Pre-existing conditions are common, but it does not mean that these conditions will stop you from going on a trip abroad or carrying on with your day-to-day life. Pre-existing conditions like asthma, diabetes, high blood pressure, cholesterol, and more can be life-threatening if not treated. You need constant doctor’s visit and medications to keep them in check so that there does not lead to something chronic. However, when it comes to health insurance with pre-existing conditions, buying a plan that covers the acute onset of pre-existing conditions is certainly necessary.
Health insurance with pre-existing conditions for visitors
If you are a visitor to the US, you must buy a health insurance policy to cover you during your stay. The same goes for immigrants who have not yet got green card status. Unfortunately, visitors and immigrants cannot find plans that cover pre-existing conditions. Instead, they can find plans that cover only the acute onset of pre-existing conditions. Though each policy defines pre-existing conditions and acute onset of pre-existing conditions separately, reading the brochure is recommended.
Plans like Safe Travel USA Comprehensive, Patriot America Plus, Atlas America, Patriot Platinum, Safe Travel USA, Safe Travel Elite, and Visitors Care are some plans that offer acute onset of pre-existing conditions coverage. For instance, Safe Travel USA Comprehensive covers 1 acute episode per pre-existing condition up to policy medical max for non-cardiac ($25,000 limit for cardiac) conditions for 69 years & under; and up to $35,000 for non-cardiac ($15,000 limit for cardiac) conditions for 70-years & above.
In contrast, Atlas Travel provides a limited benefit up to the medical coverage lifetime maximum for eligible medical expenses. For example, if you are younger than 80, you may be covered for an acute onset of non-chronic pre-existing condition. This also includes a $25,000 lifetime maximum for emergency medical evacuation. But this plan does not cover complications or consequences of chronic or congenital conditions that gradually worsen over time.
Health insurance with pre-existing conditions for US citizens
US citizens with pre-existing conditions can buy plans from the Marketplace. All plans available in the Marketplace must cover pre-existing conditions. No plans can charge you more, reject you, or refuse health benefits because of your pre-existing conditions. Once you have enrolled for Open Enrollment plans, you will receive the coverage. In addition, if you have enrolled for Medicaid or CHIP (Children’s Health Insurance Program), you can be covered for pre-existing conditions.
Pregnancy is considered a pre-existing condition. Therefore, if you are pregnant at the time of application, you will not be denied coverage. Pregnancy and childbirth are covered right from the day the plan starts. However, check your eligibility before enrolling for a plan. If you have given birth or adopted after enrollment, you can check if your child qualifies for Special Enrollment.
Grandfathered plans do not cover pre-existing conditions. These health insurance plans were bought by individuals before 23rd March 2010 and were not sold by the Marketplace. These were sold by insurance companies, agents, or brokers. If you have bought a grandfathered plan and are now looking for pre-existing coverage, you have two options- i) you can buy a plan from Marketplace during Open Enrollment, and ii) you can buy a plan outside the Marketplace only if you qualify for the Special Enrollment Period.
In short, under the Affordable Care Act, you will not be denied coverage due to a pre-existing health condition. However, do check the eligibility criteria before buying.
Immigrants or visitors to the US must buy insurance plans with acute onset of pre-existing coverage from a US insurance provider to cover them during their stay. When it comes to US nationals, residents, and legal permanent residents, they can buy pre-existing plans from the Marketplace. Before buying any plans, it is recommended to read the brochure and check eligibility.
For any concerns or queries, contact NRIOL.net.