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Employee Health Care Plan – Pre-existing Conditions

A Pre-existing Condition is defined as a physical or mental condition, except for pregnancy, whether or not diagnosed or misdiagnosed, which within the six-month period before your enrollment date, (a) you incurred expenses, received medical treatment, services or advice, underwent diagnostic procedures, took prescribed drugs or medicine, or consulted a physician or other licensed medical professional; or (b) was discovered or suspected as a result of any medical examination, including a routine medical examination.

  • The pre-existing condition waiting period is 6 months for new enrollees and 18 months for late enrollees*.
  • Employees receive credit toward the pre-existing condition waiting period for eligible creditable coverage that was in effect within 63 days of the date they began working in a benefit-eligible position.

*A late enrollee is anyone who waived coverage (did not enroll) in the University Health Care Plan when they were first eligible and then enrolled at a later date, either during Open Enrollment or after a status change event.


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