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Med+Max tm     Eligibility

Eligible

 

 

Individuals eligible to apply for coverage:

·         Individuals between the ages of 18 and 64 (If applying as a couple , both you and your spouse must be under 65) and dependent children under age 19;

·         Unmarried dependent children with proof of full-time student status between the ages of 19 and 25;

·         Primary applicant must be currently employed at least 15 hours per week. Proof of employment required with application submission;

·         Individuals not in full-time service in the Armed Forces (military);

·         Individuals residing in the US;

·         Individuals not eligible for Medicare;

·         Individuals not receiving disability benefits or workman’s compensation.

Membership

Annual dues are $20.00 per individual, $30.00 per family (regardless of the number of family members). Coverage under the plans described is available only to association members.

Pre-existing Conditions Pre-existing conditions are not covered until the policy has been in effect for more than 12 consecutive months. A pre-existing condition is any condition you have now or had within a 6 month period prior to the effective date of coverage for each covered person. Med+Max is HIPAA compliant. Persons who leave the plan will receive a HIPAA Certificate of Creditable Coverage. Those who enter the plan presenting a valid Certificate of Creditable Coverage will receive credit toward this plan’s pre-existing conditions limitation.
Terms of Coverage Coverage remains in effect as long as you pay the required premium charges on time, and as long as you maintain membership eligibility. Coverage will terminate if you become ineligible due to any of the following circumstances: a) Non-payment of premium and fees, b) Residency requirements, c) For other reasons permissible by law.

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