Waiting Periods for Pre-Existing Conditions
Subscribers and dependents must satisfy a 12-month waiting period for pre-existing conditions under this health benefit plan
. Any waiting period for pre-existing conditions begins on the effective date of this health benefit plan. During a waiting period for pre-existing conditions, neither you nor your dependents will receive benefits for conditions for which medical advice, diagnosis, care or treatment was recommended or received within the 12 months immediately preceding the effective date of this health benefit plan. However, provided there was no significant break in coverage, a waiting period for pre-existing conditions will not apply to any condition first identified, treated and covered under prior creditable coverage. Medical records may be ordered to make this determination. Genetic information [variable] is never treated as a pre-existing condition.
For purposes of determining the specifics around any waiting period for pre-existing conditions, a significant break in coverage is 63 or more consecutive days before your application receipt date, during which you have no proof of creditable coverage. The waiting period for pre-existing conditions will be reduced by the number of days you or your dependents had prior creditable coverage, so long as there was no significant break in coverage.
The information in this article is from the 2011 Product Guidelines for Blue Advantage and Blue Options HSA plans from Blue Cross Blue Shield of NC.
For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.
Tags: BCBSNC, Blue Cross Blue Shield, Blue Cross Health Insurance, pre-existing conditions