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Visitors Insurance USA - Heart Attack Coverage



Many elderly visitors to USA are worried that if they get heart attack while visiting USA, whether it would be covered or not.


Q: If my visiting father gets heart attack, will that be covered?

A: There is no way to answer for sure whether that would be covered or not in advance. Once the providers (doctors, hospital etc.) submit all the medical records such as physician report, treatment records etc. to the claims department, they will look into it to determine whether it would be a covered expense or not.


Q: If a visitor gets a heart attack, what are the possible scenarios?

A: A heart attack may be caused because of many different reasons.

  • If the heart attack is determined to be a completely new medical condition, it will be covered up to the policy maximum according to the terms and conditions of the insurance you have purchased.

  • If it is determined to be an acute onset of pre-existing condition, it will be covered up to the limits of acute onset of pre-existing condition, provided the insurance you have purchased has coverage for the same, depending upon your age, the chosen policy maximum and the type of the plan purchased.

  • If it is determined to be an sudden and unexpected recurrence of pre-existing condition, it will be covered up to the limits of sudden and unexpected recurrence of pre-existing condition, provided the insurance you have purchased has coverage for the same, depending upon your age, the chosen policy maximum and the type of the plan purchased.

  • If it is determined to be a pre-existing condition that is not acute onset of pre-existing condition or the plan you have purchased does not have any coverage for an acute onset of pre-existing conditions, it will not be covered at all.


Q: My mother never had a heart attack before. In that case, how can that be pre-existing condition?

A: If it is determined that heart attack was caused due to other pre-existing medical conditions such as high blood pressure, diabetes, prior heart disease etc., it would still be considered as pre-existing condition.


Q: My father had a heart attack 8 years back. If he gets any heart related sicknesses, will that be covered?

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. If not, at the time of the claim, based on attending physician statement(APS), the claim adjuster will determine whether it will be considered as a pre-existing condition or not.


Q: I am reading the brochures for various visitors insurance plans and they say that the pre-existing condition exclusion is for 2 years or 3 years, but my mother had heart attack 5 years ago. If she gets heart attack now, how can that be pre-existing condition?

A: Obviously, the person does not continuously get heart attack every day. Actually, the heart disease is a pre-existing condition and the heart attack is an aggravated condition of the ongoing heart disease. Even though the last heart attack was 5 years ago, if the person is still taking medications regularly for the ongoing heart disease and therefore, the heart disease is still a pre-existing condition. And according to our prior experience, everyone who had a heart attack early takes regular medication for blood thinning, etc.


Q: Does it mean that if the person has high blood pressure or diabetes, the heart attacks will always be excluded?

A: That is absolutely not the case. We have seen heart attacks being covered as well as being declined. Therefore, it really depends upon the details of individual case, which can only be determined after it already happens and the Claims Department has all the medical records to look at.


Q: My friends are telling me that visitors insurance would never cover heart attack with one excuse or another. What is the point of buying visitors insurance?

A: That is not true. It is determined on a case by case basis. Based on medical records, it will be determined whether it is a covered expense or not.


Q: Why don't you answer in simple Yes or No whether the heart attack would be covered or not?

A: It is not possible to do so. Until someone looks at all the medical records of the condition that has occurred, there is no basis to make such determination in advance. It can be determined only the after fact.


Q: If I send you my father's medical records, can you tell me whether it would be covered in future when he visits USA?

A: No. The determination is not based only on the prior medical records, but more importantly, the most current medical records, the ones that will be generated if and when he gets the heart attack for which the coverage is in question. And those medical records can't be generated in advance. Therefore, until that happens, there is no way to know for sure.


Q: Could you please give an example of a heart attack that would be considered as acute onset of pre-existing condition?

A: If the person has high blood pressure and everything is stable and all of sudden a person gets a heart attack without any prior symptoms or warnings and the person needs to take treatment in the next 24 hours, and that may be an acute onset of pre-existing conditions.

Important: Everyone is reminded that you should not simply consider all such similar looking cases to be exactly the same and assume that such case would always fall under acute onset of pre-existing condition. It is determined on a case by case basis based on medical records received.


Q: Could you please give an example of a heart attack that would NOT be considered as acute onset of pre-existing condition?

A: If the person is having a minor chest pain for the last 4-5 days, or if the person has been complaining of the elevated blood pressure for the past 3-4 days, and then the person gets a heart attack, it was not acute, it was not all of sudden nor unexpected and therefore, it would not be considered as acute onset of pre-existing condition. And therefore, not covered.


Q: Could you please give an example of a heart attack that would be considered a sudden and unexpected recurrence of pre-existing condition?

A: A heart attack is most often an acute manifestation of the underlying medical condition of coronary artery atherosclerosis (CAD) (Please note that there are some rare causes of heart attacks that are not caused by CAD, e.g., Takotsubo Cardiomyopathy, Prinzmetal Angina, etc., but examples below deal with CAD as the primary cause of heart attacks.) If someone had a pre-existing diagnosis of CAD, she/he could have had symptoms or manifestations of CAD without having had a prior heart attack – e.g., chest pain diagnosed as Coronary Angina, stent placed in a blocked artery, or the discovery of CAD on routine physical leading to medical or surgical intervention. If the same person had that condition stabilized then suffered a heart attack after their Effective Date, that could be considered a sudden recurrence of the pre-existing condition.


Q: It seems that there is no way for visitors insurance companies to tell me in advance whether a particular heart attack would covered or not. When it happens, the medical bills have already incurred and if the visitors insurance company determines it to be non-covered expenses, it would be too late and I would be stuck with big bills. What do you suggest?

A: Your analysis is correct. There is no way to know in advance whether a particular condition would be covered. You should carefully analyze the risk before inviting elderly relatives about how you would handle non-eligible medical expenses.


Q: Do you personally know anyone whose heart attack was covered in visitors insurance when the person had other disease such as high blood pressure?

A: Yes, in addition to numerous customers being covered, our company's President/CEO's mother-in-law had a heart attack while traveling overseas and it was covered even though she had high blood pressure. But please note that each case is different and no one should assume that everyone in such a manner would be covered under all circumstances because it is determined entirely at the time of claim based on the medical records and attending physician's statement.


Important Note:
Safe Travels series of plans from Trawick International completely exclude cardiac disease or conditions, whether as new medical conditions or as acute onset of pre-existing conditions.

Disclaimer: The information within this article is intended as a broad summary of benefits and services and is meant for informational purposes only. The information does not describe all scenarios, coverages or exclusions of any insurance plan. The benefits and services of an insurance plan are subject to change. This is not your policy/certificate of insurance. If there is any discrepancy between the information in this article and the language of your policy/certificate wording, the language of the policy/certificate wording will prevail.