{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3514.1.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3514.1.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3514.1.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3514.1.html"}],"law_id":77154,"edition_id":1,"section_id":77154,"structure_id":13349,"section_number":"38.2-3514.1","catch_line":"Preexisting conditions provisions","history":"1995, c. 522; 1997, c. 291; 1999, c. 1004.","full_text":"A\n\nIn determining whether a preexisting conditions provision applies to an insured, all coverage shall credit the time the person was covered under previous individual or group policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis if the previous coverage was continuous to a date not more than thirty days prior to the effective date of the new coverage, exclusive of any applicable waiting period under such coverage.B\n\nAs used herein, a “preexisting conditions provision” means a policy provision that limits, denies, or excludes coverage for charges or expenses incurred during a twelve-month period following the insured’s effective date of coverage, for a condition that, during a twelve-month period immediately preceding the effective date of coverage, had manifested itself in such a manner as would cause an ordinarily prudent person to seek diagnosis, care, or treatment, or for which medical advice, diagnosis, care, or treatment was recommended or received within twelve months immediately preceding the effective date of coverage or as to pregnancy existing on the effective date of coverage.C\n\nThis section shall not apply to the following insurance policies or contracts:1\n\nShort-term travel;2\n\nAccident-only;3\n\nLimited or specified disease contracts;4\n\nLong-term care insurance;5\n\nShort-term nonrenewable policies or contracts of not more than six months’ duration which are subject to no medical underwriting or minimal underwriting;6\n\nPolicies subject to Article 4.1 (§ 38.2-3430.1 et seq.) of Chapter 34 of this title;7\n\nPolicies or contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under state or federal government plans; and8\n\nDisability income.","order_by":null,"text":{"0":{"id":276772,"text":"In determining whether a preexisting conditions provision applies to an insured, all coverage shall credit the time the person was covered under previous individual or group policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis if the previous coverage was continuous to a date not more than thirty days prior to the effective date of the new coverage, exclusive of any applicable waiting period under such coverage.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":276773,"text":"As used herein, a “preexisting conditions provision” means a policy provision that limits, denies, or excludes coverage for charges or expenses incurred during a twelve-month period following the insured’s effective date of coverage, for a condition that, during a twelve-month period immediately preceding the effective date of coverage, had manifested itself in such a manner as would cause an ordinarily prudent person to seek diagnosis, care, or treatment, or for which medical advice, diagnosis, care, or treatment was recommended or received within twelve months immediately preceding the effective date of coverage or as to pregnancy existing on the effective date of coverage.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":276774,"text":"This section shall not apply to the following insurance policies or contracts:","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"C1"},"3":{"id":276775,"text":"Short-term travel;","type":"section","prefixes":["C","1"],"prefix":"1","entire_prefix":"C1","prefix_anchor":"C1","level":2,"prior_prefix":"C","next_prefix":"C2"},"4":{"id":276776,"text":"Accident-only;","type":"section","prefixes":["C","2"],"prefix":"2","entire_prefix":"C2","prefix_anchor":"C2","level":2,"prior_prefix":"C1","next_prefix":"C3"},"5":{"id":276777,"text":"Limited or specified disease contracts;","type":"section","prefixes":["C","3"],"prefix":"3","entire_prefix":"C3","prefix_anchor":"C3","level":2,"prior_prefix":"C2","next_prefix":"C4"},"6":{"id":276778,"text":"Long-term care insurance;","type":"section","prefixes":["C","4"],"prefix":"4","entire_prefix":"C4","prefix_anchor":"C4","level":2,"prior_prefix":"C3","next_prefix":"C5"},"7":{"id":276779,"text":"Short-term nonrenewable policies or contracts of not more than six months’ duration which are subject to no medical underwriting or minimal underwriting;","type":"section","prefixes":["C","5"],"prefix":"5","entire_prefix":"C5","prefix_anchor":"C5","level":2,"prior_prefix":"C4","next_prefix":"C6"},"8":{"id":276780,"text":"Policies subject to Article 4.1 (§ 38.2-3430.1 et seq.) of Chapter 34 of this title;","type":"section","prefixes":["C","6"],"prefix":"6","entire_prefix":"C6","prefix_anchor":"C6","level":2,"prior_prefix":"C5","next_prefix":"C7"},"9":{"id":276781,"text":"Policies or contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as Medicare, or any other similar coverage under state or federal government plans; and","type":"section","prefixes":["C","7"],"prefix":"7","entire_prefix":"C7","prefix_anchor":"C7","level":2,"prior_prefix":"C6","next_prefix":"C8"},"10":{"id":276782,"text":"Disability income.","type":"section","prefixes":["C","8"],"prefix":"8","entire_prefix":"C8","prefix_anchor":"C8","level":2,"prior_prefix":"C7"}},"ancestry":[{"id":13349,"edition_id":1,"name":"Individual Accident and Sickness Insurance Policies","identifier":"1","label":"article","depth":3,"order_by":1,"parent_id":13348,"metadata":{},"date_created":"2026-06-26 03:44:41","date_modified":"2026-06-26 03:44:41","permalink":{"id":215643,"object_type":"structure","relational_id":13349,"identifier":"1","token":"38.2\/35\/1","url":"\/38.2\/35\/1\/","edition_id":1,"permalink":0,"preferred":1}},{"id":13348,"edition_id":1,"name":"Accident and Sickness Insurance Policies","identifier":"35","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:44:41","date_modified":"2026-06-26 03:44:41","permalink":{"id":215641,"object_type":"structure","relational_id":13348,"identifier":"35","token":"38.2\/35","url":"\/38.2\/35\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12698,"edition_id":1,"name":"Insurance","identifier":"38.2","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:49","date_modified":"2026-06-26 03:43:49","permalink":{"id":210661,"object_type":"structure","relational_id":12698,"identifier":"38.2","token":"38.2","url":"\/38.2\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":81706,"structure_id":13349,"section_number":"38.2-3500","catch_line":"Form of policy","url":"\/38.2-3500\/","token":"38.2\/35\/1\/38.2-3500","metadata":false},{"id":54330,"structure_id":13349,"section_number":"38.2-3501","catch_line":"Policy forms; powers of Commission","url":"\/38.2-3501\/","token":"38.2\/35\/1\/38.2-3501","metadata":false},{"id":56141,"structure_id":13349,"section_number":"38.2-3502","catch_line":"Notice to be printed on policy; return of policy to insurer","url":"\/38.2-3502\/","token":"38.2\/35\/1\/38.2-3502","metadata":false},{"id":67765,"structure_id":13349,"section_number":"38.2-3503","catch_line":"Required accident and sickness policy provisions","url":"\/38.2-3503\/","token":"38.2\/35\/1\/38.2-3503","metadata":false},{"id":83509,"structure_id":13349,"section_number":"38.2-3504","catch_line":"Other provisions","url":"\/38.2-3504\/","token":"38.2\/35\/1\/38.2-3504","metadata":false},{"id":87251,"structure_id":13349,"section_number":"38.2-3505","catch_line":"Inapplicable or inconsistent provisions","url":"\/38.2-3505\/","token":"38.2\/35\/1\/38.2-3505","metadata":false},{"id":72012,"structure_id":13349,"section_number":"38.2-3506","catch_line":"Order of certain policy provisions","url":"\/38.2-3506\/","token":"38.2\/35\/1\/38.2-3506","metadata":false},{"id":62115,"structure_id":13349,"section_number":"38.2-3507","catch_line":"Third-party ownership","url":"\/38.2-3507\/","token":"38.2\/35\/1\/38.2-3507","metadata":false},{"id":67338,"structure_id":13349,"section_number":"38.2-3508","catch_line":"Requirements of other jurisdictions","url":"\/38.2-3508\/","token":"38.2\/35\/1\/38.2-3508","metadata":false},{"id":71696,"structure_id":13349,"section_number":"38.2-3509","catch_line":"Denial or reduction of benefits because of existence of other like insurance","url":"\/38.2-3509\/","token":"38.2\/35\/1\/38.2-3509","metadata":false},{"id":65637,"structure_id":13349,"section_number":"38.2-3510","catch_line":"Conforming to statute","url":"\/38.2-3510\/","token":"38.2\/35\/1\/38.2-3510","metadata":false},{"id":77787,"structure_id":13349,"section_number":"38.2-3511","catch_line":"Application","url":"\/38.2-3511\/","token":"38.2\/35\/1\/38.2-3511","metadata":false},{"id":78397,"structure_id":13349,"section_number":"38.2-3512","catch_line":"Notice; waiver","url":"\/38.2-3512\/","token":"38.2\/35\/1\/38.2-3512","metadata":false},{"id":65509,"structure_id":13349,"section_number":"38.2-3513","catch_line":"Age limit","url":"\/38.2-3513\/","token":"38.2\/35\/1\/38.2-3513","metadata":false},{"id":72827,"structure_id":13349,"section_number":"38.2-3514","catch_line":"When liability not to be denied because of preexisting disease, physical impairment or defect","url":"\/38.2-3514\/","token":"38.2\/35\/1\/38.2-3514","metadata":false},{"id":77154,"structure_id":13349,"section_number":"38.2-3514.1","catch_line":"Preexisting conditions provisions","url":"\/38.2-3514.1\/","token":"38.2\/35\/1\/38.2-3514.1","metadata":false},{"id":74263,"structure_id":13349,"section_number":"38.2-3514.2","catch_line":"Renewability of coverage","url":"\/38.2-3514.2\/","token":"38.2\/35\/1\/38.2-3514.2","metadata":false},{"id":71909,"structure_id":13349,"section_number":"38.2-3515","catch_line":"Repealed","url":"\/38.2-3515\/","token":"38.2\/35\/1\/38.2-3515","metadata":false}],"previous_section":{"id":72827,"structure_id":13349,"section_number":"38.2-3514","catch_line":"When liability not to be denied because of preexisting disease, physical impairment or defect","url":"\/38.2-3514\/","token":"38.2\/35\/1\/38.2-3514","metadata":false},"next_section":{"id":74263,"structure_id":13349,"section_number":"38.2-3514.2","catch_line":"Renewability of coverage","url":"\/38.2-3514.2\/","token":"38.2\/35\/1\/38.2-3514.2","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-3514.1\/","history_text":"

This law was first created in 1995. The record of its establishment is cataloged in chapter 522<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. It has been modified 2 times. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. Those modifications are as follows: in 1997, chapter 291<\/a>; in 1999, chapter 1004<\/a>.<\/p>","references":[{"id":72434,"section_number":"38.2-3407.11:3","catch_line":"Breast cancer underwriting and preexisting condition restrictions","order_by":null,"url":"\/38.2-3407.11_3\/"},{"id":64580,"section_number":"38.2-3605","catch_line":"Coverage of preexisting conditions; Medicare supplement policies","order_by":null,"url":"\/38.2-3605\/"},{"id":55347,"section_number":"38.2-4214","catch_line":"Application of certain provisions of law","order_by":null,"url":"\/38.2-4214\/"},{"id":67952,"section_number":"38.2-4319","catch_line":"Statutory construction and relationship to other laws","order_by":null,"url":"\/38.2-4319\/"}],"refers_to":[{"id":77688,"section_number":"38.2-3430.1","catch_line":"Application of article","order_by":null,"url":"\/38.2-3430.1\/"}],"permalink":{"id":215705,"object_type":"law","relational_id":77154,"identifier":"38.2-3514.1","token":"38.2\/35\/1\/38.2-3514.1","url":"\/38.2-3514.1\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3514.1\/","token":"38.2\/35\/1\/38.2-3514.1","dublin_core":{"Title":"Preexisting conditions provisions","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3514.1","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> In determining whether a preexisting conditions provision<\/span> applies to an insured, all coverage shall credit the time the person<\/span> was covered under previous individual or group policies providing hospital, medical and surgical or major medical coverage on an expense incurred basis if the previous coverage was continuous to a date not more than thirty days prior to the effective date of the new coverage, exclusive of any applicable waiting period under such coverage. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> As used herein, a “preexisting conditions provision<\/span>” means a policy provision that limits, denies, or excludes coverage for charges or expenses incurred during a twelve-month period following the insured’s effective date of coverage, for a condition that, during a twelve-month period immediately preceding the effective date of coverage, had manifested itself in such a manner as would cause an ordinarily prudent person<\/span> to seek diagnosis, care, or treatment, or for which medical advice, diagnosis, care, or treatment was recommended or received within twelve months immediately preceding the effective date of coverage or as to pregnancy existing on the effective date of coverage. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> This section shall not apply to the following insurance policies<\/span> or contracts<\/span>: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> Short-term travel; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> Accident-only; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> Limited or specified disease contracts<\/span>; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> Long-term care insurance; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

5.<\/span> Short-term nonrenewable policies or contracts<\/span> of not more than six months’ duration which are subject to no medical underwriting or minimal underwriting; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

6.<\/span> Policies subject to Article 4.1 (§ 38.2-3430.1<\/a> et seq.) of Chapter 34 of this title; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

7.<\/span> Policies or contracts<\/span> designed for issuance to persons<\/span> eligible for coverage under Title XVIII of the Social Security Act, known as Medicare<\/span>, or any other similar coverage under state<\/span> or federal government plans; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

8.<\/span> Disability income. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nPREEXISTING CONDITIONS PROVISIONS (\u00a7 38.2-3514.1)\n\nA. In determining whether a preexisting conditions provision applies to an\ninsured, all coverage shall credit the time the person was covered under\nprevious individual or group policies providing hospital, medical and surgical\nor major medical coverage on an expense incurred basis if the previous coverage\nwas continuous to a date not more than thirty days prior to the effective date\nof the new coverage, exclusive of any applicable waiting period under such\ncoverage.\n\nB. As used herein, a “preexisting conditions provision” means a\npolicy provision that limits, denies, or excludes coverage for charges or\nexpenses incurred during a twelve-month period following the insured’s\neffective date of coverage, for a condition that, during a twelve-month period\nimmediately preceding the effective date of coverage, had manifested itself in\nsuch a manner as would cause an ordinarily prudent person to seek diagnosis,\ncare, or treatment, or for which medical advice, diagnosis, care, or treatment\nwas recommended or received within twelve months immediately preceding the\neffective date of coverage or as to pregnancy existing on the effective date of\ncoverage.\n\nC. This section shall not apply to the following insurance policies or\ncontracts:\n\n 1. Short-term travel;\n\n 2. Accident-only;\n\n 3. Limited or specified disease contracts;\n\n 4. Long-term care insurance;\n\n 5. Short-term nonrenewable policies or contracts of not more than six\n months’ duration which are subject to no medical underwriting or minimal\n underwriting;\n\n 6. Policies subject to Article 4.1 (§ 38.2-3430.1 et seq.) of Chapter 34\n of this title;\n\n 7. Policies or contracts designed for issuance to persons eligible for\n coverage under Title XVIII of the Social Security Act, known as Medicare, or\n any other similar coverage under state or federal government plans; and\n\n 8. Disability income.\n\nHISTORY: 1995, c. 522; 1997, c. 291; 1999, c. 1004.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}