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

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

10 October 2019 |

If you are planning an upcoming vacation to the United States and are looking at purchasing visitor health insurance to cover any medical expenses during your trip, you have probably come across the term “pre-existing condition” more than once in your research. If you are unfamiliar with medical insurance, you might be wondering what a pre-existing condition is, and more importantly, what qualifies as a pre-existing condition according to 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 visitor health insurance coverage begins and can affect anyone. In general, they tend to be long-term or chronic conditions. While you can still travel with a pre-existing condition, it’s important to get clearance from your doctor first.

If you have—or suspect you have—a pre-existing condition, be sure to find the best visitor health insurance plan, preferably one that provides some type of coverage for pre-existing conditions, while shopping around.

It may seem like your insurance options are limited when it comes to purchasing visitors insurances with a pre-existing condition, but there are still plenty of coverage possibilities to keep you covered throughout your trip.

What Is Considered a Pre-existing Condition?

A pre-existing condition includes any ailment or illness that is experienced or diagnosed before your visitor insurance coverage begins. Anyone can be affected by a pre-existing condition and it does not necessarily mean that you are unable to travel or purchase a short-term visitor health insurance plan. Common pre-existing conditions include, but are not limited to the following:

  • 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.)

Purchasing Visitor Health Insurance With A Pre-existing Condition

If you have a pre-existing condition, you might be worried that you will not be able to obtain visitor health insurance coverage before your trip. In general, visitor health insurance will not provide coverage for pre-existing conditions.

However, some policies DO provide coverage for the acute onset of many pre-existing 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.

It is worth noting that no medical examination needs to be conducted before or after your arrival into the U.S. However, you should get a comprehensive check-up by your family doctor before leaving for your trip.

If you fall ill or have an injury that requires medical attention 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 and the claims process will begin. Depending on your coverage, you may need to pay out of pocket to cover any plan deductible or co-pays.

So, why don’t insurance companies like to provide coverage to travelers with pre-existing conditions? In short, it is expensive. Insurance companies will lose money covering those who are much more likely to need expensive medical care and treatments while they are visiting the United States.

Luckily, there are options for those who are purchasing visitor health insurance with pre-existing conditions. Visitor Guard® offers a wide range of short-term health insurance plans for travelers planning to visit the United States, including plans like Patriot America Plus and Atlas America, which provide coverage for the early onset of pre-existing conditions.

Should I Disclose My Pre-existing Condition?

It can be stressful to think that your medical claim may be denied if you disclose a pre-existing medical condition prior to purchasing short term visitor health insurance. Insurance companies are smart and are adept at finding fraudulent insurance claims, so it is very difficult to try to deceive the system.

Leaving out crucial medical history information to avoid being denied a claim is extremely risky, and if you are caught, you will not only be responsible for paying high medical bills but could also be faced with fines and legal action for attempting insurance fraud.

Not being honest about pre-existing conditions also poses a greater health risk to insured travelers who need to seek out emergency medical attention. There can be severe risks associated with mixing certain medications and withholding your medical history from doctors could lead to disastrous consequences.

Honesty is the best policy, especially when it comes to medical insurance, and it is best to be as upfront as possible about previously diagnosed issues, as well as any symptoms you happen to be experiencing when purchasing visitor health insurance with a pre-existing condition. If you are unsure about whether something will be covered under a plan, review the listed schedule of benefits, which will go into detail about services and conditions that will be covered under your insurance plan.

Tips for Visiting the US with a Pre-Existing Condition

If you or a family member have a pre-existing condition and are planning to visit the United States, it is well worth the time and money to research and invest in a visitor health insurance plan to help with the financial burden of a medical emergency. Follow these steps to keep peace of mind and avoid financial or physical hardship:

Visit your doctor

Before leaving for your trip, pay a visit to your family doctor and ask for a brief copy of your medical records and a list of medications. This will come in handy not only at the time of service, but also will expedite the claims process should you need to make a claim with your insurance company.

Bring your medications

It is wise to stock up on extra medication for your trip, as you never know when you might need more. Delays and flight cancellations are common when travelling abroad and you don’t want to be stuck without access to medications or a way to contact your doctor for a refill.

Ask for a medical history letter

Have your doctor include a detailed note about your current medical condition, past treatments, and required medications, and keep it on you at all times. This will be extremely helpful in the event of an emergency and will also be beneficial if a claim is denied.

Familiarize yourself with the claims process

Research what to expect if you need to seek medical care on your trip and know if you will need to pay up front and out of pocket for any services and what will be covered by insurance. Be sure to hang on to any medical receipts and itemized bills for the appeals process, should you need it.

Be ready to appeal

You may need to file an appeal if you are denied treatment or insurance does not pay for a condition that is not pre-existing. Be sure that you keep all of your medical records together in a safe place with a copy of your passport for easy access.

Ask about payment options and discounts

If your insurance claim is denied, you don’t need to worry, 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 before paying.

Use your best judgment

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

Purchasing visitor insurance with a pre-existing condition before a trip to the United States doesn’t have to be a stressful process or prevent you from enjoying the trip of a lifetime. Visitor Guard has plenty of visitor insurance coverage plans that will easily suit the needs of any traveler. Ensuing you and your loved ones are financially covered in the event of a medical emergency is the best way to enjoy your time abroad.

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