RCW 48.66.130
Preexisting condition limitations.
(1) On or after January 1, 1996, and notwithstanding any other provision of Title 48 RCW, a medicare supplement policy or certificate shall not exclude or limit benefits for losses incurred more than three months from the effective date of coverage because it involved a preexisting condition.
(2) On or after January 1, 1996, a medicare supplement policy or certificate shall not define a preexisting condition more restrictively than as a condition for which medical advice was given or treatment was recommended by or received from a physician, or other health care provider acting within the scope of his or her license, within three months before the effective date of coverage.
(3) If a medicare supplement insurance policy or certificate contains any limitations with respect to preexisting conditions, such limitations must appear as a separate paragraph of the policy or certificate and be labeled as "Preexisting Condition Limitations."
(4) No exclusion or limitation of preexisting conditions may be applied to policies or certificates replaced in accordance with the provisions of RCW 48.66.045 if the policy or certificate replaced had been in effect for at least three months.
(5) If a medicare supplement policy or certificate replaces another medicare supplement policy or certificate, the replacing issuer shall waive any time periods applicable to preexisting conditions, waiting periods, elimination periods, and probationary periods in the new medicare supplement policy or certificate for similar benefits to the extent such time was spent under the original policy.
(6) If a medicare supplement policy or certificate replaces another medicare supplement policy or certificate which has been in effect for at least three months, the replacing policy shall not provide any time period applicable to preexisting conditions, waiting periods, elimination periods, and probationary periods for benefits similar to those contained in the original policy or certificate.
[ 2005 c 41 § 6; 2002 c 300 § 3; 1995 c 85 § 2; 1992 c 138 § 9; 1981 c 153 § 13.]
NOTES:
Intent—2005 c 41: See note following RCW 48.66.025.
Structure Revised Code of Washington
Chapter 48.66 - Medicare Supplemental Health Insurance Act.
48.66.010 - Short title—Intent—Application of chapter.
48.66.025 - Restrictions on issuers—Age of applicants—Preexisting conditions.
48.66.030 - Renewability—Benefit standards—Benefit limitations.
48.66.035 - Commissioner's approval required.
48.66.041 - Minimum standards required by rule—Waiver.
48.66.045 - Mandated coverage for replacement policies—Rates on a community-rated basis.
48.66.050 - Policy or certificate provisions prohibited by rule—Waivers restricted.
48.66.060 - Equal coverage of sickness and accidents.
48.66.070 - Adjustment of benefits and premiums for medicare cost-sharing.
48.66.080 - "Benefit period"—"Medicare benefit period"—Minimum requirements.
48.66.090 - Guaranteed renewable—Exceptions.
48.66.100 - Loss ratio requirements—Mass sales practices of individual policies.
48.66.110 - Disclosure by insurer—Outline of coverage required.
48.66.120 - Return of policy and refund of premium—Notice required—Effect of return.
48.66.130 - Preexisting condition limitations.
48.66.150 - Reporting and recordkeeping, separate data required.
48.66.160 - Federal law supersedes.
48.66.165 - Conformity with federal law—Rules.
48.66.910 - Effective date—1981 c 153.
48.66.920 - Construction—Chapter applicable to state registered domestic partnerships—2009 c 521.