Why are pre-existing conditions generally excluded from visitor medical coverage?

No insurance company can afford to cover these sure losses with few premium dollars. The insurance premiums are determined on the basis of probabilities, and not the sure or near certain probabilities obtained from pre-existing conditions. Hence there is no insurance company that would cover the pre-existing conditions. Many insurance companies in the US will not even underwrite coverage if pre-existing conditions are found in medical reports. The Consult a Doctor Program of India Network Foundation is designed to help visitors with non-emergency nature problems arising out of pre-existing medical conditions.

If a visitor has pre existing coverage, the Premier plan from India Network Health Insurance offers medical insurance with a pre existing rider.  This is especially popular for senior parents visiting from India.

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I am browsing various sites on internet and they authoritatively say that pre-existing conditions are not covered by any insurance company. Is that correct?

Unfortunately, there are many health insurance plans sold by insurance agents that provide only psychological satisfaction when it comes to real benefits for people with pre-existing conditions. These agents are contracted with various General Agents and operate web sites under various names using bogus forums to generate questions and answers. The forums are used promote products that do not serve consumer interest. If you come across some comments on India Network plan, these are most probably posted by an agent trying to get some money by selling what he/she could sell. Most of these activities are unfortunately target Asian Indian community. No agent is allowed to sell or market India Network Health Insurance in the US or elsewhere. There is no insurance program other than India Network Health Insurance that is designed based on member feedback and member welfare as the core of its program. India Network Program is the ONLY ONE that covers pre-existing conditions in case of life threatening emergencies for the elderly including 80 plus.

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If couple is visiting and want coverage, do they both need to be members of India Network? Do they have to file separate forms?

No. A visiting relative can be sponsored by India Network Member (Citizen/GCard holder/any resident alien) who is in the United States or Canada. They can obtain coverage under one form except when spouses are in different age groups. For example, one spouse is below 70 years (or below 50) old and one is above 70 years old (or above 50), they must file separate enrollment forms.

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Can I renew the insurance after it expires?

You may apply afresh again for coverage. The Insured will be subject to pre-existing period again from the start date if there is a break in coverage.

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Can I select a doctor or is the plan open to any doctor?

The Standard and Premier plans are an open network and claims can be made 24x7 through claims processing or travel assistance for emergencies. This is especially convenient for many visitors who have not built established relationships with doctors and other specialists.

The Network based comprehensive plan offers both an open and in network option. The reimbursement for open network providers in the Network based plan is 60/40 and reimbursements is 80/20 when MultiPlan providers are used.  When using the Network based plan, it is recommended to use in network providers to maximize your out of pocket expenses at $1,000 should medical expenses exceed $5,000.

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How does Premier Coverage differ from Standard Coverage?

Premier Coverage includes all the benefits of Standard Coverage and coverage for pre-existing conditions. This policy when purchased would cover life threatening emergency situations due to any pre existing medical condition.

 Premier Plan DOES NOT COVER maintenance of pre existing problems such as prescriptions, lab tests, x-rays or doctor consultations or any outpatient services. If you have non-emergency nature of sickness, you may make use of India Network Foundation Consult a Doctor program.

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What is the deductible amount?

The program is sickness- and injury-based, and for each sickness, or injury, the chosen deductible is to be paid by policy holder. The usual and customary charges are paid by the insurance as outlined in the Schedule of Benefits located on the web page after meeting the deductible.

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Can I get pre-existing coverage if I am 70 years of age?

The pre existing coverage offered by India Network Plan is the highest available in the USA. Pre existing coverage of $25,000 is available for 70 plus members with $100,000 policy and a pre existing deductible of $5,000. Alternatively, if the visitor elects the $1,000 Pre Existing Deductible, the Pre Existing Maximum Coverage is $15,000.

For example, your mom is suddenly sick and rushed to the emergency room. She is treated and stabilized. The emergency visit is related to pre existing high blood pressure problem. The insurance will pay U&C charges as given in benefits schedule. The Insurance will pay for services related to the visit until it reaches $25,000 for this sickness (subject to $5,000 deductible with the $100,000 policy)  for the visitor age 70 plus.  IT IS NOT TEN PERCENT OF THE BILLS. ALL BILLS WILL BE SETTLED AS PER THE POLICY UNTIL THE AMOUNT REACHES $25,000 in this example.

Keep in mind, if an accident or sickness occurs unrelated to the pre existing condition, the standard deductible and standard maximum coverage applies.

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How much does it cost? How much does it pay in case of emergency?

Premier Coverage provides a maximum of $50,000 coverage with $150K policy and with a deductible of $5,000 for 2-69 Year old and $25,000 to 70 Plus members with $100K policy and with a deductible of $5,000. The pre-existing coverage offered by India Network Plan is the highest available in the USA. Premier Coverage is NOT available with $50,000 program. For example, a member purchases the Premier Coverage plan with $150,000 policy for parents. Mom got suddenly sick and rushed to emergency room. She was treated and stabilized. The emergency visit is related to pre-existing high blood pressure problem. The insurance will pay U&C charges as given in benefits schedule. The Insurance will pay to services related to the visit until it reaches $50,000 for this sickness (subject to $5,000 deductible) . IT IS NOT TEN PERCENT OF THE BILLS. ALL BILLS WILL BE SETTLED AS PER THE POLICY UNTIL THE AMOUNT REACHES $50,000 (with 150K policy).

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Can I cancel my policy once the policy starts?

No. The insurance can be cancelled prior to the coverage start date subject to $25 cancellation fee. After the start date, premiums are considered fully earned and no refunds will be possible.

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