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International Health Insurance for Pre-Existing Conditions

Learn about international health insurance options for expats with pre-existing conditions to find medical coverage living or traveling abroad.

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Expat Health Insurance Coverage for Pre-existing Conditions

The best way for expats to secure international health insurance coverage for people with pre-existing conditions is to participate in a large group policy that covers pre-existing conditions. If you are unable to participate in a large group policy, additional options are available.

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Expat Coverage Options for Pre-existing Conditions

International health insurance policies may choose to cover or exclude pre-existing conditions in the following ways:

  • Pre-existing coverage available through a group insurance policy
  • Insurance coverage for unrelated medical conditions that excludes any coverage for the pre-existing condition
  • Waiting period or moratorium on coverage for the pre-existing condition(s) on an individual or family policy
  • Coverage including the pre-existing condition(s) with higher annual premiums
  • Have a limit on the amount of benefits that can be used toward the pre-existing condition
  • Decline any medical coverage for someone with a pre-existing condition

Coverage decisions vary depending on the insurance provider. Working with a broker allows you to consider options from multiple providers and select the company and policy that best fits your needs and budget.

Here is a more detailed explanation of each coverage scenario for a policyholder with a pre-existing condition:

Group Insurance Benefits

The best way to get medical insurance abroad with pre-existing conditions is through a large group, such as your employer.

Insurance providers will cover individuals with pre-existing conditions in a large group because enough people are participating in the policy to offset the cost of coverage.

Explore corporate insurance options.

Exclusion of Pre-Existing Condition

International health insurance companies may cover an expatriate’s medical expenses but exclude the pre-existing condition. This means that insurance will only cover claims unrelated to the pre-existing condition.

Moratorium or Waiting Period

International Health Insurance providers may be willing to cover your pre-existing condition after you have been paying premiums for a pre-determined amount of time or waiting period. This amount of time may be a year or two, and the length of time is determined at underwriting.

A moratorium means that the insurance provider will use a waiting period to determine whether or not coverage is feasible. If you have had no recurrences or did not need any treatment during the moratorium, coverage of your pre-existing condition in the future may be available.

Coverage with Higher Annual Premiums

An expat health insurance provider may offer coverage of a pre-existing condition with a higher annual premium. This happens when the insurance provider determines that a higher premium will offset enough financial risk from covering the medical condition during the underwriting process.

Limit of Benefits for Pre-existing Conditions

Expat medical insurance companies may choose to cover a pre-existing condition but provide a lower limit on the benefits that can be claimed related to the pre-ex condition. This decision will be made during underwriting.

Decline Insurance Coverage

International insurance companies may also decline to insure an individual with a pre-existing condition. Declined coverage from one expat health insurance provider does not necessarily mean all insurance companies will decline coverage.

How an Insurance Broker Can Help With Pre-existing Condition Coverage

Insurance brokers help expats with pre-existing conditions find and compare policies from different international insurance companies at no cost. Brokers represent the expat seeking insurance and not the insurance company so that expats can trust advice and recommendations from a broker.

Insurance brokers partner with insurance companies to sell policies, and insurance companies pay the broker for their services. However, because the broker represents multiple companies, the broker will still give expats the best recommendations and make sure they’re happy.

Brokers may also help expats file insurance claims. This could be especially helpful for expats with pre-existing conditions. Pacific Prime has a dedicated claims team to help policyholders file claims with their medical insurance provider.

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Relevant Health Insurance Plan Features

Expats with pre-existing conditions already know that medical treatment and care will be an expense. That means that balancing deductibles, annual benefit limits, and premiums requires a different strategy than one for an expat with no health concerns.

Remember that underwriting and coverage decisions ultimately remain with the insurer. However, there are some general guidelines that all expats with pre-existing conditions should consider when deciding which health insurance plans to apply for.

Annual Benefit Limits

Expats with pre-existing condition coverage need to carefully consider whether the annual limit is sufficient for their pre-existing condition because they will have to pay for any medical expenses that exceed the benefit limits.

Most international plans have a total benefit limit and limits for different categories, such as inpatient versus outpatient expenses. Some insurers also have annual benefit limits per condition.

When you are choosing insurance plans, make sure any limits on benefits are feasible for your pre-existing conditions. Apply for plans with appropriate benefit limits or unlimited benefits to ensure adequate coverage.

Inpatient and Outpatient

Some pre-existing conditions require more specialists and outpatient care than others. Compare the annual outpatient limits and co-pays for seeing your general practitioner and specialists. Also, check that inpatient coverage is sufficient for your condition(s).

Emergency Evacuation

Emergency medical evacuation will cover the cost of getting you to the nearest medical facility that can treat your condition in an emergency. Expats with pre-existing conditions should be especially careful in selecting plans that will pay for emergency medical evacuation.

Be aware that not every country in the world has a public medical emergency transportation service. In many countries, someone needs to contact the hospital and arrange for private emergency transportation.

Pharmacy Benefit Limits and Exclusions

Many pre-existing conditions are chronic and require continuous medication management, so expats selecting insurance plans should be aware of any annual pharmacy benefit limits with their desired plan. Each plan will also have its own limits or exclusions for alternative therapies.

Common exclusions or benefit sub-limits exist for homeopathy and traditional Chinese medicine.

Physical Therapy and Chiropractor Coverage

Most expat health insurance plans exclude or limit the number of covered physical therapy and chiropractor sessions each year. For a higher premium and more comprehensive plan, there are insurance plans that cover unlimited sessions when medically necessary.

Sudden injuries may only need one round of physical therapy. For someone with a chronic or recurring type of pre-existing condition, physical therapy may be an ongoing treatment process. Keep in mind what your needs are or may become when you select insurance plans.

Deductibles & Copays (Excess)

Expats with pre-existing conditions are more likely to save money with a higher premium and lower deductibles and copays (excess) if they are able to secure coverage for their pre-existing conditions.

Conditions that require regular medical consultation and/or treatment need to find plans are more likely to accumulate out-of-pocket expenses on high deductible plans. Choosing a plan with a higher premium and lower or no excess will help someone with these conditions save money.

Direct Billing

Some international health insurance carriers have direct billing agreements with hospitals, clinics, and providers. Other carriers may use a reimbursement claims process. If you are financially unable to wait for reimbursement, seek out insurers and medical providers with direct billing agreements.

If the hospital, clinic, or provider does not have a direct billing agreement with your insurance company, you will have to pay the medical bill and then file a claim for reimbursement.

Hospitals and clinics abroad have direct billing agreements with certain insurers. Which insurers have direct billing agreements varies from hospital to hospital.

Direct billing information is available on your insurance provider’s website and sometimes the medical care provider’s website as well. For questions, contact your insurance company and medical providers to verify coverage and direct billing agreements.

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Travel or Short-term Medical Insurance for Pre-Existing Conditions

Travel insurance policies or short-term international insurance plans have coverage options for tourists and travelers with pre-existing conditions. Often this coverage is available with an additional rider and fee. Certain policy benefits may be unaffected by pre-existing conditions.

Travel and Short-Term International Insurance Providers

VUMI Travel VIP, IMG Globehopper, and GeoBlue offer benefits that cover stable pre-existing conditions while traveling or staying abroad short-term. April International offers short-term international insurance and travel insurance with pre-existing riders.

VUMI Travel VIP offers both single-trip and multiple-trip annual coverage for traveling abroad and includes medical benefits up to USD $500,000 for stable pre-existing conditions. The policy also includes popular non-medical benefits like lost or delayed baggage.

IMG Globehopper travel insurance plans cover medical expenses and medical evacuation for sudden and unexpected recurrences of pre-existing conditions for US citizens. Policies cover terrorism and also have sports and adventure riders available.

GeoBlue plans, like the Trekker Choice Plan, include some coverage for pre-existing conditions for travelers abroad, the largest direct billing network, and up to USD $500,000 for emergency medical evacuation.

April International sells both short-term international health insurance plans and travel insurance. April International’s short-term insurance policies offer a rider to cover pre-existing conditions while you’re abroad. This company also has a sizable direct billing network worldwide.

Trip Cancellation Insurance and Pre-existing conditions

Many travel insurance policies include coverage for trips canceled due to unexpected illness. Consult the policy guidelines to see if sudden and unexpected recurrences of a pre-existing condition are included under trip cancelation benefits.

Travel Medical Insurance and Pre-existing Conditions

Travel medical insurance benefits often exclude pre-existing conditions. Plans available from  GeoBlue, IMG Globehopper, and VUMI Travel VIP do not exclude stable pre-existing conditions from medical benefits.

Other insurance providers, like April International, offer travel medical insurance and short-term international health insurance policies with supplemental riders to cover pre-existing conditions.

Contact for Assistance with Pre-existing Condition Coverage

If you are looking for an impartial insurance expert to help you find and compare policies, you have come to the right place. Contact Pacific Prime online or by calling 1-(626)-600-7089 in the United States. Pacific Prime helps individuals, families, and large groups secure health insurance.

Navigating the international health insurance market with a pre-existing condition can be stressful. Keep in mind that there may be ways to find at least some medical insurance, even if it does not fully cover your pre-existing condition.

The best method to secure coverage for a pre-existing condition is to obtain international health insurance with a group policy, like one through your employer. Large groups are often granted insurance benefits that an individual or family will not be.

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Frequently Asked Questions

Can I get international health insurance in the Philippines with pre-existing condition coverage?

Expats in the Philippines can get health insurance policies that will either cover their pre-existing conditions, cover their conditions with higher premiums or after a waiting period, or offer medical coverage excluding expenses related to their pre-existing conditions, depending on underwriting.

What is the best expat health insurance for pre-existing conditions?

The best expat health insurance for pre-existing conditions is a large group policy, such as one through your employer. International health insurance policies for large groups are more likely to cover pre-existing conditions than individual or family plans.

Is an HMO or PPO better for pre-existing conditions?

Health Management Organizations (HMOs) have less expensive plans, but Preferred Provider Organizations (PPOs) have more options to see in-network and out-of-network providers. If your pre-existing condition requires many specialists, consider PPOs for the flexibility.

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For further advice on the most appropriate way of covering your pre-existing condition give us a call or leave your details with us here.

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