Inform Article

Children's Pre-Existing Conditions under the Affordable Care Act

07.12.2011
Posted by Nicole Stroud
Children's Pre-Existing Conditions under the Affordable Care Act picture

Prepared By: Leadership Palm Beach County Class of 2011 in cooperation with Palm Beach County Medical Society

Summary of key provisions in the Affordable Care Act of 2010: Children's Pre-Existing Conditions

Under the Affordable Care Act, health plans cannot limit or deny benefits or deny coverage for a child younger than age 19 because the child has a "pre-existing condition" - that is, a health problem that developed before the child applied to join the plan.

What This Means for You:

Until recently, plans could refuse to accept anyone because of a pre-existing health condition, or they could limit benefits for that condition. Under the new law, health plans that cover children can no longer exclude, limit, or deny coverage to your child under age 19 solely based on a health problem or disability that your child developed before you applied for coverage. This new rule applies to all job-related health plans as well as individual health insurance policies issued after March 23, 2010. The rule will affect your plan as soon as it begins a "plan year" or "policy year" on or after September 23, 2010.

Some Important Details:

  • This rule applies whether or not your child's health problem or disability was discovered or treated before you applied for coverage.

  • The new rule doesn't apply to "grandfathered" individual health insurance policies. A grandfathered individual health insurance policy is a policy that you bought for yourself or your family (and is not a job-related health plan) on or before March 23, 2010 (the date that the new law was passed).

  • These protections will be extended to people of all ages starting in 2014.


Began March 23, 2010.

Extends to people of all ages in 2014.