Employers and Employees

Pre-Existing Conditions

Healthy NY coverage is subject to a pre-existing condition waiting period.

A pre-existing condition is a condition that you have been diagnosed with or treated for in the last six months before applying for Healthy NY.

For individuals age 19 and older, an insurance company may exclude services for the treatment of pre-existing conditions for up to 12 months. This is called a pre-existing conditions waiting period.

The pre-existing waiting period may be reduced or eliminated if you had prior health insurance coverage and apply for Healthy NY within 63 days of your prior coverage ending. You should contact your insurance company in advance to determine how this waiting period might affect coverage for your existing health conditions.

If you have a pre-existing waiting period, you will still have coverage for all other covered conditions.

Pregnancy is a pre-existing condition in individual contracts. Coverage for pregnancy can be excluded for up to 10 months. Pregnancy is not a pre-existing condition in contracts issued to small businesses or sole proprietors.