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Health Plan Nondiscrimination

Meaning

Health Plan Nondiscrimination is a legal mandate requiring group health plans to ensure that eligibility, benefits, and premiums are not determined based on an individual’s health status, including medical conditions, claims experience, or genetic information. This principle is codified across multiple federal laws, notably HIPAA and the Affordable Care Act (ACA). In the realm of hormonal health, nondiscrimination ensures that an individual cannot be charged a higher premium or denied coverage for essential endocrine treatments, such as hormone replacement therapy or advanced testing for adrenal fatigue, due to a pre-existing hormonal imbalance. It is a critical safeguard for equitable access to clinical care.