Pre-Existing Condition Limitation Definition:
Pre-Existing Condition(s) means a condition for which medical advice, Diagnosis, care or treatment was recommended or received within the 12 month period before the Covered Person's Rider Effective Date. A Pre-Existing Condition is excluded from coverage for period of 12 months following the Covered Person's Rider Effective Date.
What does that mean at time of claim?
If the Covered Person is Diagnosed with a condition listed in the Certificate of Insurance and Rider that is determined to be a Pre-Existing Condition, no benefit amount is payable for that listed condition.
Read the Certificate(s) of Insurance of your product carefully. This is a brief description of various group association insurance products and is not an insurance contract, nor part of the Certificate of Insurance and is subject to the terms, conditions, limitations, and exclusions of the Certificate(s) of Insurance and/or Certificate Riders. Coverage may vary or may not be available in all states. You'll find complete coverage details in the Certificate(s) of Insurance and/or Certificate Riders. Critical Illness Insurance benefit is underwritten by United States Fire Insurance Company. Coverage for Critical Illness Insurance Benefit ends at age 65 and is available to Covered Member and Eligible Spouse only. The insurance described in this document provides limited benefits. Limited benefit plans are insurance products with reduced benefits intended to help supplement comprehensive health insurance plans. The insurance coverage is not an alternative to comprehensive coverage. It does not provide major medical or comprehensive medical coverage and is not designed to replace major medical insurance. Further, the insurance coverage is not minimum essential benefits as set forth under the Patient Protection and Affordable Care Act.
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.