Tuesday, March 22, 2011

MAXICARE PRE EXISTING NON DREADED AND DREADED CONDITIONS

PRE EXISTING NON DREADED AND DREADED CONDITIONS*



* Applies to Family and Individual Accounts
* These conditions are waived under Maxicare's Corporate Plans



NON DREADED CONDITIONS are as follows, but not limited to:

1. All tumors (benign masses)

2. Anal Fistulae

3. Arthritis

4. Bronchial Asthma

5. Buergher’s Disease

6. Cataract and Glaucoma

7. Cholecystitis, Cholelithiasis, Cholecystolithiasis

and Choledocholithiasis

8. Ear-Nose-Throat conditions requiring surgery

(except cancers which are considered dreaded

conditions)

9. Endometrioses/Dysfunctional Uterine Bleeding

(except if caused by uterine malignancies)

10. Gastric or Duodenal Ulcers

11. Hallux valgus

12. Hemorrhoids

13. Hernias (Congenital Hernia will have coverage

as listed in the Congenital Clause)

14. Migraine

15. Muscular Dystrophies (Duchenne, Becker,

limb girdle, facioscapsulohumeral, myotonic,

oculopharyngeal, distal, and Emery-Dreifuss)

16. Ovarian cysts (except Ovarian Malignancies)

17. Peripheral Nervous System Diseases (except

Multiple Sclerosis and GBS)

18. Tuberculosis (Pulmonary or Extrapulmonary

including Pott’s disease)

19. Uncomplicated Hypertension

20. Urinary Tract Stones/Calculi

21. All complications resulting from above list of

conditions

DREADED CONDITIONS are as follows, but not limited to:

1. All cancers (malignant masses) including

carcinoma in situ and related conditions

2. Blood Dyscrasias (Leukemia, Idiopathic

Thrombocytopenic Purpura, etc)

3. Central Nervous System Infections

(Poliomyelitis/Meningitis/Encephalitis)

4. Cerebrovascular Accident (Stroke, Cerebral,

Cerebellar and all Intracranial Hemorrhage)

and related conditions

5. Chronic Cardiovascular Diseases

(Complicated Hypertension and related

conditions, Aortic Dissection, Abdominal Aortic

Aneurysm, etc.)

6. Chronic Endocrine Disorders and their

complications (Dyslipidemia, Impaired Fasting

Glucose, Impaired Glucose Tolerance,

Obesity, Diabetes Mellitus, Hormonal

Dysfunctions, etc.) excluding surgical

treatment/procedures for obesity-exclusion

7. Chronic Gastrointestinal Diseases (ex. Irritable

Bowel Syndrome, Crohn’s disease)

8. Chronic Genito-urinary Disorders

9. Chronic Kidney Disease/Failure

10. Chronic Liver Parenchymal Diseases (Liver

Cirrhosis, Chronic hepatitis, etc)

11. Chronic Pulmonary Diseases except asthma

(COPD, emphysema, and other chronic lung

disease)

12. Collagen-Vascular/Connective Tissue/

Immunologic Disorders

13. Complications of immuno-compromised state

(except HIV/AIDS)

14. Injuries incurred prior to and up to one year

from date of effectivity and their subsequent

complications

15. Systemic Lupus Erythematosus including

Lupus Nephritis

16. Thyroid conditions (Hypothyroidism,

Hyperthyroidism) except Thyroid masses

17. Valvular Heart Diseases (except for surgeries

for valve correction, ie valvuloplasty)

18. Any illness other than above which would

require Intensive Care Unit Confinement

19. All complications resulting from above list of

conditions



For more information about Maxicare’s Pre Existing Conditions coverage, you may inquire at (02) 6228892; 09178046275 or email us at maxicareinquiry@gmail.com


Thank you.

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