Will Humana health insurance pay for my medical expenses despite my pre-existing condition? I told them it only got worse during the coverage. I purchased my health insurance plan at the beginning of the year. I cannot afford to pay $3,000 out of pocket.
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Have you checked your Humana health policy regarding pre-existing conditions? If you just received your Humana health insurance at the beginning of the year, it means you still don’t have a creditable coverage. Even other insurance companies may have questions about paying for the $3,000 cost of medications for your pre-existing condition. Your doctor will receive a request for a certification but there is still no guarantee that you can get the claim.. If you have consulted with the doctor and have gotten treatment less than 24 months before the enrollment in the health plan, your claim may be denied. Your claim will depend on what your plan says even if your pre-existing condition got worse during the coverage. However, there are plans that only deny coverage for a certain period or what they call the pre-existing exclusion period. Some job-based coverage has 12 months pre-existing condition exclusion period or 18 months for individuals who enrolled late in the plan. There is federal law governing pre-existing condition. In general, the insurance company is allowed to check your medical history before signing you up. If you sought medical help or were hospitalized during the six-month period preceding your enrollment, these events will help the insurance company determine the clauses to be included in your plan. But if you received medical care “more than” six months before getting the plan, the federal law defines that as not pre-existing. You must have disclosed the information about your pre-existing condition to your health agent before you signed up for the plan. Ask the company to explain the clauses to you and if your condition can be an exception. Answer by general public — June 19.2009 @ 4:14pm
