Accident & Health FundamentalsQuestion 7 of 315
A 45-year-old applicant with a history of diabetes applies for an individual ACA-compliant health policy through Covered California. The insurer may:
a.Not deny coverage or charge a higher premium based on the diabetes
b.Exclude diabetes-related claims for the first 12 months
c.Charge a 50% surcharge for the pre-existing condition
d.Deny the application outright
Explanation
Since 2014, the ACA has prohibited individual and group market insurers from denying coverage, charging higher premiums, or excluding benefits based on any pre-existing condition. Permitted rating factors are limited to age, geography, family size, and tobacco use.
Law Reference: 42 U.S.C. §300gg-3 (ACA pre-existing conditions)Practice all 315 questions free — no signup required.
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