Health Care Benefit Plan

What is Covered?

Medical Treatments

• Covered: Participants and their children, under the age of 18, are covered for (in-patient) hospitalization costs, physical examinations, treatments from accidental injury and maternity costs. Participants are also covered for operations, hospital visits, and consultations rendered on an out-patient basis.

• NOT Covered: Health care coverage does not extend to nursing home care, dental care, orthopedic devices, or prescription drugs outside hospital use. Telephone and television charges are not covered, as well as any medical expenses incurred prior to completion of the enrollment waiting period.

Waiting Period:
In order to qualify for benefits, participants may incur the following waiting periods:

1. New LRFA members who are accepted in to the Health Care Benefit Plan may receive benefits for medical expenses arising no sooner than three (3) months from the date of admission into a plan.

2. LRFA members of one (1) year or more who are accepted into a Health Care Benefit Plan may begin receiving benefits for medical care occurring after one (1) month from the date of admittance into the plan.

3. Plan participants may receive benefits without a waiting period for treatment of accidental injuries sustained after admission into the plan, provided that treatment begins within 21 days of occurrence.

4. With the birth of a child, the mother may receive benefits only if she has been enrolled in a certain health care plan for at least nine (9) continuous months prior to the time of delivery.

These pages are designed to provide general descriptions of our benefit plans and further restrictions may apply or may have changed. For further information, please contact the LRFA office or refer to specific plan Regulations.