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Visitors Medical Insurance - Pre-Existing Medical Conditions FAQ

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What are the pre-existing conditions?

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.

Are any pre-existing conditions covered? If not, how does the insurance company determine whether something was pre-existing or not? Is there any medical exam to be done in the home country or in the United States after arrival?

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

  • For Inbound® plans (USA, Guest, Immigrant and Choice) from Seven Corners, pre-existing conditions in the last 6 months (1 year for age 70+) are NOT covered.

  • For Liaison® plans (Continent, International, and Majestic) 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 Services plans, such as Visit USA and WorldMed, pre-existing conditions in last 18 months are NOT covered.

  • For HCCMIS Atlas products, pre-existing conditions in last 2 years are NOT covered.

  • For Global Underwriters(Diplomat) products, pre-existing conditions in last 24 months 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. If you have a medical problem after arriving in the U.S. while you have 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.

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

My mother-in-law has diabetes and she needs to take insulin injections every day. Is that covered in visitor medical insurance?

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.

My father needs bypass surgery (or cancer treatment or cataract surgery or any other medical treatment). I would like to bring my father to the USA to get the treatment done here as the facilities are better in the USA. Can I buy health insurance to cover that?

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

My father needs to go for kidney dialysis twice a week. Is that covered in visitor medical insurance?

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.

What is the point of buying insurance if it does not cover pre-existing medical conditions? These are the ones we need to get covered. Probability of other illnesses is very low anyway.

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 allergies in a new place, change of food, cold, fever, flu, diarrhea, pneumonia, food poisoning, snake bites, 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.

I am willing to pay a higher premium, but could you suggest me the insurance plan that would cover 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.

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 without paying the part of payment not covered by insurance. Is it true? If yes, then why should we take insurance?

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.

I want to invite my parents and they have pre-existing conditions. What is the solution?

Unfortunately, there is no solution. No insurance company will pay for pre-existing conditions and when you invite them, you are taking the risk. You should be prepared 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.

What if I can't afford to pay the high healthcare costs in the U.S. and no insurance will pay for pre-existing conditions for visitors to USA?

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 it is the reality.

If my mother-in-law has diabetes and high blood pressure, won't any new medical conditions like heart attack be considered pre-existing conditions as well? I guess the insurance company will try to tie any new medical conditions with pre-existing conditions. If that is the case, why should I buy visitors insurance?

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

However, it is certainly possible that you may have a new medical condition which is not related to a pre-existing condition, 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. 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.

My father has pre-existing medical conditions. I understand that no insurance company will cover pre-existing conditions for visitors to the United States. I can't afford the high cost of treatment in the USA. Will the insurance company pay for sending him back to India in case he needs treatment for pre-existing conditions?

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 related to this context:

My mother has diabetes and my father has high blood pressure. I completely understand that their daily medications, insulin etc. will not be covered by the insurance. However, if an emergency arises because of those conditions and they need to get admitted in the hospital, will the insurance plan at least cover the emergencies?

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.

My mother was diagnosed with breast cancer. She has already finished her chemotherapy treatment. However, she needs to go through frequent check ups for monitoring purpose. Would that be covered?

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

I am seeking information about coverage for a particular health problem. Why is this not mentioned here?

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. It is not a legally binding contract, not an advertisement, and not a 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.

Are there any visitors insurance plans available that provide coverage anything related to pre-existing conditions for the persons of age 70 years and above?

Even though there are a few plans that provide some coverage for pre-existing conditions for the persons of age 70 years and above, it is very limited and typically highly inadequate as described below:

Please note that in case of Visitors Care and Liaison Majestic plans above, there would be no network negotiated rates for such expenses.

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