ARE PRE-EXISTING CONDITIONS COVERED?
If you were enrolled in a plan through Freelancers Union in December 2008 and you begin your FIC coverage in January 2009, the pre-existing condition rule does not apply to you. For new enrollees, most pre-existing conditions aren’t covered until you’ve been on the plan for 12 months. However, any time you spent on a previous insurance plan without a gap in coverage of more than 63 days will be credited toward that 12-month waiting period. (This is known as “creditable coverage.”) Certain conditions, such as the following, are NOT subject to a pre-existing condition limitation: • Pregnancy • Any condition affecting a newborn who has had creditable coverage from within 30 days of birth, provided that there has not been a continuous lapse of more than 63 days between the end of the creditable coverage and the child’s enrollment date in an FIC plan. • Any condition afflicting an adopted child under age 18 who has had creditable coverage from within 30 days of adoption or placement for ado
• Short Term Medical from Fortis Health does not cover pre-existing conditions. A pre-existing condition is defined as one that a covered person has had signs or symptoms of, or medical treatment or advice for, within the last five years (except in certain states where this exclusion may be limited by law). Although pre-existing conditions are not covered, people with certain medical conditions shuld not be offered Short Term Medical coverage. • There are two types of pre-existing conditions – those diagnosed by a doctor and those that produce symptoms, but have not been diagnosed. It needs to be determined if either of these situations are present by asking questions regarding health history.
A. This plan does not provide benefits for pre-existing conditions, work related conditions, and preventive care. If you or a dependent have an existing health condition, you may want to consult with your independent insurance agent prior to applying for or changing health/medical insurance. Insurance fraud is a crime. Any person who, with intent to defraud or knowingly facilitates a fraud against an insurer, submits an application or files a claim containing false, deceptive and/or incomplete information is subject to civil and criminal prosecution.
