- Any pre-existing conditions if not stable for three months (rate category A) or six months (rate category B and C) before the effective date of your insurance
- Your heart condition if any heart condition was not stable or required any form of nitroglycerine for the relief of angina pain during the stability period for your rate category
- Your lung condition if any lung condition was not stable or required treatment with oxygen or Prednisone during the stability period for your rate category
Pre-existing condition means a medical condition that existed before your effective date.
Medical condition means sickness, injury, disease or symptom; or complication of pregnancy within the first thirty-one (31) weeks of pregnancy.
Stable medical condition means that all of the following apply:
- There have not been any new symptom(s); and
- Existing symptom(s) have not become more frequent or severe; and
- A physician has not determined that the medical condition has become worse; and
- No test findings have shown that the medical condition may be getting worse; and
- A physician has not provided, prescribed or recommended any new medication, or any change in medication; and
- A physician has not provided, prescribed or recommended any investigative testing, new treatment or any change in treatment; and
- There has been no admission to a hospital or referral to a specialty clinic or specialist; and
- A physician has not advised referral to a specialist or further testing, and there has been no testing for which the results have not yet been received.
Change in medication means the medication dosage, frequency or type has been reduced, increased or stopped, and/or new medication(s) has (have) been prescribed. Exceptions: the routine adjustment of Coumadin, Warfarin or insulin (as long as they are not newly prescribed or stopped) and there has been no change in your medical condition; and a change from a brand name medication to a generic brand medication of the same dosage.
Conditions, limitations and exclusions apply. See policy for details