Michigan Laws 500.3406ii – Prohibition on the limitation or exclusion of benefits based on preexisting condition; exceptions
Current as of: 2024 | Check for updates
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Terms Used In Michigan Laws 500.3406ii
- Health insurance policy: means an expense-incurred hospital, medical, or surgical policy, certificate, or contract. See Michigan Laws 500.608
- Insurer: means an individual, corporation, association, partnership, reciprocal exchange, inter-insurer, Lloyds organization, fraternal benefit society, or other legal entity, engaged or attempting to engage in the business of making insurance or surety contracts. See Michigan Laws 500.106
- state: when applied to the different parts of the United States, shall be construed to extend to and include the District of Columbia and the several territories belonging to the United States; and the words "United States" shall be construed to include the district and territories. See Michigan Laws 8.3o
(1) An insurer that delivers, issues for delivery, or renews in this state a health insurance policy shall not limit or exclude coverage for an individual by imposing a preexisting condition exclusion on the individual.
(2) This section does not apply to any of the following:
(b) Insurance coverage that provides benefits for any of the following:
(i) Hospital confinement indemnity.
(ii) Disability income.
(iii) Accident only.
(iv) Long-term care.
(v) Medicare supplemental.
(vi) Limited benefit health.
(vii) Specified disease indemnity.
(viii) Sickness or bodily injury, or death by accident, or both.
(ix) Retiree-only health insurance coverage.
(x) Stand-alone dental plans.
(xi) Stand-alone vision plans.
(xii) Other limited benefit policies.
(3) As used in this section, “preexisting condition exclusion” means a limitation or exclusion of benefits or a denial of coverage based on the fact that a physical or mental condition was present before the effective date of coverage or before the date coverage is denied, whether or not any medical advice, diagnosis, care, or treatment was recommended or received for the condition before the date of coverage or denial of coverage.