional practice questions.