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Core Health hospitalization benefits

TA | November 17, 2008

Q: The Core Health Insurance plan details say: "Benefits under Hospital, ICU/CCU, Surgery or Anesthesia are not payable for any pre-existing condition for the first 12-months following an insured's effective date." Okay, but "benefits under hospital" is a pretty vague statement. If you have outpatient surgery performed at a hospital, an MRI performed at a hospital, or some other type of test or lab work performed at a hospital on an outpatient basis, is that considered "benefits under hospital" just because those things are physically done at a hospital? Or does "benefits under hospital" mean that only INPATIENT hospital services for a pre-existing condition aren't covered?

A: Outpatient surgery is considered a hospital service under the policy subject to the waiting period for new policies. Lab tests are covered under a separate policy provision regardless of where performed and are not subject to the waiting period. More information is available in the article "Review of Core Health Insurance".


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