Survivorship A to Z -

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In the health insurance arena, eligibility refers to the group of people who are eligible to obtain a particular health insurance coverage. Of course, eligiblity also refers to eligiblity for government or other programs which provide health coverage, such as Medicare and Medicaid.

Eligiblity comes into play with respect to private health insurance policies in two areas: legal prohibitions against discrimination in a group setting, and eligiblity for a particular individaul health insurance policy.

With respect to prohibitions against discrimination in a group setting, the most common area relevant to people with a life changing condition.is prohibition against excluding people with a serious health condition from group coverage. Such a prohibition is found in federal laws such as Americans With Disabilities Act and HIPAA, as well as the laws of various states.

Eligibility for a particular individual policy generally depends on the standards set by the insurer with respect to the particular policy.

Eligibility for Medicare, Medicaid and other government programs depends on the specifics of the particular program.