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Mississippi Health Insurance Disclosure Requirements

Disclosure Requirements

Whether you are considering enrolling in a traditional insurance plan or managed care plan, you should know your legal rights. Mississippi law requires all insurers to clearly and truthfully disclose the following information in their insurance policies:

• A complete list of items and services that the health care plan pays for.
• A complete list of items and services that the health care plan does not pay for (exclusions and limitations).
• Any situations where the plan may not pay for all of your medical care (exceptions, reductions and limitations).
• How long you may have to wait before the policy covers recent health problems (pre-existing condition exclusion period).
• How the policy may be renewed;
• How the policy may be canceled;
• How the policy may be terminated;

A health plan may refuse to pay for health care services that relate to a health condition you had before joining your health plan. This is called a "pre-existing condition exclusion period". State laws limit how long preexisting condition exclusion periods can be for individual and group health plans.

• If you have a group health plan, a pre-existing condition is a health condition for which medical advice, diagnosis, care or treatment was recommended or received within 6 months of joining a plan. Your plan may refuse to pay for services related to your pre-existing condition for 12 months.
• If you have an individual plan, a pre-existing condition is a health condition for which medical advice, diagnosis, care or treatment was recommended or received within 12 months of joining your plan. Your plan may refuse to pay for services related to your pre-existing condition for 12 months.

You may not have to serve a pre-existing condition exclusion period if you are able to get credit for your health care coverage you had before you joined your new plan. This is called "creditable coverage" and generally applies to group insurance. Ask your plan for more information. Your health insurer must renew your plan if you want to renew it. The insurer cannot cancel your policy unless it pulls out of the Mississippi market entirely, or you commit fraud or abuse or you do not pay your premiums.