How Does HIPAA Effect You As a Person?

The Health Insurance Portability and Accountability Act, known as HIPAA, was established to provide insurance coverage protections and patient health information confidentiality guidelines. Understanding your rights under HIPAA can help you manage medical and health insurance situations.

Preexisting Conditions

• HIPAA limits the exclusions for preexisting conditions that employers and insurance providers can place on an individual. Specifically, if you have not been treated by a healthcare provider for a specific medical condition during the six months prior to seeking health insurance coverage, you cannot be denied covered based on that medical condition.

Coverage Credit

• HIPAA provides you with credit for "time served" with another insurance provider. If you seek coverage through a new employer or an individual insurance provider, a preexisting condition clause (typically requiring a six month waiting period before you can receive treatment for certain conditions) can be waived. You will need to provide your new insurer a certificate of prior coverage.

Confidentiality

• Healthcare providers and local, state and federal health agencies must always balance a patient's right to medical confidentiality with the need to protect citizens from contagious disease outbreaks or other public health concerns. HIPAA sets standards for a patient's right to confidentiality and guidelines for how and when your medical records can be accessed. Talk with your medical provider about your confidentiality rights.