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Queries regarding your Patriot America product Greetings, I am looking to get travel/medical insurance for my mother and my father. We live in Mumbai, India and my parents want to visit my brother in Manhattan, New York. They plan to travel in the 3rd week of June. We are looking for a plan which has: 1) Deductible 0f $250 2) Cover of $100,000 My mother has some pre-existing diseases which needs to be covered under the insurance. Below is a list of pre-existing diseases she has: 1) Diabetes (Stable condition) 2) Heart Disease 3) Has undergone bypass surgery in year 2007 4) Currently on insulin 5) Currently on multiple heart medication including blood thinner and blood pressure 6) Suffers from diabetic foot (ulcers on both feet) Past History ---------------------- My mother had been to New York in October 2012 and unfortunately, fallen sick. She Was admitted in Metropolitan Hospital Centre which falls under the South Manhattan Healthcare network. However, she has not been hospitalized since then. I have gone through a few insurance product brochures and have a few questions regarding your product: 1) I see some products have sub-limits for each item like limits for ambulance, pharmacy, surgeon visits etc but do not see that in your product. Does that mean you do not have sub-limits? Is your product comprehensive or fixed? 2) I saw limits for Hospital Indemnity as 100$ per night in your product. I did not understand this. Please could you explain this in a little more detail. 3) How do I know which hospital, regardless of it being in your PPO network or not, will bill directly to the insurance company? I do not want to first pay cash to get medical attention. 4) I read that to receive benefits, pre-ceritification is required for hospitalization, surgery, emergency medical evacuations, CT scans and MRIs. However, it also says that pre-certification does not guarantee benefits. what does this mean? Appreciate your cooperation. We are looking to buy an insurance cover asap. Regards

Answer:

Thank you for your interest in purchasing insurance through us. Before we suggest any plan would like to know their age, travel duration. Once we get these information will be glad to answer all your questions.


Greetings, Thank you for your email. Mother: 57 yrs Father: 61 yrs They plan to travel for 3 months or under 90 days from the 4th week of June. Thanks


Thank you for your interest in purchasing visitors insurance for your parents. Please note there is no visitors insurance product available anywhere in the market that would cover all expenses related to pre-existing conditions. Some of the plans cover acute onset of pre-existing conditions up to some amount under some circumstances. Please read the following articles to understand that better. /visitor-medical-insurance-pre-existing-conditions/ /visitor-insurance-acute-onset-of-pre-existing-conditions/ /visitors-insurance-usa-heart-attack-coverage/ 1. We offer both fixed and comprehensive coverage plans. Please look at /visitor-insurance/ You will see two separately marked sections: Fixed and Comprehensive. You have not specified which specific product you are looking at. However, if you are looking at the plan with $250 deductible, that must be comprehensive plan because no fixed coverage plan has $250 deductible. 2. Please look at /visitor-health-insurance/#indemnity That is for other additional expenses such as food, telephone, taxi etc. 3. We offer several different visitors insurance plans. Some of them participate in PPO network while others don’t. The ones that participate in the PPO network has a link next to it that says something like “Direct Billing: Through _______ Network”. You can look at /visitor-insurance/ and search for the participating providers in a given area. 4. Pre-certification simply means that informing the insurance company about certain procedures you are going to get done. Whether a particular expense is covered or not can only be determined when the provider sends all the medical records to the claims department and not in advance. Please read various articles about Claims Process at /guide/ I hope that answers your questions. If you have any other questions, please feel free to contact us at any time.


I just noticed that you have specified the product name in the subject line. Therefore, I will try to answer your questions again. Patriot America covers sudden and unexpected recurrence of pre-existing conditions up to $50,000 for people below the age of 65 years. Please read /patriot-america-lite-insurance/ for further information. 1. Yes, Patriot America is a comprehensive coverage. 2. Same answer. 3. Patriot America participates in Coventry/First Health PPO network. You can search for the providers in your area at /international-medical-ppo-network/ Please read /what-is-visitors-insurance/ and /international-travel-insurance/ for further information. 4. Same answer. If you have any other questions, please feel free to contact us at any time.


Thank you for your email. However, I have a few more questions: 1) In your previous email, you said that there is no insurance product in the market, which will cover pre-existing conditions. However, your product will cover acute onset of pre-existing conditions. I have gone through the links you sent but just want to confirm. Am I right in thinking that my mother will not get any heart or diabetes treatment or insulin expense but if there is an immediate need for medical attention like an infection in her existing ulcers in her feet or because of her any pre-existing conditions, that medical expenditure will be covered by your product? 2) The $250 deductible I mentioned is just a ballpark figure. I am flexible if I am able to get a good comprehensive insurance. 3) You mentioned that your product is comprehensive. Does that mean there are no sub-limits for each medical expense? I read in one of the products that it will pay only $200 for pharmacy. If, God forbid, the medication needed is $2000 because of an acute on-set of a pre-existing condition, would that be covered by your product? Appreciate your reply. Thanks


1. Patriot America will cover sudden an unexpected recurrence of pre-existing conditions. It is not possible to give any more specific answer in advance until it actually happens as each case is unique. 2. Patriot America provides the deductible choices of $0, $100, $250, $500, $1,000 or $2,500. 3. That is correct. Patriot America does not have sub-limits for each medical expenses. There is no $200 limit for pharmacy for eligible claims. Please look at the brochure at /patriot-america-lite/visitor-insurance/ and the certificate wording at /patriot-america-lite/travel-medical-insurance/ If you see any such limit, please let me know as I didn’t see. I hope that answers your questions. If you have any other questions, please feel free to contact us at any time.


Thank you for your email. It has answered almost all of my queries. However, I do have one more: Another concern I have is direct billing. Parents are going to be residing in the zip code 10128. I have searched for the hospitals in the link you gave but none of the hospitals I looked for, show the link 'Direct billing'. This is one of my biggest concerns. If, god forbid, the bill is $50,000, then I do not have $50,000 to pay upfront and then make a claim for it. Is there are solution for this? Many thanks


Hospitals in the PPO network are direct billing. I have never seen any hospital demanding upfront payment like you mentioned. Most people in the US don’t have $500 cash with them, let alone $50,000. In other words, the link I sent you is not a simple Yellow Pages or Google search of hospitals or other providers. That is the list of providers that have contracted with the First Health PPO network, bill the insurance company directly and charge only the network negotiated fees. In Indian terms, providers in the PPO network provide cashless treatment. /cashless-visitors-insurance/ If you have any other questions, please feel free to contact us at any time.

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DISCLAIMER: Information presented in our Questions and Answers section is generic and was deemed to be accurate at the time of response. Please use the answers as a guide and do not make decisions based on the answers. The answers presented may be outdated and altogether inaccurate currently or not relevant as the details provided such as the insurance terms and conditions, plan benefits, eligibility and coverage may have changed. Insubuy assumes no responsibility for relying on such answers. You should review the latest certificate wording of the insurance policy (available on this website) for the product you are considering for the latest and complete details. If there is any conflict between the answers provided here and the certificate wording, the details of the certificate wording will prevail.

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