Patriot America Insurance Reviews, Protection America Insurance Reviews, International Medical Group Reviews, IMG Insurance Reviews, Patriot Platinum America Reviews

Protection America is currently essentially the same plan as Patriot America, except that Protection America can be purchased for any duration and can still be renewed while Patriot America must be purchased for a minimum of three months initially in order to be able to renew it. There were several benefit differences between Protection America and Patriot America earlier and most of them have been eliminated in Patriot America recently.

Protection America Certificate and insured effective 7/25/05 to 12/25/05. The Passport Protection Plus insured was admitted in the United States for cellulites on or around their knee on 11/20/05. Upon admittance to the hospital, it was determined the patient also had diabetes. A pre-existing condition review began 12/19/05 by IMG's claims department. Medical records were received on 3/3/06. A summary of the records were sent to medical review and the reviewing physician stated that "the condition of cellulitis is not a pre-existing condition. It does not appear to be related to any history of osteoarthritis. The fluid obtained from the aspiration of the knee did not show any evidence of an acute inflammatory process. The data relating to the diabetes was consistent with a new onset of that condition. " The physician further determined that the patient's conditions could have easily developed following the date of onset of coverage, which was effective 7/25/05. They also state in the review that "the osteoarthritis condition could not be traced to the acute onset of cellulitis that led to the hospital admission of 11/20/05." With this positive outcome, IMG claims department was able to consider all charges presented for benefits under the certificate. Total charges presented were $11,476.50 and IMG was able to obtain a PPO discount which reduced the charges to $4,568.00. After the insured paid their deductible and coinsurance, IMG paid $3354.15 to the hospital facility.
Protection America - The insured was originally hospitalized for a mental/nervous condition. As Protection America excludes this condition, these services were excluded. However, the insured then developed urinary retention and was transferred to another hospital for treatment of this condition. The urinary retention charges were allowed. Charges were $27,281.70
Protection America - This was a cardiac condition. The insured was effective 8/05 and had a heart attack 12/05 which was originally denied. Appeals received from insured, agent (Narendra Khatri of InsuBuy.com) and Dr. regarding denial of heart attack in December 2005. Information sent to outside peer review. Peer review physician's opinion was that the insured's heart attack was not a pre-x condition as defined by the certificate. However, condition of high blood pressure was pre-x but did not receive expenses primarily for the treatment of high blood pressure. Letter sent to insured and Dr. advising that we are overturning our previous denial and reconsidering the charges for benefits. Also included a copy of the peer review physician's opinion with the appeal response. Allowed charges in the amount of $96,120.70 to date.
Protection America - File nor medical records not sent to peer review, but the condition was allowed. IMG medical staff determined the small bowel obstruction 3 months after the effective date was not pre-existing. Charges were $27,172.30.

My positive experience with IMG

In Dec 2007 my dad got admitted to the hospital for 17 days due to DVT (Deep Venous Thrombosis). Total bill from the hospital was $48,000.00. IMG paid most part of it and I paid approximately $2000.00 as patient responsibility.

hope4best
April 27, 2009 at 05:21 PM
Good experience with Patriot America Insurance. Claims paid. Smooth.

I bought Patriot America by img global for my parents. We had to take my mother to ER. The total claim was close to 10k and to my surprise IMG did pay exactly as whatever it said. It is not a pre existing condition. Based on my research, nobody covers a pre existing condition.

The advantage of using the american, comprehensive policy is, the hospital took the insurance card, no questions asked. Send me a PM if you want more details as it was really painful in the first place to go to ER, let alone worry about insurance.

jgh_res
March 3, 2009 at 03:51 PM
Huge Medical Bill... IMG Paid

My mother visited this year (2006) from February to June. This was her 2nd visit in 10 years and she was all fine in the first visit in the year 2000. She was all fine until May and got sick. Initially, she had a throat infection, then it was followed by nausea, vomiting and burning in the stomach. Taking her to a Urgent care center did not help, and finally I had to take her to the emergency room.

Once I went into the emergency room, they started doing all kind of things. Since she was Diabetic and had BP, the Dr. started diagnosing for possible heart problem. Then, this diagnosis went on for 2 days admitting her to the ICU unit. For our question to why this diagnosis when the patient is having no chest pain or whatsoever related to heart, the Dr. said that is the normal procedure they follow for BP and Diabetic patients.

I had taken Protection America 80/20 Comprehensive coverage insurance. As anything related to BP/Diabetic could be considered pre-existing, I was worried the insurance company may not cover these expenses.

After 2 days of straining my mom w/ all kind of heart tests, all the results came negative for any possible heart problem. Then, it was the gastro (GI) Doctor's turn to finally find out what problem she had. On the third day, he scheduled for and Endoscopy and came out to say it is just "inflammation in the stomach", that has caused all these problems. I asked the Dr. right there if this is considered pre-existing? The Dr. said "NO", it is a true "medical emergency" , then sent my mom home back on the third day and she is fine in India now.

I raised a question to the case worker in the hospital on all the tests they did for heart, when it was actually related to Stomach. I also said, the insurance company may not consider your tests as they may consider this as pre-existing. His answer was, that is how we proceed for patients who are BP & Diabetic.

After 10 days, I got a huge $35,000 bill from the hospital and other providers. I submitted all the claims as per IMGs claim procedure. IMG started the claim procedure, and in the meantime the providers started sending the same bill every 15 days.

IMG did the review on the case, and paid all the bill up to $5000 at 80/20, and the remaining $30,000 at 100%. This left me to complete the deductible and 80/20 co-insurance formality.

I purchased this Insurance thru Narendra Khatri. Thank you Narendra for all the help in selecting the right insurance.

The bottom line is:
1. If your parents are above 65 and have pre-existing conditions, then it is your decision to sponsor them to visit U.S.
2. If you sponsor, do some home work and buy comprehensive insurance here in the US (not India).

Hope my experience helps guys who are planning to sponsor their family members.

drs (Username: USVisit123) - November 24, 2006 at 07:14 AM
Experience with IMG Visitors Insurance - Protection America

Hi Folks,

I purchased medical insurance from IMG for my mother (78 years) visiting from India. I used the insurance several times during the last 6 months. Here is a summary of my experience with IMG.

Cost for six months: $1642. Coverage: Max $50,000 with $100 deductible.

Accepted by all doctors, urgent care and medical labs except U.S. HealthWorks on Miramesa (Dr. Henry Poon).

IMG paid all the medical bills without having to file any claim forms i.e. they took care of all the paper work. In addition, the doctors and labs offered significant discounts on the bills for having IMG insurance. Please see details below:

(a) Dermatologist: Amount Charged: $130, Amount after discount: $116, Amount I paid: $100

(b) ENT Specialist: Amount Charged: $850, Amount after discount: $405, Amount I paid: $81

(c) UCSD Urgent Care: Amount Charged: $290, Amount after discount: $138, Amount I paid: $28

(d) UCSD Urgent Care: Amount Charged: $690, Amount after discount: $180, Amount I paid: $36

Thanks.

Prasad
San Diego CA USA - September 19, 2006 at 07:59:30 PM
Great Experience With Insubuy, OK with IMG (Long but must read)

IMG Protection America - My Experience and Tips

Before I rate IMG Protection America, let me rate Insubuy as excellent. I also want to thank Mr. Narendra Khatri of Insubuy who took very good care of me. The service provided by Insubuy was more than what was expected from them.

My mom's claim of around $20K was denied by IMG (Protection America) on the basis of pre-existing condition. Following this I contacted Mr. Khatri and with his help we filed an appeal along with our Doctor's note. His continued effort and follow up with IMG led to the reversal of denial and the claim was processed and paid per the plan benefit. I didn't expect an insurance agent to fight for their customer’s rights so hard. So if you need to buy insurance, I will suggest this is the best place to buy because unlike other agents, here you get the support even after you bought it.

My mom was admitted for severe dehydration and low sodium in her body following Vomiting and Diarrhea. She has high BP as her pre-existing condition. During and after her treatment all doctors were very confident that neither her condition is chronic nor pre-existing, nor it has any relation with her pre-existing condition of high BP.

I was shocked when IMG (Protection America) denied the claim on the basis of pre-existing. I would have expected this with an Indian Insurance company, but not from an American company. It was only after the appeal, note by the attending physician and the good effort by Mr. Narendra Khatri that they reversed their decision and decided to pay.

Therefore, Protection America, I will rate them OK/Good. I cannot give them a better rating, as they did deny my mom's claim first on the basis of pre-existing condition that was not correct. Other than this, my experience with IMG was very good. They paid in time and directly to the providers and per the benefit. Customer service was also good, and I was able to talk to the same person each time I called. This made it a lot easier.

Here are some tips from my experience. I had debated the all questions below myself and decided to buy insurance, I am glad I did it.

1) If pre-existing is not covered, why should I bother taking insurance for elderly with pre-existing conditions like BP, Heart problem, Diabetes etc? Most likely they are going to have trouble with those conditions, if any.

Answer is you never know what is going to happen to whom and when. My mom's all pre-existing conditions were in control all the time and something happened we never heard or expected of. Beside illness, one can have accident, which has nothing to do with a pre-existing condition.

2) By reading forum it seems like almost every insurance company will try to tie any treatment whether or not pre-existing with pre-existing and deny the claim.

Yes, they do that, and that's what happened to me. But if you buy American Insurance, and if your case is genuine, you can appeal and even take help of your state's insurance commissioner and most likely will get a favorable result in time. For me it took just 3-4 weeks for them to reverse the decision. If you buy Indian Insurance, I can't imagine you can get the result so fast and in your favor.

3) There is a huge difference between premium of comprehensive and fixed. With the age of my parents and there duration of stay, comprehensive becomes very expensive. Shall I just take fixed?

Well, this was the most important question for me. My wife and I debated a lot on this. She wanted to take fixed, and I wanted to take comprehensive. I am so glad I took comprehensive. Now when I look back, if I would have taken fixed, I don't think insurance company would have paid even half or one third of the total bills. I feel fixed is as bad as no insurance. If you just want to have insurance for namesake, take fixed. If you want to protect yourself from unexpected, then take comprehensive. Yeah, it’s so expensive, true! What we did is increased our deductible to the maximum we can afford. That brought down the premium a lot.

4) If we take high deductible like $1000 on my comprehensive, what is the use of taking insurance if first $1000 I have to pay from my pocket.

Well, I take insurance to protect myself for unexpected things like what happened to my mom. I don't see the point in taking insurance to cover your $100 office visit. I think most of us can afford that. What we worry about is, if something major happens to them. Well, that's why one needs to decide what the maximum one can afford, $500 or $1000 or even $2000. See chances are very high that nothing will happen to them. That's why insurance company makes money. So your $1000 deductible doesn't mean anything, as most likely you will never have to go to doctor, but this will save you money now in premium. Only, if you get unlucky like me, the deductible comes into the picture.

5) What is the point of taking comprehensive with large deductible when I can get fixed with zero deductible and same amount of coverage?

For example, you get unlucky and go to ER. Say, your total bill comes to $5000. Assume fixed plan will pay only $2300 per their schedule and even with zero deductible, but you are still liable for $2700. Whereas on the other hand, comprehensive with $1000 deductible, insurance will pay 80% of $4000 (for Protection America, first $5000 is covered at 80%) i.e. $3200 and you will be liable for $1800. Still works out better than fixed.

6) I heard that if you don’t sign any paper saying you are responsible for the medical expenses of your parents, you can get away with paying the part of payment not covered by insurance. Is it true? If yes, then why should we take insurance?

I do not know the answer of this. May be Mr. Khatri can respond to this. (Response from Insubuy: This question has been answered in our FAQ about pre-existing conditions.)

Tips:
1) If your parents’ doesn’t sound good, even though they say they are fine, go with your instinct and see a doctor. Don't wait too long to see doctor, even if it sound not serious.

2) If your parents are religious and want to fast, allow fasting only if their health allows and you feel comfortable with their decision to fast.

3) If something unexpected happens, call 911 and get an ambulance, don't try to take the patient on your own to ER.

4) If you had to go to ER, call insurance ASAP to get pre-certification initiated.

5) Do not sign anything that says you are financially responsible for medical expenses. Let the other parent sign on that.

6) Don't hesitate to tell about all pre-existing medical problems to the doctor about the patient. Don't even think that your insurance will be denied if you tell them all the past medical problem. That is required for the better diagnosis/care for the patient.

7) Talk to Dr. about your concern of pre-existing clause on insurance. Dr. will be able to tell if the condition is pre-existing or not.

8) When patient come out of hospital, get copy of all the medical records from hospital. You might need these later if you have problem with insurance as well as for further treatment back home.

9) Before they return home, get a medical confidentiality release form, authorization letters etc. signed by the patient in your name. Its a good idea to let them sign a few authorization letters saying they authorize you to discuss all health/insurance on your behalf. Insurance companies/hospitals wouldn't even talk to you without these letters.

10) Before they board flight home, if any of your parents were in hospital, get a written authorization from Doctor saying that the passenger is in good condition and able to travel back home and keep that with the passenger. Airline may deny boarding without travel authorization letter from doctor if they find out that the passenger was in hospital or had medical problem recently. Happened to me, Air India were almost ready to leave them behind if my Dr. wouldn't have faxed the letter to the airport right at that time. All we did is asked for wheel chair, and all these became a huge problem for Air India!

11) Keep the pager number of the Doctor who treated your parents, all the time with you, until they go back home. If I wouldn't had the pager number for my doctor with me at the airport, air india would have left them behind.

I took a long time to write this, just thinking that I can help a little bit this way to all my countrymen who love their parents, call them here with all good intention, but have to go through this difficult insurance and medical uncertainty. Thanks.

Manoj
USA - April 13, 2006 at 08:40:09 AM
Good experience with Protection America

My elderly parents arrived here in last week of January 2005. Right at the Boston Logan Airport, my dad injured his back while handling the baggage.

Soon after we got home, his pain had become severe, and he was almost unable to move. We ran to the emergency room in Lahey Clinic in Burlington. He was immediately admitted into the hospital, several tests were performed and treatment was done. He spent next 4 days in the hospital.

Fortunately, I had purchased Protection America (IMG) from this website. When we went to the hospital, we just showed the card and as Lahey participates in First Health PPO, they accepted the insurance and took care of all the billing with insurance company.

I have been receiving several statements from hospital and from IMG indicating that the claims have already been paid. Bill was pretty large. Lahey has billed me for my portion, the deductible and co-pay that I was responsible for.

We are still taking my dad for follow up check ups, physiotherapy etc to several doctors and we have been just showing the health insurance card. Things are working out pretty good so far. There are several choices of insurance available on this website, and luckily I called Insubuy people, and they were kind enough to explain me various choices, and I am glad I chose the insurance I did.

It was sad that my dad got injured right from the beginning of his stay in the U.S., and matters got not so good because of my wife's delivery time approaching etc. But I am quite satisfied with the insurance I purchased. I recommend everyone to buy this policy for complete peace of mind.

Vamsi Krishna
Burlington, MA USA - February 16, 2005 at 08:09:29 PM