What is Visitors Insurance?
It is common for people to have a misunderstanding of how visitors insurance works and we hope this article provides a better understanding of it.
Concept of Insurance
Insurance is designed to make sure a person is restored to the same financial position that existed before an accident or illness (also known as a loss) occurred. The transfer of risk is the basic principle of insurance; risk simply means the "chance" of a loss. By purchasing insurance, you share risk with others, which reduces the individual potential of financial hardship. People protect themselves against risk by purchasing an insurance policy. By doing so you have a better chance at restoring and/or maintaining the financial position you had before an accident or illness. As the insured, you pay a set amount of money called a premium to the insurer (insurance company); in return, the insurer agrees to pay an amount to help cover the expenses related to a covered benefit as stipulated in the certificate wording.
Visitors insurance, unlike domestic insurance, is designed to cover a person when traveling outside their home country or country of citizenship. Visitors insurance is a short term international travel medical insurance plan designed to cover medically necessary expenses related to unforeseen injuries, accidents, or illnesses that occur after the effective date of the policy.
Visitors insurance is not the same as domestic insurance (Affordable Care Act compliant plans that are federally regulated). ACA compliant medical insurance plans are only available to U.S. citizens and residents. Benefits commonly found in domestic insurance may not be covered benefits in visitors insurance plans.
For example, the services below are not covered in visitors insurance plans:
- Birth Control
- Cosmetic Surgery
- Dental, see Dental Coverage in Visitors Insurance
- Elective Surgery
- Maintenance Medication
- Maternity Care
- Preventive Check-ups
- Routine Visits
- Treatment for Known Medical Conditions
If visitors insurance plans were to cover all of the same services as domestic insurance, or ACA compliant plans, they would cost much more, it would be mandatory for all visitors to purchase visitors insurance from a small set of insurance companies and it could be purchased only during certain times of the year (open enrollment period). Of course, such restrictions can clearly not be placed on visitors who may visit the U.S. at any time and only for a short duration.
Although no visitors insurance plan on the market will cover pre-existing conditions, some visitors insurance plans provide coverage for the acute onset of a pre-existing condition that occurs after the effective date of the policy. Coverage for the acute onset of a pre-existing condition is plan dependent, meaning it is not available with every plan. The amount of coverage, as well as age requirements may also differ depending on the plan, so be sure to review the benefits of the plan you are considering.
As previously stated, there are no visitors insurance plans on the market designed to cover pre-existing conditions. Visitors insurance should be purchased before the departure from the home country or country of citizenship and be effective on the day of departure (from the home country) in case something happens. It is unreasonable for anyone to purchase visitors insurance with the expectation that an insurance company will pay for the medical expenses related to a pre-existing condition. You should not attempt to purchase a plan at the last moment hoping to lessen your out of pocket expenses. If insurance companies were to pay for pre-existing conditions the premiums would need to be substantially higher in order to prevent an automatic loss for the insurance company, otherwise they would not be able to remain in business.
There are many types of situations to consider: car accidents, inclement weather hazards, new environments, traveling in general, etc. Here are a few examples of services that may be covered, as long as visitors insurance is in place when the event occurs:
- Father slipped on one of the kids toys; he broke a hip - new injury.
- We went out to eat for mother and father's anniversary and they both became sick, we think they have food poisoning - new illness.
- Mom and I were cooking dinner and she used my new knives, she cut her finger and now she needs stitches - new accident.
- The kids were sent home from school with a fever and now two days later my mother-in-law has the same thing - new illness.
- Brother-in-law was taking his morning walk and was bit by a dog - new accident.
When inviting your family to visit, you should not overlook their health or how it could affect you financially if something happens. You will want to ask if their doctor has cleared them for travel, especially if they have had a life threatening health condition. Medical treatment here in the U.S. is very expensive and if the treatment is related to a pre-existing condition the full cost will become your responsibility. It may not always be wise for your family member to come to the U.S. for a visit if they have had serious health conditions in the past or if they are presently undergoing treatment. You should evaluate the situation based on what you know about insurance for visitors and decide whether it is worth the financial risk.
It is important that you understand the purpose of visitors insurance, how it works, and the terms of the policy you are considering because once a claim has been denied, it is too late to question the plan you purchased. For these reasons, make sure you read the certificate wording as well as the brochure for the plan you are interested in prior to purchasing.
You can read Frequently Asked Questions about visitors insurance here:
Please contact our office with questions you have about what the plans will cover or any other question you may have.