Vermont § 8086 - Preexisting conditions

§ 8086. Preexisting conditions

• (a) No long-term care insurance policy or certificate shall use a definition of “preexisting
  condition” that is more restrictive than the following: “preexisting condition” means
  a condition for which medical advice or treatment was recommended by or received from
  a provider of health care services within six months preceding the effective date
  of coverage of an insured person. (b) No long-term care insurance policy or certificate may exclude coverage for a loss
  or confinement that is the result of a preexisting condition, unless such loss or
  confinement begins within six months following the effective date of coverage of an
  insured person. (c) The Commissioner may by rule extend the limitation periods established in subsections
  (a) and (b) of this section as to specific age group categories in specific policy
  forms upon findings that the extension is in the best interests of the public. (d) The definition of “preexisting condition” does not prohibit an insurer from using
  an application form designed to elicit the complete health history of an applicant
  and, on the basis of the answers on that application, from underwriting in accordance
  with that insurer’s established underwriting standards. Unless otherwise provided
  in the policy or certificate, a preexisting condition, regardless of whether it is
  disclosed on the application, need not be covered until the waiting period described
  in subsection (b) of this section expires. No long-term care insurance policy or certificate
  may exclude or use waivers or riders of any kind to exclude, limit, or reduce coverage
  or benefits for specifically named or described preexisting diseases or physical conditions
  beyond the waiting period described in subsection (b) of this section. (Added 2003, No. 124 (Adj. Sess.), § 2, eff. Jan. 1, 2005; amended 2021, No. 105 (Adj. Sess.), § 266, eff. July 1, 2022.)