Optional Pregnancy Benefit

Standard coverage under the Humana One traditional PPO plan includes coverage for complications of pregnancy, but excludes benefits for routine maternity.

However, routine maternity coverage IS available as an option.  An additional charge is required.

No Waiting Period for Indiana Residents

For Indiana residents who choose the optional maternity benefit, there is no waiting period for pregnancy benefits.  In other words, there is full maternity benefits as of the first day of Humana One coverage.

For Indiana residents, we view this as a uniquely attractive benefit.

12-Month Waiting Period in Illinois

For Illinois residents, Humana One routine pregnancy benefits are subject to a one-year waiting period.  You have to be covered under the Humana One health plan for 12 consecutive months before any routine maternity benefits are payable.

Additional Deductible

Under the Humana One pregnancy option, network services for routine pregnancy are subject to a $500 deductible.  Then the plan pays a 60% benefit.  If the care is delivered by a non-network provider, the deductible is $1000 and coinsurance benefit is 50%.

No Out-of-Pocket Expense Cap

Under Humana One, benefits under the routine maternity option are not subject to an out-of-pocket limit.  However, routine maternity charges are, by their nature, limited and predictable, so this benefit limitation is not significant.

When a pregnancy is unusually expensive, it's typically a result of complications, which are covered under the standard Humana One policy, subject to a $2000 coinsurance out-of-pocket limit after satisfaction of the standard plan deductible.

Not Available to Expectant Parents

Humana One health insurance coverage is not available to a person who is currently pregnant or is currently an expectant parent.