What You Need to Know About Acute Onset and how that works for pre-existing conditions

Acute Onset | India Network Forum

An acute onset involves sudden and recurrence of serious conditions that need immediate medical care. This coverage also requires that the care be sought within few hours of first systems started. In other words, this is a situation where insured requires immediate treatment within few hours of problem due to pre-existing conditions.  Many plans on various web sites (such as AXIS Insurance,  Visitor Secure, Safe Travels, Inbound Plans, Patriot America Plus, Atlas America, Atlas Premium America, etc.)   offer pre-existing coverage using Acute Onset definition.

This definition pretty much nullifies the coverage you were expecting for pre-existing conditions as it is impossible to run to hospital immediately after some discomfort. Due to this reason, the plans offer millions of dollars of pre-existing conditions coverage using the "ACUTE ONSET" definition at a very low price. As you see very well, most claims do not qualify under the definition of "acute onset" and you will soon realize that plan has no practical coverage for pre-existing conditions.

However, ACE Premier (Fixed Benefit Plan) and ACE Network (Comprehensive) plans offers pre-existing conditions coverage that simply states that new problems and pre-existing conditions are covered in the same way. There is no need to worry about whether a particular Emergency room visit is covered or not. These two plans pay your ER bill either as a new medical condition or as a pre-existing condition related. In either case, your claim is covered and paid. There is no other plan anywhere (India or the USA) that would offer the peace of mind that these two plans offer. That is one reason, these plans offer reasonable pre-existing maximums (rather than millions) and cost slightly more.

How insurance companies use acute onset description

Most insurance companies don't offer pre-existing coverage, but will offer acute onset coverage. There are a lot of exceptions that may apply when it comes to acute onset. For most insurance companies, insured must seek medical attention within 12 or 24 hour window after initial symptoms in order to be considered acute onset.

What you need to know about acute onset:

You should seek medical attention as soon as you experience any symptoms. When it comes to extreme conditions like a heart attack or stroke, people need to get immediate care since these conditions can be very severe, and could costs a lot of money.

Stay away from “acute onset”!

People should stay away from insurance plans that have pre-existing condition coverage with acute onset description. When the insured person misses the window of 12 or 24 hours period, insurance company will not cover the medical bills. On top of that, most plans which use this definition also require pre-approval (which does not mean they will pay even if they pre-approve!).  It is important to get the plans that will provide coverage for pre-existing conditions with no acute onset restrictions.

What are the best plans? Are there any plans with no acute onset description?

India Network Health Insurance offers ACE Network Comprehensive plan and ACE Premier Plan for people with pre-existing conditions. These plans do not have acute onset descriptions; hence, they provide great coverage with fewer restrictions. These plans are recommended for older people (50 years and up), and for people with pre-existing conditions. Visit our website for more information.

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Written by Help Desk


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