Frequently Asked Questions  >  NJ Eligibility and Pre-Existing Condition Limitations


NJ Eligibility and Pre-Existing Condition Limitations
  1. Will pre-existing health conditions be covered?





  1. Will pre-existing health conditions be covered?


    There is a 12 month pre-existing exclusion limitation for NJ Individual plans; however, if you purchase a plan within 31 days of your last plan, the time satisfied towards the 12 months will be credited. If you had 18 months of prior coverage and at least the last month was group coverage, you may have up to a 63 day break in coverage and there will be no pre-existing limitation.

    A pregnancy which exists on the date coverage begins is a pre-existing condition, and will be subject to the exclusion (i.e. not covered), unless any lapse of coverage was less than 31 days and the total number of months a person had creditable coverage is at least 12 months. However, certain complications of pregnancy will not be excluded from coverage.



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