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UniCare Sound Health Plans - Illinois

 

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Pre-Existing Conditions - Defined

The UniCare Sound health insurance policy defines a pre-existing conditions as:

The existence of symptoms which would cause an ordinarily prudent person to seek diagnosis, care, or treatment within a 12 month period preceding the Effective Date of the coverage of the Insured Person or a condition for which medical advice or treatment was recommended by a Physician or received from a Physician within a 12 month period preceding the Effective date of the coverage of the Insured Person.

Pre-Existing Condition Waiting Period

UniCare will not provide coverage for any pre-existing condition-related services receive on or within twelve months after the effective date of coverage.

Hernia and Varicose Veins

An insured must be covered by a UniCare plan for six consecutive months to be eligible for for benefits concerning all services related to:
  • hernia (except strangulated or incarcerated)
  • varicose veins

This includes, but is not limited to, all tests, consultations, examinations, medications and invasive medical. laboratory or surgical procedures that are related to the evaluation or treatment of the above items.

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, UniCare 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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