What is a limited benefit plan?

Quite often called a "bare bones" plan, limited benefit plans provide much lesser benefits than a traditional health insurance plan in exchange for much lower premiums. When considering these plans, it is important to know exactly what types of care or services the plan will or will not pay for and how much coverage it actually provides. These plans usually include pre-existing conditions exclusions.

While the plan administrators of most of these plans are HIPAA compliant (meaning they must follow certain aspects of HIPAA, ie. privacy rights and other regulations), these plans are not considered to be continuous creditable coverage under HIPAA as there are certain qualifications a health plan must meet in order to be considered continuous credible coverage.

As a result, you may be subject to an exclusionary wait period for any pre-existing conditions that existed before your enrollment start date in a full featured healthcare plan, (such as a group or individual plan) if your prior coverage was under a limited benefit plan. The maximum look back period for pre-existing conditions before your enrollment start date may differ upon the insurance carrier and state/federal law.

Don't sue us! Fractured Atlas is not an insurance company. We're also not lawyers, brokers, agents, doctors, or anyone else qualified to give professional advice. We try our best to be helpful, but take anything written here with a handful of salt.