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Humana One Pre-Existing Condition Coverage Limitations - Illinois and Indiana

Humana One HSA-Compatible Health Plans
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Pre-Existing Condition Exclusion

The Humana One definition of a pre-existing condition varies a little, depending on whether you're an Illinois or Indiana resident:

Definition - Illinois

A pre-existing condition is a sickness or bodily injury which was treated within the 24-month period prior to the covered person's effective date of coverage or which produced symptoms that would cause an ordinarily prudent person to seek medical diagnosis or treatment within the 12-month period prior to the covered person's effective date of coverage.

Definition - Indiana

A pre-existing condition is a sickness or injury which was diagnosed or treated, or which produced signs or symptoms that would cause an ordinarily prudent person to seek treatment, during the 12-month period before the covered person’s effective date of coverage.

Length of Benefit Exclusion

Benefits for pre-existing conditions are not payable until the covered person's Humana One coverage has been in force for 12 consecutive months.

Exclusion Waived for
Disclosed Conditions

Humana will waive the pre-existing condition limitation for those conditions disclosed on the application, provided benefits relating to those conditions are not already excluded under the policy.  Conditions specifically excluded by rider are never covered.

Medical Condition-Specific Waivers

If you have a condition, illness, or injury that can be identified as one that does not necessarily affect your overall good health but could affect the risk balance of all insureds, Humana may waive that condition from coverage.  This means that expenses for treatment of that condition or any other condition related to it will not be covered for a specified period of time.

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