According to Health Care Finance Administration (HCFA), the Health Insurance Portability and Accountability Act (HIPPA) of 1996 protects you from insurance discrimination based on you or your family's known past or present health status. This means that legally, insurers are not permitted to change your coverage because you had genetic testing performed -- the results of your genetic testing are considered to be part of your present health status.
However, employers can establish limits or benefit restrictions under a group health plan, if those limits and restrictions apply to all individuals in your situation. Employers also can choose to charge a higher premium or request a larger contribution for individuals in similar situations. If, after submitting a claim for a genetic test, you find that your company's benefits package suddenly changes to exclude benefits associated with breast cancer, you may have reason to file a discrimination suit against your company or your insurer. However, if that exclusion is made before you had the test and the exclusion is a company-wide provision, meaning that it is applicable to all employees in the company, you have no grounds to file a complaint.
If you are not in a group health plan and you meet HIPPA eligibility requirements, you cannot be denied individual health coverage. However, the health insurance choices available to you may vary, depending on the state in which you live.
If you are not an eligible individual, state law rather than HIPPA will determine whether you can be denied coverage. Depending on your state's laws, insurers and HMOs offering individual health coverage may be able to deny coverage based on your health status. Federal laws other than HIPAA, and some state laws may ensure that certain people who have lost group health coverage are guaranteed access to health coverage, at least temporarily, regardless of their health status.
|