FAQ about pre-existing conditions and visitor medical insurance

A: Even though the precise definition of pre-existing conditions vary among various insurance companies and different insurance products, following is a general description:
A pre-existing condition is defined as any injury, illness, sickness, disease, or other physical, medical, mental or nervous condition, disorder or ailment that, with reasonable medical certainty, existed at the time of application or at any time during the X years prior to the effective date of the insurance, whether or not previously manifested or symptomatic, diagnosed, treated, or disclosed prior to the effective date, including any subsequent, chronic or recurring complications or consequences related thereto or arising therefrom.

A: Each insurance company has its own period through which pre-existing conditions are not covered.

For Inbound USA and Inbound Immigrant from Seven Corners, pre-existing conditions in the last 6 months (1 year for age 70+) are NOT covered. Please see brochure for complete information.

For Liaison International from Seven Corners, pre-existing conditions in last 3 years are NOT covered.

For IMG products, pre-existing conditions in last 3 years are NOT covered.

For Travel Insurance products such as Visit USA and WorldMed, pre-existing conditions in last 3 years are NOT covered on medical expenses.

For HCCMIS Atlas products, pre-existing conditions in last 2 years are not covered while in Citizen Secure products, pre-existing conditions are covered same as any other injury or illness if disclosed on the application and not excluded or limited by a rider.

For Global Underwriters(Diplomat) products, pre-existing conditions in last 3 years are NOT covered.

There is no medical examination to be done in the home country prior to arrival or in the United States after arrival. God forbid, if you have some medical problem after arriving in the U.S. and during the period of your insurance coverage, the U.S. doctor where you would go for treatment would be able to determine whether any condition was pre-existing or not. He/she would be able to tell the insurance company whether some treatment might have been received before the insurance coverage started. Generally high blood pressure, diabetes, heart disease, AIDS, pregnancy, cancer, cataract etc. would be considered pre-existing conditions as it would not have occurred overnight after buying the insurance plan. However, there is no fixed rule and it is extremely difficult to tell what would be considered a pre-existing condition and what not to be considered. And we can't list each and every disease or medical condition as there could be potentially millions of combinations.

Even though various number of years are mentioned above for which the pre-existing conditions are not covered, there are some conditions that would not be covered no matter how long ago it happened if you are still taking medications regarding that disease. E.g., if the person had a heart attack 10 years back, he is quite healthy now but if he is taking medications currently for it (even if it is something like one Aspirin a day), the condition would be considered existing even today and would not be covered.

For a limited coverage for pre-existing conditions, up to a limited amount, and in limited circumstances, please look at pre-existing conditions coverage.

A: No. That would be considered as pre-existing condition and hence would NOT be covered. She is in the pre-existing condition duration exclusion period as defined in the policy. It is advisable to carry enough medications from the home country itself before traveling.

A: No. That would be considered a pre-existing conditions and will NOT be covered.

A: NO. That would be considered a pre-existing condition and hence would NOT be covered. He is in the pre-existing condition duration exclusion period as defined in the policy.

A: Even though the insurance will not cover pre-existing conditions, it will cover other conditions that were not pre-existing or unrelated to pre-existing conditions. Insurance companies work on a risk basis, the lower the probability of paying the claims, the less premium they would charge. The higher the probability (generally in case of elders), the higher the premium they would charge. When the insurance companies know for sure that they will have to pay claims after the person buys the insurance, they do not want to insure those conditions because that is a clear loss of money for them, that they know about in advance.

The reason they charge something like $100/month and provide $50,000 coverage is all because the probability of the insurance company having to pay even $100 to you is quite less.

You may be worried about the pre-existing conditions. However, you never know what may happen in the future. And you are insuring yourself against the unexpected. A person may contract any new health problem such as a weather change, allergies in a new place, change of food, cold, fever, flu, diarrhea, pneumonia, food poisoning, snake bits, getting hit by a car, falling in the snow, or any other small or big health problems like a urinary tract infection, heart attack for reasons not related to pre-existing conditions. Therefore, it is very advisable to buy health insurance for visitors to USA.

For a limited coverage for pre-existing conditions, up to a limited amount, and in limited circumstances, please look at pre-existing conditions coverage.

A: For a limited coverage for pre-existing conditions, up to a limited amount, and in limited circumstances, please look at pre-existing conditions coverage.

A: According to most insurance companies' opinion, if he is taking any treatment or any medications currently (including any over the counter medicines), it will be considered a pre-existing condition, and it will not be covered. If not, at the time of the loss, based on attending physician statement(APS), the claim adjuster will determine whether it will be covered or not.

A: That is really not true because of several reasons:
* For most of the relatives that visit you in the USA, you would have sponsored them. For that, you would have provided the I-134 form, Affidavit of Support, mentioning that you would take care of everything. It is possible to catch you based on that. (Some people argue that the I-134 is not legally binding affidavit of support. How is the hospital going to go to the USCIS/Dept. of State/Consulate and get all those documents? All these are very subjective and there is no precise answer for that. It is an open ended discussion.)

* More important than that, it is possible that some people might have got away without paying in earlier times. But once that happens in a given hospital, hospital administrators and their billing department get very smart. They don't want this to happen again. Therefore, many times, I have heard and seen for myself, that the hospitals ask for U.S. residents (who has SSN) to sign as a second guarantor, in case insurance does not pay or pays partially. Otherwise, they won't treat the patient.

And don't think you would be the first patient at a given hospital who did not have this experience or has not heard about this before. There will always be people ahead of you who did that somehow.

While it is true that everywhere in the U.S., it is a law that hospitals can't refuse the treatment in life threatening cases even if you don't have insurance, have no money or are illegal in the U.S. But that is not complete treatment, just the stabilizing treatment, which may be a very small fraction of the treatment you may need. And of course, that does not mean, it is free. They will come after you for that money for the treatment received. They may also be able to put the lien on the sponsor's property (car, house etc.) or get the sponsor's assets frozen until the debt is paid off. And of course, they won't give you full treatment if you can't pay or don't have insurance.

Now that leaves the cases where the hospital does not ask the U.S. resident to sign anything and it is not life threatening. That does not mean you can get away. As long as they have your address, hospitals and collection agencies will get after you and make you pay. I have also heard verbally and read in the discussion boards about the cases where the sponsor (of parents/in-laws or other relatives) was summoned by a sheriff (police) and had to appear in court and agree to pay all the expenses.

A: Unfortunately, there is no solution.
No insurance company will pay for it and when you invite them, you are simply taking the risk and be ready to pay the expenses yourself in case something related to a pre-existing condition occurs.

For a limited coverage for pre-existing conditions, up to a limited amount, and in limited circumstances, please look at pre-existing conditions coverage.

A: Well, that is the decision you need to make whether you really want to invite them to the U.S. in that case. Instead, consider visiting them in their country. This may sound harsh, but sorry, this is the reality.

A: While it is possible that pre-existing medical conditions may cause some new medical conditions. If that happens, then new medical conditions would also be not covered.

However, it is certainly possible that you may get into new medical conditions which are not related to pre-existing conditions. And those will usually be covered.

Insurance company's claims department determines whether some conditions are pre-existing conditions or not based on the attending physician statement, all medical records, and treatment records. Even many insurance companies' claims department have doctors on staff to determine it medically.

For a limited coverage for pre-existing conditions, up to a limited amount, and in limited circumstances, please look at pre-existing conditions coverage.

A: No insurance company will pay to send the person back to the home country if the treatment is not covered by the insurance plan.

There are two terms worth mentioning in this context:
Emergency Medical Evacuation
Repatriation of Remains

A: Complications or emergencies arising out of pre-existing conditions are also considered pre-existing conditions.

For a limited coverage for pre-existing conditions, up to a limited amount, and in limited circumstances, please look at pre-existing conditions coverage.

A: No. That would be considered as pre-existing conditions and not covered.

A: Patriot TRIP Lite is only for trip cancellation and that occurs before you start the trip.

Lets assume your father has a heart disease and is below 70 years of age. You buy Patriot TRIP Lite within 14 days of purchasing the air ticket to come to the USA. Your air ticket costs $1,500. Those tickets are non-refundable.

All insureds are medically able to travel in the date coverage is purchased.

Now, God forbid, lets assume that just a couple of days before coming to the USA, he gets a heart attack because of his pre-existing condition heart disease. Now, he is in the hospital and can't travel to the USA.

What will happen to the $1,500 he paid for his air tickets? Patriot TRIP Lite is the insurance to cover that air ticket cost or cancellation penalties.

Trip cancellation insurance starts from the next day of purchase and finishes the day the person starts his trip. After starting the trip, there is no trip to cancel and therefore there is no coverage. (If the person needs to go back to the home country early, lets say if their home is flooded or something, that is called trip interruption and not relevant to this discussion.)

In other words, it is an air ticket (or other pre-paid travel expenses) insurance for before starting the trip.

It does NOT cover anything at all if the insured needs medical treatment because of pre-existing conditions while in the USA.

A: Please note that this web page is about FAQ (Frequently Asked Questions) and not the complete and exhaustive list of all medical conditions that people may have and the answers to coverage for that. This list of FAQ's is provided only for your convenience so that you get an overall idea and is not a legally binding contract, not an advertisement, and not any promise for any coverage. This web page does not list the complete terms and conditions of any insurance plan as they are governed by the policy wording of each insurance plan from a given insurance company and we have no control over it. If there is any discrepancy between anything mentioned here and the the policy wording of a specific plan, policy wording would override.