Visitor Insurance: Pre-Existing Conditions and Other Non-Covered Benefits

Visitor Insurance Pre-Existing Conditions Explained

Most visitor and travel insurance policies do not cover pre-existing conditions. Here is a video that explains why pre-existing medical conditions are not covered, and what visitors can do about it.

Q. What are pre-existing conditions? How do insurance companies determine these conditions?

Generally, pre-existing conditions include all such medical or physical conditions that cannot occur overnight, including high blood pressure, diabetes, AIDS, pregnancy, and any such condition. However, each visitor insurance plan has its own definition of what is considered a pre-existing condition, hence you are advised to read more about the plan before purchasing the same. Any injury, illness, or medical condition that meets any of the following criteria will be considered a pre-existing condition: 1) condition that requires you to seek medical advice, diagnosis, care, or treatment before the Effective Date of coverage under the policy, 2) condition for which manifestation, medical advice, diagnosis, care or treatment was recommended, received, or noticed prior to the Effective Date of coverage under the policy.

Q. Who determines if it is a pre-existing condition?

The insurance company evaluates the attending physician's (doctor's and hospital's) statement, past and present medical records, history, and nature of treatment to determine if the condition is pre-existing.

Q. Why are pre-existing conditions are not covered by visitor insurance plans?

Travel or visitor insurance plans are short terms plAns. If they start covering pre-existing conditions, they will end up paying much more than they receive from the premiums they generate, and they will not be able to run their businesses profitable.

Q. Why should I purchase visitor medical insurance if it does not cover pre-existing conditions?

Medical and health service costs in the USA are very high. The costs can be financially devastating especially in case of any emergency or accident and subsequent hospitalization. Visitors insurance is a means to insure against such unforeseen medical emergencies and should not be seen as a means to get medical treatment for existing medical problems.

Q. I want to get my surgery done for xyz problem. Will visitor insurance help?

No. Such situations come under pre-existing conditions, hence they will not be covered.

Q. I want to get a complete physical checkup done while in USA. Will my visitor insurance cover expenses for the checkup?

No, none of the visitor insurance covers physical checkup and any other preventive care.

Q. I want to have a vision/eye test and get new pair of eyeglasses. Is this covered in the insurance?

No. Visitors insurance does not cover vision/eye test.

Q. Is pregnancy and prenatal care covered?

No. Travel medical insurance does not cover for pregnancy or prenatal care.

Q. Is diabetes or blood pressure covered by plans that cover acute onset of pre-existing conditions?

The individual may be covered only if the individual's attending physician determines that his or her diabetes is "acute."
"Acute onset of pre-existing conditions" is defined as a sudden and unexpected outbreak or recurrence of a pre-existing Conditions which occurs spontaneously and without advance warning in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent care. The Acute Onset of a Pre-existing Conditions must occur after the effective date of the policy. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence.
A Pre-existing Condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered Acute Onset.

Information provided here is high level, provided for your convenience and information purpose only. Please review the Evidence of Coverage and Plan Contract (Policy) for a detailed description of Coverage Benefits, Limitations and Exclusions. Must read the Policy Brochure and Plan Details for complete and accurate details. Only the Terms and Conditions of Coverage Benefits listed in the policy are binding.
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