Visitor Health Insurance: What Qualifies as a Pre-existing Condition?

10 October 2019 |

If you’re looking for visitor health insurance, you might be wondering: What is a pre-existing condition? And, more importantly, what qualifies as a pre-existing condition in the fine print of medical insurance policies? Pre-existing conditions are defined as a medical illness or injury that you have had before your new health coverage begins. In general, they tend to be long-term or chronic conditions.

While you can travel with a pre-existing condition, it’s important to get clearance from your doctor. If you have—or suspect you have—a pre-existing condition, be sure to find the best visitor health insurance, preferably one that provides some type of coverage for pre-existing conditions.

pre-existing condition

What Is Considered a Pre-Existing Condition?

A pre-existing condition includes any ailment experienced or diagnosed before your travels.

Applicable conditions include:

  • Diabetes
  • Arthritis
  • COPD
  • Sleep apnea
  • Cancer
  • Heart disease
  • High blood pressure
  • High cholesterol
  • Breathing conditions
  • Kidney conditions
  • Stroke
  • Epilepsy
  • Liver Conditions
  • Psychological conditions (anxiety, depression, etc)
  • And many others …

In general, visitor insurance will not cover pre-existing conditions. That means that an insurer may deny your claim if it is related to a pre-existing condition. However, some policies cover the acute onset of such conditions. Acute onset refers to an unexpected or sudden flare-up or recurrence of a previously diagnosed or experienced condition that occurs without warning and requires immediate care. If you are under the age of 70, you are more likely to be covered in such situations since you’re much less likely to experience an acute onset of your condition.

As a note, no medical examination needs to be conducted before or after your arrival in the U.S. However, you should get a comprehensive check-up before you leave. Also, be sure to carry a copy of your medical records in case you need to file a claim with your visitor health insurance company.

If you fall ill or have an injury while in the United States, the doctor will determine whether any diagnosed condition was pre-existing or not. The doctor’s office or hospital will then notify your insurance company.

So why don’t insurance companies like to cover those with pre-existing conditions? In short, it’s expensive. Insurance companies will lose money covering those who are all but guaranteed to need expensive care and treatments.

Plans like Patriot America Plus and Atlas America cover the early onset of pre-existing conditions. Both companies have very high customer ratings, and you can apply directly on our site.

Should I Disclose My Pre-Existing Condition?

Many travelers wonder about whether or not they should disclose information about a pre-existing condition at all. After all, it could result in a denial of visitor health insurance coverage. In the United States, health care services are very expensive and as a result, it’s very difficult to try to deceive the system. It’s best to be as upfront and honest as possible about previously diagnosed issues, as well as any symptoms you happen to be experiencing. If you are unsure about whether something will be covered under a plan, review the schedule of benefits, which is a list of services covered under the plan.

If you take certain medications, such as insulin for diabetes or high blood pressure medication, this could also result in a claim denial. But given the diligence of health care providers, coupled with the dangers of taking certain medications simultaneously, you should always tell insurance companies and medical service providers what medications you take now and which ones you have taken in the past.

Tips for Visiting the US with a Pre-Existing Condition

If you have a pre-existing condition and plan to visit the United States, you’ll want to be prepared in case of an emergency. Follow these steps to keep peace of mind and avoid financial or physical hardship.

Visit your doctor. Before leaving, pay a visit to your doctor and ask for a copy of your medical records. This will come in handy should you need to make a claim with your insurance company.

Bring your meds.  Bring extra medication on your trip. You never know when you might need more. Delays and flight cancellations are common in the United States.

Ask for a letter. Have your doctor include a detailed note about your current medical condition, past treatments, and required medications. This might also be beneficial if a claim is denied.

Be ready to appeal. You may need to file an appeal if you are denied treatment for a condition that is not pre-existing. Be sure that you keep your medical records in a safe place—you may need them in such instances.

Ask about payment options and discounts. Medical bills aren’t always set in stone. Ask the hospital or health provider if they offer payment plans, and inquire about possible discounts or special exclusions.

Use your best judgment. Whether you’re traveling with a J-1 travel visa or visiting family, you’ll likely want to unwind at some point. Just be sure to follow your doctor’s orders. Travel can put a lot of stress on the body. Don’t discard your long-term health in favor of short-term enjoyment.

For more information on what is considered a pre-existing condition, feel free to call us at 804-325-1385 or send us an email.

You can also read more about health insurance for visitors in the USA with pre-existing conditions on our blog.