Question About Pre Existing Conditions

[ezzra]

Hi,

Question to the Thaivisa Insurance people,

What consuetude “ pre existing conditions” ?

Dose a person who say, had a minor heart problem 10 years a go

And since then lead normal life should declare it as pre existing conditions?

Would a person as such be denied medical coverage just because past ailments?

Thanks,

[JohnC]

Although I am not an insurance expert I would say you need to declare all past serious health problems, if you do not and have a health problem in the future that could (however tenous) be related back to any pre condition then the insurance company will use this to get out of paying. At the end of the day they are taking the risk on you and if you do not declare something then your policy could be null and void. On the other hand if you declare it and they acceot the risk at least you are covered although your premium may be loaded.

[ProThaiExpat]

Your best bet is to make sure the policy has a waiver of pre-existing conditions after two years or less with no medical problems in that area.

[ThaivisaInsurance]

Ezzra

The reply by JohnC is correct – do not try and hide anything - when completing the application form ‘more is better than less’.

Remember, you can always decline the insurance companies offer of cover if you feel the exclusions are not fair.

[junkofdavid2]

Depends on the insurance company.

For example, ThaiHealth only wanted to know if a particular customer had any problems for the past 5 years... and since he didn't, he got full cover.

Axa Health, on the other hand, wanted to know if the same customer had any types of problems at all (in a list of categories) in his entire life to be declared on the insurance form. Since this customer was hospitalized as a child (more than 25 years ago) for gastroenteritis and had some stomach aches (which only needed doctor's consultation and some pills) 15 years ago, they wanted to exclude practically any and all problems related to gastritis (stomach problems) which is actually very wide blanket of exclusions.

I find some international insurance companies interesting, such as IM Global (never tried it though, and expensive compared to local insurance companies... but give coverage to 5 Million USD). According to their website: "The following illnesses which exist, manifest themselves or are treated or have treatment recommended prior to or during the first 180 days of coverage from the initial effective date are considered pre-existing conditions and are subject to the waiting period and other limitations of coverage described above: asthma, allergies, tonsillectomy, back conditions, adenoidectomy, hemorrhoids or hemorrhoidectomy, disorders of the reproductive system, hysterectomy, hernia, gall stones or kidney stones, any condition of the breast, and any condition of the prostate."

Of course, we don't know exactly as to how they would interpret that, and/or if they'd be consistent with their website statement when actually taking on a customer.

http://www.imglobal.com/coverage/global/in...tion=exclusions

Anyway, hope it helps.

Edited December 19, 2007 by junkofdavid2

[jingjingna]

So, if someone is on medication for blood pressure or something linked to the heart....would that be classified as a pre-existing condition, even if the so called 'condition' is and has been under control for over five years?

[junkofdavid2]

So, if someone is on medication for blood pressure or something linked to the heart....would that be classified as a pre-existing condition, even if the so called 'condition' is and has been under control for over five years?

No guarantees (I'm not the insurance co.), but that would seem to be the case with some insurance companies.

Also, depends what you mean by "under control".

[jazzbo]

Most health insurance applications that I have seen ask:

Have you consulted a doctor within the last 5 years?

Are you currently taking any prescription medication?

So even if your condition is 'under control' you would still need to disclose the above especially if your doctor writes a prescription for you.

[Jingthing]

ThaiHealth only wanted to know if a particular customer had any problems for the past 5 years

Can someone answer this nit picking question (it actually matters to me).

How is the last 5 years defined exactly.

For example, lets say today's date was May 10, 2007

What would the exact date you would have to go back to? May 10, 2002?

Or December 31, 2001?

[jfchandler]

When I shopped for and eventually took out a Thai health insurance policy earlier this year through a broker in BKK, they told me to expect a two-year exclusion period for any pre-existing conditions.

That is, even though I might have had treatment for something in the more distant past, the exclusions I'd expect to be included in my Thai policy would be related to things I'd actually had treatment of any kind for in the prior two years.

I'd had sinus surgery during that two year prior period. So all sinus things were excluded. In talking with my broker about this, she advised that if I went two years more under the Thai policy with no doctor visits or treatment relating to sinus that I probably could get that exclusion dropped in future renewals.

[junkofdavid2]

ThaiHealth only wanted to know if a particular customer had any problems for the past 5 years

Can someone answer this nit picking question (it actually matters to me).

How is the last 5 years defined exactly.

For example, lets say today's date was May 10, 2007

What would the exact date you would have to go back to? May 10, 2002?

Or December 31, 2001?

Dunno.

But the exact words on the ThaiHealth application form are: (I'm copying it verbatim... even the wrong grammar.)

"Have you ever undergone an operation, or been hospitalization, or had and accident in the last 5 years?" (seems to ask about past conditions)

"Do you have any personal health problem or any illness or treatment under physicians care?" (seems to ask about current conditions, even doctor's outpatient care)

At the end of the day, the situation is probably similar to the inconsistencies of implementation of Thai immigration law... it depends on which company you're using, and even within that company, it depends on which doctor/actuarial analyzes your application.

Edited December 20, 2007 by junkofdavid2

[junkofdavid2]

When I shopped for and eventually took out a Thai health insurance policy earlier this year through a broker in BKK, they told me to expect a two-year exclusion period for any pre-existing conditions.

That is, even though I might have had treatment for something in the more distant past, the exclusions I'd expect to be included in my Thai policy would be related to things I'd actually had treatment of any kind for in the prior two years.

I'd had sinus surgery during that two year prior period. So all sinus things were excluded. In talking with my broker about this, she advised that if I went two years more under the Thai policy with no doctor visits or treatment relating to sinus that I probably could get that exclusion dropped in future renewals.

2 years seems to be pretty generous for an insurance company, considering that Thai Health considers 5 years and Axa Health seems to consider a customer's entire life.

What company was that?

[jfchandler]

It was LMG Pacific Healthcare....

But just to be clear, in the application documents, like others mentioned above, they ASKED about all kinds of things going back either many years or my whole life, depending on the question.

But in issuing the policy, I believe they only excluded things that I'd undergone actual treatment or doctor's visits for in the past two years.

Other than the sinus stuff, I didn't have much in my medical history. So there wasn't much else for them to chew on...

[tonydabbs]

When I shopped for and eventually took out a Thai health insurance policy earlier this year through a broker in BKK, they told me to expect a two-year exclusion period for any pre-existing conditions.

That is, even though I might have had treatment for something in the more distant past, the exclusions I'd expect to be included in my Thai policy would be related to things I'd actually had treatment of any kind for in the prior two years.

I'd had sinus surgery during that two year prior period. So all sinus things were excluded. In talking with my broker about this, she advised that if I went two years more under the Thai policy with no doctor visits or treatment relating to sinus that I probably could get that exclusion dropped in future renewals.

2 years seems to be pretty generous for an insurance company, considering that Thai Health considers 5 years and Axa Health seems to consider a customer's entire life.

What company was that?

Be careful about buying health insurance based on how you perceive they handle exclusions. Most health insurers are pretty much the same in that regard. No health insurer wants to cover treatment for already existing conditions.

Thai Health refused to renew someone's policy a while back when they discovered that he had had a heart operation about 7 years before he applied. They discovered this when he went in for treatment of an unrelated problem. They covered that problem, but then refused to renew his coverage because "he had lied" by not mentioning the heart operation.

Below the "5 year" question is the question that zapped him. It asked, "Do you have any personal health problem...? He wrote "no." The fact is, once you have a heart operation the heart is weaker and will always be considered a health problem for the rest of your life.

Keep in mind, there are no good guys when it comes to covering pre-existing conditions. But, all health insurers have to cover medical conditions that existed at the time of application if they haven't discovered and excluded them within the first 2 years that the policy has been in force.

Exclusions for pre-existing conditions can be removed eventually if a qualified physican certifies that the problem is cured. A cancer exclusion can be removed about 5 to 7 years after successful removal of the cancer with no reoccurrence .