Is pregnancy included in the MCHA six-month pre-existing condition limitation?
A. Yes. The MCHA policy is an individual plan policy, and Minnesota Statute is clear in that a pre-existing condition limitation can be applied to prenatal care services; however, deductibles and coinsurance amounts cannot be applied. The MCHA policy generally does not provide benefits for expenses incurred during the first six months of coverage for treatment of an injury, illness, or other physical or mental condition (including treatment with prescription drugs, provision of prenatal care and maternity related services) if the injury, illness or condition was diagnosed, treated, or evaluated during the 90-day period immediately prior to the effective date. This rule does not apply to newborns or children placed for adoption who added to ones policy as new dependents after the original effective date of coverage.
