Can an individual apply for MCHA if he/she has access to employer group coverage?
A. An individual is not eligible for MCHA if they are an employee of a company that offers group coverage. Exceptions: An individual can apply for MCHA if they reach an annual or lifetime benefit limit on the employer group plan. The individual still needs to meet MCHA eligibility criteria via a health rejection or have a presumptive condition. To be eligible for pre-existing condition waiver, the individual must request and meet MCHA pre-existing condition limitation waiver criteria (must apply for MCHA coverage and request the waiver within 90 days of termination of prior plan coverage). For annual benefit limits, MCHA is the primary payer only for that benefit, and secondary for all other benefits. An individual who is on a COBRA plan which he/she cannot afford is eligible for MCHA if he/she has a health related rejection or presumptive condition. To be eligible for a pre-existing condition waiver, the individual must request and meet MCHA pre-existing condition limitation waiver cr
