Pre-Existing Conditions: Maternity Coverage Options for Expats with Health Concerns
Pre-existing conditions are medical problems that you have received medical treatment, diagnosis, or advice prior to signing up for a health insurance plan. Due to financial risk, international health insurance providers tend to shy away from covering pre-existing conditions.
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While pregnancy is not considered a pre-existing condition, allowing expat parents to seek maternity insurance, other illnesses, injuries, or ailments may or may not be covered in the health insurance policy they wish to apply for.
Are you an expat venturing into parenthood and you’re looking for maternity coverage options? Today, we will be going over pre-existing conditions in international health insurance as well as maternity coverage options available to expats.
What Are Pre-Existing Conditions?
Pre-existing conditions are illnesses or injuries that you had before signing up for a new health insurance plan. Note that certain health insurance providers will include symptoms in which someone would have received treatment prior to signing up.
During your health insurance application, always remember to be honest and provide accurate information to avoid any potential claim rejections or policy cancellations.
Expat parents will be happy to know that pregnancy is not considered a pre-existing condition, allowing them to secure maternity insurance to safeguard their pregnancy while living overseas without needing to worry if their health insurance application will get rejected or not.
The Criteria for Pre-Existing Conditions
When applying for a health insurance plan, insurers will ask you to disclose pre-existing conditions and proceed with the underwriting process to determine the feasibility of your health insurance application, the premiums you are expected to pay, and your waiting period duration.
Below are possible questions insurers could ask you during your application:
- Have you been diagnosed with any condition before applying for the policy?
- Have you been treated or given treatment advice before applying for the policy?
- Have you been investigated or advised to do so before applying for the policy?
- Have you gotten medication or been advised to do so before applying for the policy?
- Have you been hospitalized or advised to do so before applying for the policy?
- Have you manifested any symptoms before applying for the policy?
- Have you developed strong anomalies such as brain tumors or cancer stages before applying for the policy?
Why is it Difficult to Find Pre-Existing Condition Coverage?
The reason why finding pre-existing condition coverage is difficult is because international health insurance providers are leery about covering pre-existing conditions due to financial risk.
Covering more known medical conditions guarantees expenses that aren’t likely to be offset by collected premiums. Health insurance applications with pre-existing conditions will be sent to underwriting for the insurance company to review the financial possibility of the coverage.
Possible Outcomes for Expat Pre-Existing Condition Coverage
Some providers may accept expats’ requests for pre-existing condition coverage with some conditions of their own such as waiting period or requiring higher annual premiums from policyholders. However, some insurance providers may not be able to cover such conditions and outright turn them down.
While pregnant women can seek maternity insurance to safeguard their pregnancy as pregnancy is not considered a pre-existing condition, other illnesses or injuries they may have had prior to the pregnancy or their health insurance application may not be covered.
Decisions on potential coverage outcomes will vary depending on the insurance providers. It is advisable to work with an insurance broker so you have options from multiple providers and select policies that best match your specific healthcare needs and your budget.
Below are the potential outcomes for expat pre-existing condition coverage.
Group Insurance Policy
The best way to secure health insurance abroad despite having pre-existing conditions is through larger groups, such as an employer. Insurance providers will cover individuals affected by pre-existing conditions in large groups because there are enough people to offset coverage expenses.
Insurance Companies Excluding Pre-Existing Conditions
On the other hand, certain international health insurance companies may still cover expat medical fees but at the cost of excluding any pre-existing conditions. As such, the insurance companies will only cover claims that have nothing to do with said pre-existing conditions.
Waiting Period for Pre-Existing Condition Coverage
While certain international health insurance companies will cover any pre-existing condition, you may need to pay premiums for a predetermined waiting period first. The waiting period could range from a year to two years, and the duration of the period is determined during the underwriting process.
Higher Annual Premiums
Alternatively, international health insurance companies will cover pre-existing conditions but at the cost of paying higher annual premiums. This is due to the insurance provider coming to the conclusion that higher premiums will offset financial risks from covering the pre-existing condition.
Benefit Limits for Pre-Existing Condition Coverage
In another scenario, international health insurance companies will cover pre-existing conditions but at the cost of limitations on coverage benefits. The decision to impose limitations on the pre-existing condition coverage will once again be made during the underwriting process.
For instance, a pregnant mother may not receive benefits for a heart condition for a certain period of time after starting the policy but can still receive care for non-pre-existing conditions such as other illnesses and injuries.
Insurance Coverage for Pre-Existing Conditions is Completely Declined
In the worst-case scenario, international health insurance companies may completely decline coverage for individuals with pre-existing conditions.
Fortunately, pre-existing condition coverage refusal from one international health insurance company doesn’t exactly mean other companies will do the same. Some other international health insurance companies may cover pre-existing conditions at the cost of either waiting periods or higher premiums.
How Insurance Brokers Help You With Pre-Existing Condition Coverage
Insurance brokers can help expats, who have pre-existing conditions, find the right international health insurance policy that matches both their budget and healthcare needs. They can also help expats compare multiple policies from various insurance companies at no additional cost.
The brokers partner with insurance companies to sell policies, while the companies pay them for their services. Fortunately, since brokers represent multiple health insurance companies, they can always give expats the best health insurance policy recommendations to ensure their satisfaction.
Insurance brokers can also help expats with filing insurance claims, which can really come in handy for expats affected by pre-existing conditions.
Thanks to the insurance brokers representing expats seeking health insurance plans and not any insurance company directly, expats have someone they can trust when it comes to health insurance selection advice and recommendations.
Frequently Asked Questions
What is the best health insurance option for expats with pre-existing conditions?
The best health insurance option for expats with pre-existing conditions is a large group policy from employers, as policies for larger groups are more likely to cover pre-existing conditions in comparison to individual or family health insurance plans.
Is pregnancy considered a pre-existing condition?
Pregnancy is not considered a pre-existing condition. This means you will not be denied coverage due to your pregnancy if you were pregnant at the time of signing up for a new health insurance policy.
What is the exclusion period in pre-existing conditions?
The exclusion period in pre-existing conditions is whenever a health plan won’t pay for pre-existing condition care. Under a job-based plan, the exclusion plan cannot exceed one year for a regular enrollee and cannot exceed 18 months for a late enrollee.
Conclusion
In conclusion, not every insurance provider will be able to cover pre-existing conditions for expats. In some instances, some providers will be able to cover pre-existing conditions but at the cost of the waiting period, higher annual premiums, or benefit limitations.
Meanwhile, in the worst-case scenario, some insurance providers may not be able to cover pre-existing conditions at all and will outright turn them down. Fortunately, some providers may still be able to cover such conditions.
It’s advisable that you work with insurance brokers as they can help you find and compare insurance policies from multiple providers to ensure you get the right coverage for your pre-existing conditions that matches your comfortable budget and your specific healthcare needs.
As a leading international insurance broker, Pacific Prime has over 20 years of experience in matching both expats and locals to health insurance plans that match both their budget and particular healthcare needs.
Whether you’re a local citizen yourself or an expat living overseas, Pacific Prime and our team of experts are more than happy to help you find the best health insurance plan to cover your pre-existing conditions effectively.
If you have any further questions, please don’t hesitate to get in touch with us.
Enjoyed this article? Check out our other articles here:
Best Insurance Plan for Pregnancy as an Expat
Newborn Care for Expats: Quality Coverage for Your Baby
Serena earned her Bachelor’s Degree in Psychology from the University of British Columbia, Canada. As such, she is an avid advocate of mental health and is fascinated by all things psychology (especially if it’s cognitive psychology!).
Her previous work experience includes teaching toddlers to read, writing for a travel/wellness online magazine, and then a business news blog. These combined experiences give her the skills and insights she needs to explain complex ideas in a succinct way. Being the daughter of an immigrant and a traveler herself, she is passionate about educating expats and digital nomads on travel and international health insurance.
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