Louisiana Administrative Code
Title 37 - INSURANCE Part
Part XIII - Regulations
Chapter 31 - Regulation 53-Basic Health Insurance Plan Pilot Program
Section XIII-3135 - Limitations
Universal Citation: LA Admin Code XIII-3135
Current through Register Vol. 50, No. 9, September 20, 2024
A. Pre-Existing Conditions
1. Until coverage for an insured
enrolled in the LA Health Plan has been in force for 12 consecutive months,
benefits for services to be paid to an authorized carrier shall not be
available for any illness, injury, or other condition for which:
a. the existence of symptoms which would
cause an ordinarily prudent person to seek diagnosis, care, or treatment, or a
condition for which medical advice or treatment was recommended by or received
from a provider of health care services within six months preceding the
effective date of coverage of an individual insured.
2. Maternity benefits are available to an
insured only if the date of conception occurred after the effective date of
coverage under the LA Health Plan.
3. No coverage is available to inpatient
hospital admissions which begin before an insured's effective date.
AUTHORITY NOTE: Promulgated in accordance with R.S. 22:244-247 of the Insurance Code.
Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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