When choosing a visitors insurance plan to cover you for certain emergency medical situations while abroad, you'll likely come across plan options that offer coverage for the acute onset of pre-existing conditions. As a traveler that has previously existing health conditions, this may be a benefit that is attractive to you. However, it is important to understand just what this benefit means and where it can provide coverage.
What is an Acute Onset of Pre-existing Conditions?
The exact definition of the acute onset of pre-existing conditions will vary from plan to plan, as each insurance company typically has its own individual interpretation of what this coverage looks like. Generally speaking, an acute onset of a pre-existing condition can be described as a sudden recurrence or a flare-up of a past treated condition after the start date of the policy, in which you must receive care within 24 hours of the onset.
It's also important to keep in mind that the acute onset of a pre-existing condition differs from pre-existing condition coverage. To best understand a plan's coverage, it is recommended to carefully review a plan's policy and coverage details to understand what treatments or services may be covered as they relate to the acute onset of pre-existing conditions.
What Typically Isn't Covered Under Acute Onset of Pre-existing Conditions?
Most health conditions that are chronic or congenital are typically excluded from visitors insurance policies, even those that offer coverage for the acute onset of pre-existing conditions. For example, care related to an existing condition such as a heart condition, cancer, or diabetes would typically be excluded as these ailments are chronic and whether known or unknown, likely existed in the policyholder before applying for a visitors insurance policy. Conditions that are ongoing, present in the body at the time of policy purchase, and those that require medication are generally not considered as acute.
Comparing How Visitors Insurance Plans Coverage the Acute Onset of Pre-existing Conditions
When reviewing multiple visitor's insurance plans and their coverage details, you may notice that while generally speaking their definition of the acute onset of a pre-existing condition may be similar, the wording used will vary. Let's take a closer look at the different language used when describing coverage for the acute onset of pre-existing conditions for some top visitors insurance companies.
IMG
IMG describes the acute onset of a pre-existing condition as the following: "a sudden or unexpected outbreak or reoccurrence that is of short duration, is rapidly progressive, and requires urgent medical care".
Coverage for the acute onset of pre-existing conditions does not include any pre-existing conditions that are chronic or congenital, or that "gradually become worse over time". Additionally, this coverage does not include any condition "for which, as of the effective date, the insured person":
- knew or reasonably foresaw he/she would receive
- knew he/she should receive
- had scheduled
- were told that he/she must or should receive any medical care, drugs or treatment
Sources:
https://www.visitorscoverage.com/policydoc/patriot-america-plus-insurance-policy-document.pdf
https://www.imglobal.com/docs/library/forms-library/patriotplatinum-brochure.pdf
Disclaimer: the definition of coverage for the acute onset of pre-existing conditions for each insurance company will vary based on the plan. It is important to review your individual plan's coverage details for exact information regarding its coverage.
WorldTrips
WorldTrips describes an acute onset of a pre-existing condition as "a sudden and unexpected outbreak or recurrence that is of short duration, is rapidly progressive, and requires urgent care".
This type of coverage excludes pre-existing conditions that are "chronic or congenital, or that gradually becomes worse over time".
The acute onset of a pre-existing condition benefit only applies if:
- The condition does not "directly or indirectly relate to a chronic or congenital condition"
- Treatment must be received with 24 hours of the sudden and unexpected outbreak or recurrence
- You are under 80 years of age
- You are not "traveling against or in disregard of the recommendations, established treatment programs, or medical advice of a physician or other healthcare provider"
- You aren't traveling with the intent of trying to receive treatment for a pre-existing condition
- You are traveling outside of your home country
Source: https://www.worldtrips.com/insurance-resources/faq
Disclaimer: the definition of coverage for the acute onset of pre-existing conditions for each insurance company will vary based on the plan. It is important to review your individual plan's coverage details for exact information regarding its coverage.
Trawick
Trawick describes an acute onset of a pre-existing condition as a condition that "occurs spontaneously and without advance warning either in the form of Physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent and immediate medical care".
The condition also has to occur a minimum of 48 hours after the effective date of the policy and treatment must be obtained within 24 hours of the sudden reoccurrence. Any repeat of a condition meeting the terms above is no longer considered an acute onset of a pre-existing condition. This benefit only covers one acute onset episode of a pre-existing condition.
Source: https://trawickinternational.com/products/safe-travels-usa-comprehensive/
Disclaimer: the definition of coverage for the acute onset of pre-existing conditions for each insurance company will vary based on the plan. It is important to review your individual plan's coverage details for exact information regarding its coverage.
Seven Corners
Seven Corners defines the acute onset of a pre-existing condition as "sudden, unexpected, and occurs without advanced warning" which also classifies as a medical emergency and happens within the plan's period of coverage and after the 7-day waiting period.
Treatment for the sudden recurrence of the condition needs to be obtained within 24 hours of the occurrence. Additionally, there can be no change in "prescription or treatment related to the underlying pre-existing condition within the last 30 days" and the condition cannot be "congenital, a previously diagnosed chronic condition with expected episodes or flare-ups, or a deteriorating condition which cannot be controlled and gradually intensifies over time".
There is also no coverage offered for the acute onset of pre-existing conditions for which you traveled after your physician advised limited or restricted travel.
Source: https://www.sevencorners.com/plans/travel-medical-insurance/including-usa
Disclaimer: the definition of coverage for the acute onset of pre-existing conditions for each insurance company will vary based on the plan. It is important to review your individual plan's coverage details for exact information regarding its coverage.
Acute Onset of Pre-existing Conditions Frequently Asked Questions
Q) Which insurance plans offer coverage for the acute onset of pre-existing conditions?
A) Many visitors' insurance plans offer coverage for the acute onset of pre-existing conditions up to the stated limit, which may vary by the age group. A list of recommended plans that offer this type of coverage can be found here.
Q) What is not covered under acute onset of pre-existing conditions?
A) Typically, any chronic, congenital or progressive conditions that may get worse over time are not covered under coverage for the acute onset of pre-existing conditions due to the short term nature of visitors insurance plans.
Q) Are conditions like diabetes, blood pressure, and hypertension covered under acute onset of pre-existing conditions?
A) Diabetes, blood pressure and hypertension are considered to be chronic, long developing pre-existing illnesses which may require medications/treatments to keep the condition in control, this is why these are not considered to be acute onset of pre-existing conditions. A medical professional would be able to determine that.
Q) Who decides if a specific condition is acute or pre-existing?
A) Your attending physician will be able to determine this based on your medical history and examination.
Q) How do you differentiate between acute onset and pre-existing conditions?
A) A pre-existing condition is a condition that existed before or at the time of obtaining the insurance plan, especially if medications are taken to keep the condition stable.
An acute onset of a pre-existing condition is defined as a sudden and unexpected recurrence of a pre-existing condition that was not diagnosed as chronic, and no medications were taken after treatment.
A physician will be able to determine whether your condition is considered acute or chronic.
To learn more about the acute onset of a pre-existing condition, read more here.
Q) My father had heart surgery in the past, if there is any stroke or heart attack in the policy period, is that acute onset?
A) It may be considered a pre-existing condition since this type of ailment is typically a chronic condition, even if he has been stable recently. The insurance company will determine whether a condition is pre-existing based on the attending physician's diagnosis.