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How Nevada State Laws and Federal Laws May Not Protect You

Although you have the right to obtain COBRA coverage when you change jobs, you are not entitled to take your old policy’s benefits with you. COBRA protects you from the exclusion periods and application processing time in between insurance, but other than that you cannot copy and paste old policies on new ones.

The new plan may have different benefits even if it is called the same plan or supposedly covering the same needs. You may also not be able to use the same doctors you could before, as networks vary and insurance coverage is different from doctor to doctor. Most healthcare providers accept certain health insurance and not others, so be aware of this if you like one doctor especially and want to stay with that physician.

There is a rule that says health insurance cannot be determined by health status of any employees or group members, not by the insurance provider or by the insurance issuer. However, employers are not required to provide health benefits. So if you lose your job and are looking for another, you will probably want to inquire about the benefits before accepting the new job. There are no federal regulations that enforce group health coverage.

For the same reason that many people use COBRA and continuation rights when changing jobs, there are insurance providers that will initiate waiting periods on new employees or group members. This means that even if you have accepted and started a new job and have applied for the group health coverage, it may not start covering you that day or that week. There are no limits on insurance providers in regards to waiting periods. This usually only applied to group coverage and HMO’s.

Although there cannot be denial of coverage on group plans with members who have pre-existing conditions, there can be changes in coverage and even an exclusion period for coverage of treatment that was not offered in your old group plan. If your old plan did not cover prescriptions for your illness, your new one may cover those prescriptions but may make you wait for up to one year to receive these benefits. This also goes with other treatment your old plan did not cover that your new plan does.

If you have a break in coverage for more than 63 days, you may have an exclusion period applied to your coverage even if you eventually find a new group plan. Remember that COBRA is limited time coverage.

Keep in mind that there are always exceptions to the rules. If you are a member of the Washoe County School District or the Cities of Sparks and Reno, not all of the group plan protections will cover you.

For more information about specific exceptions or details of health insurance laws, you will need to contact the Nevada Department of Human Services or State Commissioner.