6.
you have received benefits or funds from any settlement, judgment or award resulting from any accident, injury or other circumstance, regardless of the date of the accident or injury or any other circumstance, creating a legal liability for damages due that person by a third party so long as there continues to be benefits or assets remaining from those sources in an amount in excess of $300,000;
7.
your coverage under any health care benefit program as defined in federal criminal law on health care offenses (18 U.S.C. 24), including any public or private plan or contract under which any medical benefit, item, or service is provided, was terminated as a result of any act or practice that constitutes fraud under state or federal law or as a result of an intentional misrepresentation of material fact (within 5 years prior to the date the application for CHIP coverage is received by the Board); or
8.
you knowingly and willfully obtained or attempted to obtain, or fraudulently aided or attempted to aid any other person in obtaining, any coverage or benefits under the Plan to which you or that other person were not entitled.
Eligible persons enrolled in any Section 7 Plan may keep other substantially similar health insurance coverage solely for the purpose of having coverage for a preexisting condition, but only while satisfying the 6-month preexisting conditions limitations under CHIP.
PRESUMPTIVE MEDICAL CONDITIONS APPLICABLE TO THE SECTION 7 POOL
If you have any of the conditions listed below, you may apply for coverage under the Medicare Plan, or the Traditional Plans, without submitting a rejection notice from an insurance company. Instead, submit a letter from your physician describing your condition(s).
AIDS or AIDS Related Complex (ARC)
Arteriosclerosis Obliterans
Angina Pectoris
Chemical Dependency
Cerebrovascular Accident (Stroke)
Coronary Insufficiency
Cirrhosis of the Liver
Cystic Fibrosis
Coronary Occlusion
Hemophilia (Classical)
Friedreich's Ataxia
Huntington's Chorea
Hodgkin's Disease
Kidney Failure Requiring Dialysis
Juvenile Diabetes
Lupus Erythematosus Disseminate
Leukemia
Multiple or Disseminated Sclerosis
Metastatic Cancer
Myasthenia Gravis
Muscular Atrophy or Dystrophy
Paraplegia or Quadriplegia
Myotonia
Poliomyelitis
Parkinson's Disease
Polycystic Kidney
Severe Traumatic Brain Injury
Sickle Cell Anemia
Silicosis Pneumoconiosis (Black Lung)
Syringomyelia
Wilson's Disease
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