Columbia University Health Services

Pre-Existing Conditions
Limitations on coverage of Pre-Existing Conditions will apply to students, and their covered dependents, who elect coverage more than 30 days after the date they become eligible for coverage under the Columbia Student Medical Insurance Plan. For these late applicants, expenses incurred as a result of a pre-existing condition will not be considered covered expenses unless no charges are incurred for treatment of the condition for a period of 6 months while covered under the Columbia Student Medical Insurance Plan.

Special Rules Regarding Pre-Existing Conditions
If a person had alternative insurance coverage which terminated within 63 days prior to the date he or she enrolled (or was enrolled) in the Columbia Student Medical Insurance Plan, then any limitation as to a Pre-Existing Condition under the Columbia Student Medical Insurance Plan will apply for that person only to the extent that such limitation would have applied if he or she had remained covered under the prior Creditable Coverage. Please see definition of Creditable Coverage in the Terms to Know section.

Also, if a person enrolls (or is enrolled) in the Columbia Student Medical Insurance Plan immediately after any applicable probationary period has been served, and that person had Creditable Coverage which terminated within 63 days prior to the first day of such probationary period, then any limitation as to a Pre-Existing Condition will apply for that person only to the extent that such limitation would have applied if he or she had remained covered under the prior Creditable Coverage. The waiting period for Pre-Existing Conditions will have been met if the individual has been continuously insured under the Columbia Student Medical Insurance Plan or another comparable plan for at least 12 consecutive months.

For example, if a student enrolls as a late applicant in the Plan effective October 1, 2005 and seeks treatment for diabetes after that date, treatment would not be covered if the student were diagnosed and/or had treatment between March 31, 2005 and September 30, 2005 of that year.

Covered claims related to the diabetes condition would be covered after October 1, 2006 provided the insured maintains continuous coverage.

Treatment for Pre-Existing Conditions is provided on-campus through Health Services. If additional treatment off-campus is needed for a Pre-Existing Condition, the additional treatment would not be covered until the established waiting period has elapsed. Treatment for a new, covered illness connected with a Pre Existing Condition will be covered, within Policy maximums.

For example, if you have a Pre-Existing Condition of hypertension, but suffer an allergic reaction to drugs prescribed for hypertension after enrollment in the Plan, treatment of the allergic reaction would be covered.

Continuously Insured
A person is considered continuously insured if they were insured under prior Creditable Coverage, including the Columbia Student Medical Insurance Plan, and are now insured under the Columbia Student Medical Insurance Plan. Persons who have remained continuously insured will be covered for conditions first manifesting themselves while continuously insured except as specified in the Pre-Existing Conditions provision.

Previously insured dependents and students must re-enroll for coverage for the Fall Term by September 30, 2006 and for the Spring Term by February 1, 2007 in order to avoid a break in coverage for conditions that existed in prior Policy Years.

Once a break in continuous coverage occurs, the definition of Injury or Sickness will apply in determining coverage of any condition that existed during the break.