NJ FamilyCare and pre-existing conditions

[myw7]

What is the name of your state (only U.S. law)? New Jersey

My parents lost their insurance 1-2 years ago and did not have any coverage during that time, but they applied for NJ FamilyCare in early February this year. They got an approval letter on March 21st with April 1st as the enrollment date and they are enrolled in Plan D. Unfortunately, my father had a severe stroke on March 18th. We did not expect the health insurance to cover any hospital bills up until April 1st, but we thought that it would pick up the inpatient rehabilitation and medication after the enrollment period began. However, that does not seem to be the case. Currently the insurance representative my mother has talked to claims that they cannot cover anything related to the stroke because it is a pre-existing condition.

Is this legal? I have been unable to find anything on the NJ FamilyCare website or in the AmeriChoice Member Handbook regarding pre-existing condition exclusion periods. The only thing I have found on the internet that even mentions NJ FamilyCare and pre-existing conditions together is a New Jersey Health Care Options Matrix Guide from The Foundation for Health Coverage Education ([url]http://www.coverageforall.org/pdf/matrix/NJ_Matrix.pdf[/url]). All it says is "Pre-Existing Health Conditions Covered" but I am not sure what situation that applies to.

I am not very familiar with insurance law (which is why I am here asking questions) but my understanding was that the pre-existing condition exclusion policy was to prevent people from applying for health insurance after they became ill. This is not the case in our family because the application for the insurance was sent out before there was any indication of a stroke. However, I doubt this will sway anybody in the insurance claims department.

Please, any help or advice offered would be appreciated. Thank you very much

[cbg]

A pre-existing condition can be applied to any condition for which treatment has been received in the lookback period (which is usually between six months and a year, depending on the state) prior to the date the insurance began, not the date the insurance was applied for.

[myw7]

That's what I was reading. This really sucks. Especially since applicants were only eligible for NJ FamilyCare "if they have been uninsured for a period of three months or more". So it seems that one must be off of health insurance for a long enough period of time that any credit towards the pre-existing exclusion period from prior coverage expires in order to be considered for this program. Am I understanding this correctly?