In general, pre-existing medical conditions are not covered under travel medical insurance for foreign nationals visiting the United Sates.
So how do you determine which conditions are pre-existing medical conditions for travel insurance?
In simple terms, any medical condition that existed before you secured your international travel insurance is a pre-existing condition.
There are 3 general ways a condition can be linked with a pre-existing condition:
1. Health History Form
All new patients are required to fill out this form before seeing any doctor in the United States. The form seeks information about the general health history of the patient and makes it binding on the doctor to properly diagnose and treat the patient.
2. Attending Physician's Opinion
During the consultation, the doctor or physician may ask the patient specific questions about their health history for proper diagnosis and treatment. The information will be used by the doctor to form an opinion about the health history of the patient, including whether there was any pre-existing condition, and share the same with the travel insurance company.
3. Diagnosis and Lab Results
The doctor will communicate to the travel insurance company the diagnosis results of the patient in the form of Doctor Notes if there is any relevant information with regard to a pre-existing condition.
Contesting a Denial of Claim Based on a Pre-Existing Condition
Problem:A previous condition that was earlier cured and was no longer a problem until now has resurfaced. But it would not be categorized as a pre-existing condition; rather, it would be considered a new condition. However, your insurance company denies the claim citing it as a pre-existing condition.
Solution: You have the right to make an appeal on the matter by providing supporting evidence to contest the denial of the claim based on a pre-existing condition. The evidence can include a recent physical (general health checkup) report or written statement from your family doctor, stating this condition was under control or not existing before the start date of the current insurance.
The appeal will be reviewed, and most likely, the claim will be paid, depending on the genuineness of the evidence.
A claim form can be obtained from the insurance company. File the claim within the specified period/date, generally within 90 days from the day the service was obtained. Follow up the process from time to time with the insurance company.
- Provide all the documents and/or information on time when requested by the travel insurance company to avoid any delay and frustration.
- Some of the information and supporting documents might be requested from the doctor/hospital. The claim process can be delayed if the hospital or doctor doesn't send the requested information on time.
- It's a good idea to get a health check up done prior to traveling to the United States. Those reports can be vital to support your claim.
The claim process might take time and effort on your part, but if its a genuine case, you can be rest assured that your claims will be paid.
Learn more about travel insurance with pre-existing medical conditions for US travelers upto a certain limit: Pre-Existing Condition Insurance Plans