New Pre-Existing Condition Form for Medicare Supplement
Effective February 19, 2016, Transamerica Premier will be adding a pre-existing condition exclusion clause, for new business only, for all states except Hawaii, Ohio and Texas. Note that premium rates will not be changing.
If an applicant does not have creditable health coverage at the time of application, Transamerica will not pay claims for six months after the policy’s effective date on pre-existing conditions that occurred in the six months prior to the policy’s effective date . A pre-existing condition is a condition or illness diagnosed or treated before new health care coverage begins.
For example, say “John” was treated for a heart condition on January 1, 2016 and he does not have health coverage. John turns 65 on April 1, 2016 and applies for a Medicare Supplement policy effective April 1. Since he was advised of his heart condition within the six months before his policy effective date, and he did not have prior creditable coverage, his policy will not pay for claims associated with the heart condition until the policy has been active for six months. In John’s case, claims incurred beginning October 1 and later would be eligible for reimbursement.
In most states, applicants will be required to sign an addendum to the application, stating they are aware the policy contains a pre-existing condition exclusion clause. For New Jersey and South Carolina, the exclusion clause will be imbedded within the application, so no addendum will be required. E-Application available! Electronic application is available, go to taagentnetinfo.com and click on the E-App tab!