In order to claim under this benefit, the member’s condition must be one of the listed chronic conditions; and must meet a set of defined criteria to qualify for the benefit (i.e. clinical entry criteria).
In other words, just because a member has one of the conditions listed, this does not mean that we will cover the expenses out of the Chronic Disease Benefit. The condition must also meet a set of defined criteria. Your employees should contact Fedhealth for more information in this regard.