Pre-existing conditions – Covered up to a maximum of $25,000 for up to age 69 and up to $20,000 for ages 70 and older.
The deductible for the pre-existing conditions benefit is $1,500 per Injury or Illness (no coinsurance applies).
Pre-existing Condition
An Illness, disease, or other condition of the Insured Person that existed before the Insured Person’s coverage became effective under this insurance.
Eligible Medical Expenses will be reimbursed for a Pre-existing Condition which:
- first manifested prior to the Effective Date; or
- worsened or exhibited symptoms during the Period of Coverage that would have caused a prudent person to seek diagnosis, care, or Treatment including prescribed drugs or medications; or
- was Treated by a Physician.
Conditions and Restrictions
- Treatment for Insured Person’s Pre-existing Condition is not considered Elective in nature; and
- the Insured Person must not be traveling against or in disregard of the recommendations, established Treatment programs, or medical advice of a Physician or other healthcare provider; and
- the Insured Person must not be traveling with the intent or purpose to seek or obtain Treatment for the Pre-existing Condition; and
- the Insured Person must not be traveling during a period of time when the Insured Person is preparing or waiting for, involved in, or undertaking a new, changed or modified Treatment program with respect to the Pre-existing Condition, and is not traveling subsequent to any such new, changed or modified Treatment program having been advised or recommended; and
- the Pre-existing Condition must have been stabilized for at least thirty (30) days prior to the Effective Date without change in Treatment.