Many people living and working in the US have insurance through their employer, so when they have to buy insurance for their visiting relatives they assume that all the health insurance plans work the same way, but they don't. Visitors insurance is a short-term international travel medical insurance designed to cover any new medical conditions, injuries or accidents that may occur after the effective date of the policy. There are many available visitors insurance plans to choose from in the US market. While the coverages included in each plan with have some similarities there are multiple plans available because they do not have the same coverage, some plans may include coverages that are more important to you.
Having a visitors medical insurance plan does not mean it will cover everything you want it to. It is best to look at the brochure and certificate wording for details of each plan. The following are the most common exclusions found in visitors insurance plans:
Routine maintenance related to pre-existing conditions or any scheduled treatment related to pre-existing conditions are excluded in all visitors insurance plans.
However, some visitors insurance plans cover acute onset of pre-existing conditions up to a certain amount for persons below a certain age. It is the coverage for an unexpected, unforeseen emergency occurring out of pre-existing conditions and you need to take the treatment within the next 24 hours.
Visitors insurance does not cover preventive care such as physical checkups or vaccinations. Even in the major medical insurance plans, a general checkup is covered only once a year. Short term plans can't cover such things.
Before traveling to the USA, it is advisable to have a comprehensive general checkup done to ensure that you are in good health and there are no surprises away from home.
Before visiting the USA, you should get a comprehensive dental checkup done, and complete any necessary treatment.
Visitors insurance plans are medical insurance plans and therefore, don't cover vision care such as an eye exam, eyeglasses or frames.
Before visiting the USA, have a comprehensive vision exam done, and get two pairs of eyeglasses to bring with you if eyeglasses are necessary.
No visitors insurance plan will cover any cosmetic treatment or surgery for anything that is not medically necessary.
Specific Medical Conditions
Some visitors insurance plans don't cover skin disease, cancer, foot problems, or urinary tract infection (UTI) for a certain duration after the effective of the policy.
Please read the certificate wording very carefully.
Maternity and Childbirth
It is already risky to travel when a person is pregnant. Therefore, travel to USA when being pregnant should be avoided if possible.
Many people specifically inquire about maternity and child birth coverage with the intent to travel to deliver their baby in USA so their child is a US citizen. Unfortunately, no visitor's insurance plan can afford to pay for maternity or child birth related expenses.
However, a few visitors insurance plans cover complications of pregnancy up to first 26 weeks of pregnancy.
Mental or Nervous Conditions
Visitors insurance plans typically exclude coverage for mental or nervous conditions, or self-inflicted injury. If you need treatment for anxiety, depression or any other psychological conditions, you will have to pay out of your pocket.
Alcohol or Drugs Influence
Any injuries or accidents that occur under the influence of alcohol or drugs influence are typically excluded in visitors insurance plans.
War and Terrorism
All visitors insurance plans exclude medical expenses occurring from injuries due to war.
However, several visitors insurance plans cover medical expenses occurring from injuries incurred due to terrorism.
Some visitors insurance plan may offer an optional war and/or terrorism related coverage.
Most visitors insurance plans exclude coverage for hazardous sports as they are high risk. If you plan to engage in any such sports activities, make sure to purchase the optional coverage that would cover them.
Exception: Atlas Travel Insurance covers many hazardous sports at no additional cost.
Out of pocket costs
All out of pocket costs such as deductible, coinsurance, copay and expenses beyond your policy maximum are your responsibility in visitors insurance and would not be reimbursed by the insurance company.
Make sure to read the brochure and the certificate wording so you fully understand what is covered and what the exclusions are for a plan. Paying the premium does not necessarily mean that everything will be covered at 100%.
Also, know that insurance companies don't randomly reject claims, an insurance company is legally obligated to pay all legitimate claims they receive.
If you have any questions or doubts, please consult a licensed insurance professional that specializes in visitors insurance.