INDIA NETWORK HEALTH INSURANCE PROGRAM

Questions and Answers on Pre-existing Condition Rider - Rev. 8/09/08

1. 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 dedication was prescribed prior to the effective date of an Insured Person's coverage. Diabetics, blood pressure, chronic back pain, high cholesterol, kidney stones, skin problems, or any other similar medical conditions are some examples of pre-existing conditions.

2. Why pre-existing conditions are excluded from coverage?

No insurance company can afford to cover these sure losses with few premium dollars of few months. 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 fully. 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

3. What is this "Pre-existing Condition Rider? How does work?

Pre-existing condition rider is an add on option for 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 health problems. The rider DOES NOT COVER day today lab tests, x-rays or doctor visits related to pre-existing conditions. If you have non-emergency nature of sickness, you may make use of India Network Foundation Consult a Doc program.

4. 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 for the same problem in ordinary circumstances, the physician visit is not covered either by the rider program or the medical insurance.

The Rider option would cost twenty five percent additional premium for 18-69 years old and sixteen percent for those 70 plus years old. The rider provides up to $15,000 with $100K; $20,000 with $150K policy; and $3,000 with $50,000 for 70 plus old.  Rider is not available with $50,000 program for 18-69 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).

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.

7. 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. 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.