Pre-Existing Condition covered by Private Health insurance but not International Health Insurance

[4MyEgo]

I thought I would just mention my experience with trying to get international health insurance as its referred to, i.e. I am wanting cover here in Thailand and the option to return to Australia for surgery, if ever required.

My pre-existing condition, is a stent in one of my artery's which was performed a decade ago, with no issues ever since, and I have been on a couple of medications for blood pressure, cholesterol and blood thinner so I don't end up with a clot again, as was the case that gave me a mild heart attack back then.

Each time I have had my blood pressure done, its spot on, blood tests all good as well, and I am in good health, eat well and exercise, but no one will touch me, so I self insure, because I believe paying 100k baht a year for a international health care policy that is not going to cover my cardiovascular system in any form is just out right robbery in my opinion.

Below is a copy and pasted article that I got from an expat site, please read on and see the difference, i.e. in Australia it is compulsory for insurers to cover you with a pre-existing condition, I have also heard this to be the case in the US and UK, but it appears the international insurers can get away with it.

 

I am hoping someone who reads this can prove me wrong and say they have an insurer who has covered them, for either of the points below, i.e. 1 and 2, because 3 has been all I have ever been told.

Pre-Existing Illnesses

One of the big differences between private health insurance in Australia and international health insurance for Australian Expats is the cover for pre-existing illnesses.

Private health insurance in Australia must cover you (subject to waiting periods if applicable) for any pre-existing conditions and at no additional cost to the insured person.

However, for International Health Insurance for Australian Expats the situation is quite different.  The Insurance Company may offer  :

1.  Cover for the pre-existing condition with no additional premium;

2. Cover for the pre-existing condition with additional premium; or

3. Cover, but exclude cover relating to the pre-existing condition.

 

I am assuming that international insurers can get away with it because there is a loop hole or no legislation covering international insurers, anyway I am sure there will be some interesting replies.

Edited February 23, 2018 by 4MyEgo

[Sheryl]

Actually US insurers also refused cover to people with pre-existing conditions until very recently, it was only the legislation brought in under Obama that stopped this.

 

A private insurer who is legally allowed to, will exclude coverage for a condition which the insured person is clearly at an above average risk of developing or already has, because it simnply makes good business sense for them to do so.

 

HOWEVER you can not assume that this means that all insurers will exclude all heart conditions in your specific case, since it has been 10 years since your heart attack with no further problems (and, I assume, good BP and cholesterol control? You mention meds but insurer will want to know the current numbers). Rather than making this assumption, you should actually find out. Suggest you try Cigna global first.

 

 

[4MyEgo]

On 23/02/2018 at 11:35 PM, Sheryl said:

Actually US insurers also refused cover to people with pre-existing conditions until very recently, it was only the legislation brought in under Obama that stopped this.

 

A private insurer who is legally allowed to, will exclude coverage for a condition which the insured person is clearly at an above average risk of developing or already has, because it simnply makes good business sense for them to do so.

 

HOWEVER you can not assume that this means that all insurers will exclude all heart conditions in your specific case, since it has been 10 years since your heart attack with no further problems (and, I assume, good BP and cholesterol control? You mention meds but insurer will want to know the current numbers). Rather than making this assumption, you should actually find out. Suggest you try Cigna global first.

 

 

Thanks once again Sheryl, I did try Cigna, but they came back stating that the underwriter would exclude the Cardiovascular system.

 

I have just about given up, and totally understand its all about business, but as you also say, its been 10 years, the BP is and always has been fine, last checked 23 September 2017 i.e. SYS 119 (mmHg) DIA 79 PUL 76 bpm and the cholesterol is and has always been fine, i.e. below 2, that's the part that doesn't make sense to me, I mean anyone who is insured can have as equal chance as having a heart attack, me already having had one due to over exerting myself with a clot having formed and lodged into the left arterial artery which, then having a stent inserted, clearing the clot and Bob's your uncle as they say.

 

Going to do some more investigating, although this retired dog, doesn't want to start taking to bones again, because once he starts, he just wont let go, and is now in a position to self insure, but I think its more so the principal, something I should also let go of...lol  

[Sheryl]

You are unlikley to find an insurer more reasonable than Cigna in my experience. If your communication with them was some years ago, it is worth trying again. You might also  ask them though if they would lift the exclusion after a few years if you remain free of cardiac problems.

 

Otherwise you might want to consider insuring with the exclusion You will still be covered for everything else, including accidents, cancer, stroke.

 

Your prior hart attack was not, incidentally, due to over exertion. Overexertion cannot create a blood clot, and when clots form or lodge in the coronary arteries it is usually because there are already changes to the lining of the artery which promote this.

[4MyEgo]

5 hours ago, Sheryl said:

You are unlikley to find an insurer more reasonable than Cigna in my experience. If your communication with them was some years ago, it is worth trying again. You might also  ask them though if they would lift the exclusion after a few years if you remain free of cardiac problems.

 

Otherwise you might want to consider insuring with the exclusion You will still be covered for everything else, including accidents, cancer, stroke.

 

Your prior hart attack was not, incidentally, due to over exertion. Overexertion cannot create a blood clot, and when clots form or lodge in the coronary arteries it is usually because there are already changes to the lining of the artery which promote this.

Hey Sheryl this was as recent as a month ago, see copy and paste from email: 

 

The exclusion on the policy would probably be a cardiovascular exclusion which would be along the lines of the exclusion below. Exclusions are not set in stone, they can be challenged at the renewal after the 1^st year and if something was to happen to you so we would always be guided by doctors and if something happened to you they would advise if it was related to your existing condition or not.

 

 The exclusion below could not be copied and pasted, but read:

 

Cardiovascular Disease/Disorder

and any associated or related conditions or symptoms and any complications

 

That to me pretty much summed it up, i.e. unless I am missing something.

 

I am aware that I can get cover for everything else, but its a gamble, 100k per year Vs getting ill and requiring treatment Vs not getting ill and not requiring treatment, the longer you don't require treatment, the more you save, and if you require it, then its an outlay you anticipate that you will have to pay, its more so the principal to me, I mean if they said we will insure you, but are adding a premium, fine, or we will insure you but put in a 2 year, 3 year, 4 year, 5 year no cover for your pre-existing condition, fine, at least I would know I am completely covered sometime down the track for the outlay.

 

I am only using the word the Cardiologist stated, i.e. "overexerted" myself which brought on the heart attack, which I know was brought on by being a smoker for years, having stopped smoking 7 years prior, and as we all know smoking narrows the artery's, overexerting myself probably had to do with the blood flow and then a clot forming and lodging itself in the artery, only going off what I was told, and I am in no way saying that I am an expert in the matter, although I could have misunderstood the Cardiologist, but that is what I remember.

 

Your suggestion of asking them if they would lift the exclusion in a couple of years if I remained free from cardio problems sounds logical and worth a try, and it was Cigna as previously recommended by yourself in another post.

 

As always, really appreciate your feedback.

Edited February 27, 2018 by 4MyEgo

[Sheryl]

The language "would probably be" implies that they did not actually make a determination yet, sounds like you asked them a question but did nto actually submit an application. .  You would need to actually submit an application, which underwriters would then review in detail, and then only will you know what they are willing to offer you.

 

[4MyEgo]

11 hours ago, Sheryl said:

The language "would probably be" implies that they did not actually make a determination yet, sounds like you asked them a question but did nto actually submit an application. .  You would need to actually submit an application, which underwriters would then review in detail, and then only will you know what they are willing to offer you.

 

You are 100% correct regarding not filling in an application, I gave them all the background and wanted to know if I would be wasting my time, and I pressed on with the copy and pasted last email reply below from them.

 

I have just checked with the Underwriters and the exclusion will more than likely be the cardiovascular exclusion I noted below so it would mean that if another artery in the heart was to clot then it would not be covered on the policy.

 

When I pressed them further, my question was, ok, so if they exclude the current artery that has the stent, will they cover the other arteries, and the above was the nail in the coffin, so to speak.

 

I will however go back to the person I was dealing with and ask him if I submit an application, if he thinks the underwriters could have a serious look at the history, i.e. nothing in a decade since the heart attack & my age.

Edited February 27, 2018 by 4MyEgo

[Sheryl]

Nobody can tell you with certainty what the underwriters will decide, the only way to know for sure is to submit an appliction.

 

I do not recall the application as being too hard or time consuming to complete. doing so does not commit you in anyway, you can still decide not to buy the policy once you see what is offered

[HampiK]

The "new" cigna close care" seems for me actually very interesting, as it is without outpatient, but still covers some sickness, which are normaly not covered on inpatient only.

 

[4MyEgo]

17 hours ago, Sheryl said:

Nobody can tell you with certainty what the underwriters will decide, the only way to know for sure is to submit an appliction.

 

I do not recall the application as being too hard or time consuming to complete. doing so does not commit you in anyway, you can still decide not to buy the policy once you see what is offered

Solid advice once again Sheryl

 

I will get in touch with them today and discuss, then submit the form with a background letter, as that may assist, and let you know of the outcome.

 

Again, thanks for you replies, they might just get me across the line.