Medical Expense✓ Verified · outline & fact-checked · Sep 2026Difficulty 2/5
Under federal law, a group health plan's preexisting condition exclusion:
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Answer & full 3-part explanation (select an option above, or peek)
Why A is correct
HIPAA limits how group plans may use preexisting condition exclusions: the exclusion period is capped, and the plan must reduce the exclusion by the individual's prior creditable coverage, such as time under a previous employer plan or COBRA. This portability rule prevents workers from being locked out of coverage when changing jobs. Pregnancy is expressly excluded from preexisting-condition treatment. These limits are part of the legislative-influence material for group medical plans under AH-III.B.4, where HIPAA portability is a named federal law.
Why the other options are wrong
- B) HIPAA imposes a maximum exclusion period that must be offset by creditable coverage, so an unlimited exclusion is unlawful.
- C) Pregnancy cannot be treated as a preexisting condition under HIPAA, regardless of when it began.
- D) Plans must reduce the exclusion by prior creditable coverage; ignoring it violates the portability rules.
Memory hook
HIPAA says: prior coverage counts, and pregnancy is never a preexisting condition.