How does the Pre-existing Condition limitation work?
All members including dependents are subject to a six-month pre-existing condition limitation. No benefits will be payable for services related to the pre-existing condition during the pre-existing condition limitation time period. After the applicable pre-existing condition limitation time period is satisfied, regular plan coverage provisions apply without any pre-existing condition limitation. The pre-existing condition limitation time period may be offset by coverage the individual had under another plan. To receive credit for coverage under another plan, they will need to provide Presbyterian Insurance Company, Inc. with a Certificate of Creditable Coverage. No creditable coverage shall be considered if, after such creditable coverage, there occurs a continuous 63 day period during all of which the individual was not covered under any creditable coverage.
All members including dependents are subject to a six-month pre-existing condition limitation. No benefits will be payable for services related to the pre-existing condition during the pre-existing condition limitation time period. After the applicable pre-existing condition limitation time period is satisfied, regular plan coverage provisions apply without any pre-existing condition limitation. The pre-existing condition limitation time period may be offset by coverage the individual had under another plan. To receive credit for coverage under another plan, they will need to provide Presbyterian Insurance Company, Inc. with a Certificate of Creditable Coverage.
