The Vermont Statutes Online
The Statutes below include the actions of the 2025 session of the General Assembly.
NOTE: The Vermont Statutes Online is an unofficial copy of the Vermont Statutes Annotated that is provided as a convenience.
(Cite as: 8 V.S.A. § 8086)
-
§ 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.)