What happens if a special enrollee has a preexisting condition?

A preexisting condition exclusion cannot apply to a special enrollee for longer than 12 months. As with those who signed up with the plan at the first opportunity, a special enrollee can show creditable coverage and reduce or eliminate the maximum preexisting condition exclusion period. A newborn, an adopted child, or a child placed for adoption cannot have a preexisting condition exclusion, as long as the child is enrolled in health coverage within 30 days of the event, without a subsequent significant break in coverage.

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