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Information about all aspects of finances affected by a serious health condition. Includes income sources such as work, investments, and private and government disability programs, and expenses such as medical bills, and how to deal with financial problems.
Information about all aspects of health care from choosing a doctor and treatment, staying safe in a hospital, to end of life care. Includes how to obtain, choose and maximize health insurance policies.
Answers to your practical questions such as how to travel safely despite your health condition, how to avoid getting infected by a pet, and what to say or not say to an insurance company.


HIPAA provides a variety of protections for health care consumers which were a break-through for working people with a health condition. A general description of each of the protections follows. Information about each protection is in other sections of this article.

As you read about the protections, keep in mind that because of the Affordable Care Act (sometimes referred to as "Obamacare"), the provisions which eliminated job lock for people with a health condition or health history are no longer as important to your life as they once were. Under the Affordable Care Act, you cannot be denied health insurance because of your current or historic health condition.

Employer group coverage: Guarantee of coverage; right to convert

  • HIPAA applies to all employers with two or more employees which offer health insurance to people in a position similar to yours.
  • HIPAA does not guarantee that an employer will offer health insurance in general, or with respect to your job. However, if you become eligible for group health insurance because of your job, you cannot be refused coverage because of a medical condition or medical history.
  • HIPAA guarantees the right to convert your employer based health insurance to individual coverage if the group coverage ends (including at the end of COBRA). For information, click here.

Job Lock (preventing employees from moving from one job to another because of fear of losing health insurance due to an existing health condition)

HIPAA protects against job lock in two ways:

  • Limitation on amount of time an employee is not covered by health insurance
    • HIPAA limits the amount of time an employer may postpone coverage for a pre-existeing health conditon to 12 months if you sign up for the group coverage as soon as you are eligible.If you delay enrolling, the employer can impose a waiting period of up to 18 months.
  • If there is no more than a 62 day gap between coverages, you can offset the number of months you previously had creditable health insurance against the new pre-existing condition exclusion period.
  • By providing a credit for existing "Creditable Coverage" against the period of time during which pre-existing conditions are not covered under a new employer's coverage. Click on the following links for information about: Creditable health insurance (what it is; how to prove; how to get a certificate etc.)  Pre-existing health condition
  • During the waiting period, any other health claims you have will be covered.
  • NOTE: 

Individual health coverage cannot be cancelled due to health conditions

  • HIPAA provides that your individual health insurance cannot be cancelled because you become ill or because of your health status. Still, keep in mind that your health coverage can be canceled if you: do not pay the premiums. move out of the area served by your health plan and/or commit fraud - such as lying on an application.

Privacy About Medical Information; Your Right To See And Copy Medical Records

  • HIPAA provides a minimum national standard of privacy with respect to your medical information. HIPAA also gives you a right to see and copy your medical records. To learn more, click here.


  • HIPAA is enforced by the government, not by individuals. HIPAA authorizes Health and Human Services (HHS) or the U.S. Department Of Justice to enforce the law. For information about filing a complaint with the federal government, click here offsite link.

If Your Group Health Insurance or COBRA Ends, Right To Convert


To be federally eligible for purposes of HIPAA, you must meet all of the following:

  • You must have had 18 months of "continuous creditable coverage," at least the last day of which was under a group health plan. "Continuous creditable coverage" means that there is no break in coverage of 63 or more consecutive days under any of the following health insurance plans:
    • A group health plan
    • An individual health plan
    • Medicare
    • Federal Employees Health Benefits Program (FEHB)
    • Indian Health Service
    • Peace Corps
    • COBRA Continuation Coverage
    • A state health insurance risk pool
  • You must have used up any COBRA or state continuation coverage for which you were eligible.
  • You must not be eligible for Medicare, Medicaid, or another group health plan.
  • You must not have health insurance.
  • You must apply for the health insurance for which you are federally eligible within 63 days of losing your prior coverage.

Your federally eligible status ends as soon as you enroll in an individual health plan because the last day of your continuous health coverage must have been in a group plan. You can become federally eligible again by rejoining a group health plan.

For Example: Henry continued on his former employer's COBRA plan for the full 18 months. After that, he exercised his rights as federally eligible under HIPAA to purchase an individual HMO health policy. However, twelve months later, he moved to Georgia which his HMO does not serve so he lost his individual coverage. He has no federal eligibility to get another health plan, because his last health coverage was individual. If Henry goes to work and gets the employer's group coverage, he will again become federally eligible if he leaves that employer, or when COBRA coverage ends.

Certificate of Creditable Coverage

When group health insurance coverage ends, the administrator or insurance company is required to give you a statement which includes the dates your coverage began and ended.

If the company doesn't send the certificate, you're entitled to request it at any time up to 24 months after coverage under the plan ends. See Certificate of Creditable Coverage if you want more information about this Certificate.

The Policy To Which You Can Convert

Once you are eligible for the HIPAA right to convert health insurance regardless of your health condition, the question of what coverage is available depends on what state you live in.

HIPAA requires that each state have at least one insurance plan to which people can convert, but doesn't specify which one. To learn about the guarantee issue policies available in your state, see the website of the Disability Rights Legal Center by clicking here.

No matter what state you live in, when you convert from group health insurance, there will not be a waiting period for pre-existing conditions. Keep in mind that to take advantage of this guaranteed right to individual health insurance, the individual plan must start within 63 days of the termination of the group coverage.

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HIPAA And Medical Information: Right of Privacy; Right To Copy Your Records

HIPAA sets a national standard for accessing and handling medical information. State laws can give you more rights, but cannot give you less rights.

Right To Privacy

  • Medical information which identifies you cannot be disclosed without your authorization. Exceptions are made for treatment, payment or operations, as well as business associates of your health care provider or health plan.
  • You must be given a notice of privacy practices about how your medical information will be used and disclosed.
  • For addional information about HIPAA And The Privacy Of Your Medical Record, click here.

Right To See And Copy Your Medical Record

  • HIPAA sets a national standard for accessing medical information. State laws can give you more rights, but cannot give you less rights.
  • HIPAA guarantees you the right to see, copy and request changes to your medical record. Your medical record includes your doctor's notes in addition to test and other results.
  • While you can be charged to copy all or part of your records, HIPAA sets a limit on the fees.
  • To learn the legal limitations on what you can be charged to copy medical records in a particular state, as well as how to request a copy, see: offsite link