INDIA NETWORK FREQUENTLY ASKED QUESTIONS AND
ANSWERS
Pre-existing Condition Rider - Rev.
1/20/2010
1. Does the program cover doctor visits
related to pre-existing problems?
No. However, every policy holder with
pre-existing coverage can avail physician consultation (on
Phone) offered by India Network Foundation during their stay in the United States
for a small fee of $25 per consultation. The consultation can be requested
by completed the Consult A Doctor
Form. The Physician consultation can be used for prescription refills,
discuss their current medications, seek second opinions, or non-emergency
illness. All participating physicians are USA Board Certified and practicing
physicians in USA.
2. What are pre-existing conditions? Can you provide some
examples?
A health or medical condition is
categorized as pre-existing condition if that condition is known to the insured,
a Physician was consulted, or for which treatment or
medication was prescribed prior to the effective date of an Insured Person's coverage.
Diabetics, Blood Pressure (BP), chronic back pain, high cholesterol, kidney stones,
skin problems, or are some examples of
pre-existing conditions.
3
. Why pre-existing conditions are
excluded from 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 sure or near certain
probabilities. 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 Doc Program of India Network
Foundation is designed to help visitors with non-emergency nature problems
arising out of pre-existing medical conditions. President Obama's health care
reform when enacted may help people with pre-existing conditions, who currently
can not obtain private medical insurance.
4
. What is this "Pre-existing Condition
Rider? How does work?
Pre-existing condition rider is an add on
option to India Network members who wish to insure their visitors or
themselves. This rider when purchased would cover life threatening emergency
situations due to any pre-existing medical condition. The
Rider DOES NOT COVER maintainence 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 Doc program.
5. Can you give some examples where rider would be of help?
For example, someone has blood pressure problem
and is under control with medication. Suddenly the insured become sick with
brain hemorrhage and rushed to hospital. This would be a scenario where rider
would be of help. If the visitor want to see either a specialist or a family
physician to checkup blood pressure problem in ordinary circumstances, the
doctor consultation is not covered either by the rider program or the medical
insurance. The India Network Program also offers Medical Evacuation benefit and
Repatriation benefit (see program link for details).
6. How much does it cost? How much does it
pay in case of emergency?
The Rider option would cost twenty five percent
additional premium for 18-69 years old and 80 + visitors, and twenty percent for
those 70-79
years old. The rider provides up to $15,000 with $100K; $20,000 with
$150K policy; and $3,000 ($8,000 effective 1/1/2010) with $50,000 and $4,500 ($10,000
effective 1/1/2010) with $100,000 program for 70 plus old. The deductible for pre-existing condition rider is $1,000 per
incident for all age groups.
Rider is NOT available with $50,000 program
for 2-69 years old. For example, a
member purchases the pre-existing condition rider 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
$20,000 for this sickness. IT IS NOT TEN PERCENT OF THE BILLS. ALL BILLS WILL
BE SETTLED AS PER THE Policy UNTIL THE AMOUNT REACHES $20,000 (with 150K
policy).
7 We have used all our rider amount and
is there anything else that would help with pre-existing problem?
India Network program offers up to $25,000
for medical evacuation (with $150K policy). This amount would still be available
to the family should the family and attending physicians decide to shift the
care to home country.
8. 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 programs sold
by insurance agents that do not serve consumer needs. These agents are
contracted with various General Agents that DO NOT Offer any pre-existing
coverage programs. No agent is allowed to sell or market India Network Health
Insurance program in the US or elsewhere. Hence Agents are not allowed to sell
India Network Program on their web sites. 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 their program. India Network Program is the
ONLY ONE that covers pre-existing conditions in case of life threatening
emergencies for elderly including 80 plus.
9. Are there
any other companies that provide some coverage for pre-existing conditions for
shorter durations ie less than 3 months?
Multinational Underwriters provide limited coverage for pre-existing
conditions. The India Network Rider Program is much broader and provide blanket
coverage for pre-existing condition related emergencies. Please read the policies
carefully before you signon. The Multinational program can be purchased for any
duration.