Pre-existing Condition for Accident & Sickness Hospital Cash Insurance Benefits:
The insurance does not pay any benefits for Sickness caused by or resulting from a Covered Person's Pre-existing Condition if the Sickness occurs during the first 12 months that a Covered Person is insured under this policy. Pre-existing Condition means an Accident or Sickness for which, in the 6 months before the Covered Person becomes insured under the policy, medical advice, treatment or care was sought by a Covered Person, or was recommended by, prescribed by or received from a Physician.
WHAT DOES THAT MEAN FOR ME AT CLAIM TIME?
This means that if you were admitted to the hospital or ICU or went to the ER or Physician's office or had a Surgical procedure related to a Pre-existing Condition as defined above, those benefits may not be payable during the first 12 months of your plan.
This Policy provides limited benefits on a fixed indemnity basis. It does not constitute comprehensive health insurance coverage (often referred to as "major medical coverage") and does not satisfy a person's individual obligation to secure the requirement of minimum essential coverage under the Affordable Care Act (ACA). For more information about the ACA, please refer to http://www.HealthCare.gov.
Read the brochure and the group insurance certificates carefully. This is a brief description of the important features of this insurance product. It is not an insurance contract. Insurance benefits are underwritten by Federal Insurance Company. Coverage may not be available in all states or certain terms may be different where required by state law. Chubb NA is the U.S. -based operating division of the Chubb Group of Companies, headed by Chubb, Ltd. (NYSE: CB). Insurance products and services are provided by Chubb Insurance underwriting companies and not by the parent company itself.
Important: Healthy America and United Business Association (UBA) are not authorized to pay claims or be involved in the claims decision process. All claim decisions are made by the TPA claims administrator and the insurance carrier.