Visitors Insurance for parents

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Pre existing condition

For parents travelling from India, how do you demonstrate lack of pre existing condition, if needed. For travel insurance, how do you proove that a condition is not pre existing. Is the burden on the insurance company to demonstrate pre existing condition. If I buy Insurance from a US based insurer, how would they determine what is pre existing and what is not? How does this work?

Adi

[insubuy]

Please read Pre-existing conditions visitor medical insurance

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Tata aig

Mr. Narendra

I called your office yesterday but they said you were on the phone and I may try again today /tomorrow

I am getting a bit insane comparing the diff insurance plans :-) Obviously all your postings suggest we buy from US companies, potentially for good reason.

I wanted to do some due dilligence before spending more than double the amount on the premium (TATA AIG vs. ATLAS). So first I talked to the insurance agent in India who was trying to sell the policy to my parents. He explained to me about the policy and then gave me a US toll free number (1-866-866-2619) for TATA AIG. This is a 24 hr number and so you dont have to call India at midnight like you indicated in one of your posts. I called this number today and on the other end of the line was an extremely patient customer service rep (didnt sound American but not Indian either). She told me more details about the policy and indicated that TATA AIG partners with United health care group and directed me to the website myUHC.com. There I was able to chose the plan that she indicated would go along with my gold/platinum TATA policy. She asked me to choose United Healthcare Options PPO. I was then able to put in my ZIP code and a bunch of providers in my area showed up who are within the network including two major hospitals located 5 miles from my house.

My question to you- what is so bad about the policy if I am able to go to one of these location and get treated. Please dont send me the general links. I would like for you to answer this specifically.

Though I have seen some bad reviews for India based policies, honestly, I havent come across many positive reviews for US based policies either. I am considering Atlas America for my Dad (70 1/2) and Mom (65) but based on what I have encountered so far, I am also considering TATA AIG. Also, for comprehensive plans, does it mean that regardless of what happens the max amount of policy will back you up in any situation (as no sublimits). Can you help me out. No disrespect but I would greatly appreciate if you can provide some unbiased comparisons/thoughts. Thank you very much.

Regards
AST

[insubuy]

I am not available in the office all the time as we have long office hours and we are open seven days a week. Even if I am in the office, I may be on another line or taking care of other responsibilities. That is why we have staff. Anyone that answers the phone call in our company is a licensed and experience insurance agent who can answer your questions.

I could point out lots and lots of specific differences, and probably write an entire book about it, but I should not make specific comments (especically negative ones) about the plans that we don't sell.

However, just to give you one example of the difference, do you understand the difference between fixed vs comprehensive coverage plans? If not, read Visitors Insurance types. You are right that comprehensive plans do not have sub-limits but fixed coverage plans do. Did you know that most insurance plans from India are fixed coverage plans for persons above the age of 55 years, not comprehensive?

All I can say is look at
Visitors Insurance from USA v India Go through each and every point carefully and verify everything yourself.

Also read
Visitors Insurance Reviews
Visitors Health Insurance Reviews
Visitors Insurance Discussion Forum - Immihelp
Visitors Health Insurance Discussion Forum - Insubuy

Also, I suggest you carefully compare the exact wordings of the different policies and the brochures.

You can always go to any facility you like and get treated. However, what happens there at that time and after that may greatly vary based on the insurance you have.

If you feel that someone is charging you double amount for no reason, you need to look deeper. If that were really the case, no body would pay double amount for no reason and such more expensive plans would not exist in the first place, as the overall concept of the insurance and the rules of economics are the same everywhere. If you feel that the insurance plan from India is better and cheaper, go ahead by all means.

Regarding positive experiences from U.S. based companies, as I have said so many times before, no one cares if everything is going smoothly and correctly. Only when people have problems, they want to do something about it. Most people simply don't care if they are taken care of correctly. However, I have posted my own positive experience, as a customer and not a broker, at Atlas America Insurance Reviews.

If you have any questions regarding the plans that we offer, we would be glad to answer them. In that case, please post them here or contact us at any time.

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Mr. Narendra

My heartfelt sympathies for the tragedy to your brother-in-law. It is gut wrenching. I also appreciate the speed with which you respond to these queries. Kudos to your professionalism.

I am sure there are fine print differences and I understand the US policies wont charge more for no reason. That is why I am seriously considering that. However, do you concur that TATA AIG policy holders would have access to the United healthcare options PPO, regardless of fixed vs. comprehenisve?
My father is 70 1/2 and I am concerned the limit of $50,000 from Atlas America is on the low side.

Also, for atlas america, it says if you go within the network AND the provider bills directly to the insurer, you wont have to pay the 20% but if you go to wihtin the network, why wont the provider bill directly to the insurer?

Lastly, my parents are stopping over in UAE for 3 days after there 90 day visit to the US. Should I take Atlas America or something else like Atlas International?

Thanks again for your insights.

AST

[insubuy]

1. Thank you.

2. Regarding PPO, I don't have enough information to make firm comments one way or another. In fact, I have never heard of that affiliate before. (That does not mean necessarily mean it may not exist, I just don't know.)

However, I would like to give you certain pointers so that you can make sure what exactly is the case there.

A. Sometimes, there is no PPO attached to the plan. They just use the PPO directory, just like any other yellow pages or Google search. That may be helpful to a complete stranger foreigner who does not where to go at all.
B. Sometimes, there is PPO but there are no network negotiated fees.
C. Sometimes, the PPO gateway is used only as a clerical PO box to collect the claim papers and sent to the insurance company. From there, the insurance company (which would be in India) would take care of the claims and you have to deal with them. The PPO company (United HealthCare, in this case) would not be making any payments to the providers or dealing with the claims at all. When the providers come to know that, they may not want to deal with the company in India.

Or could be any other scenarios that I can't think of. You need to find out the exact details from them regarding how exactly it works, as I don't know.

In most like scenario, it is not exactly the same as having a United HealthCare insurance, if at all they have any affiliation with them.

Best thing to do, why don't you directly call United HealthCare and find out what exactly is the case? And see what they have to say.

3. Policy maximum. You have to consider the fixed vs comprehensive while looking at the policy maximum and you can't ignore it. e.g., a perfectly healthy person falls down in the bathroom and needs hip surgery that costs $40,000, if the fixed coverage plan is going to pay you $3,300, what difference does it make if you have $50,000 coverage or $50,000,000,000 coverage? In other words, it is very hard to reach even $50,000 policy max in fixed coverage plan, let alone any higher amount.

If you think $50,000 is too low in Atlas for 70 years old, consider
Patriot Platinum America Insurance - $100,000
WorldMed - $150,000

4. Atlas in-network payment.
Yes, the providers in network would bill the insurance company directy in almost all cases. I have never heard from the customers otherwise. That is why they are in the network and they should be billing and they do bill directly. However, there is a rare possibility, at least in theory, which holds good for any PPO insurance, even domestic ones.

Sometimes, it just happens the receptionist does not know any better, or does not care, or is in bad mood or simply any reason silly reason, tells you that they don't participate in some network (which they do) or tell you that they won't accept it. But that would be rare situation that I don't hear from customers.

Another possibility is that some provider stopped taking the insurance effective MM/DD/YYYY. I sometimes see the board like that in Dr's office that effective MM/DD/YYYY, we no longer participate in the XYZ insurance (could be any). If they never inform the XYZ company, it would be some time until they find out and meanwhile, they would not have updated the directory and this could possibly happen.

However, in any case, this is not something I would worry about.

5.
Atlas America will cover for 3 days in UAE as well. It covers outside the home country including the U.S. You don't need to buy separate Atlas International, as it is for those who are visiting just outside the U.S.

I hope that answers your questions.

If you have any further questions, please feel free to contact us at any time or post them here.

[insubuy]

I just called the number 866-866-2619 given on their web site and talked to the lady there.

I am narrating this to the best of my abilities and memory based on my discussion with her.

The insurance plan you are buying is from Tata-AIG which is a company in India and all claims are handled by their office in Mumbai, India. This is not a United HealthCare product and the plan does not really participate in United HealthCare PPO network. You don't get any United HelathCare PPO insurance card. You get the policy from Tata AIG India.

Therefore, it is not true all the providers in the United HealthCare participate in the Tata AIG insurance plan (in fact none of them do). Therefore, there are no network negotiated fees and they don't bill United HealthCare. When I asked her your question about the agent showing myUHC.com web site and the providers in there, she said that it is inappropriate to do so as this is not United HealthCare product.

For all outpatient treatment (no matter how big, could also be an emergency room visit or outpatient surgery which could be even $10,000 or $20,000 or any moment), you have to first pay and file for reimbursement upon your return to India.

For inpatient treatment, it is up to the hospital whether they want to bill the Tata-AIG in Mumbai, India or not and work with them. Therefore, you have to ask your local hospital whether they are willing to do so or not.

I asked what exactly does the United HealthCare do in this case? She said that they just use their system to electronically request the medical records, rather than by mail which could take a longer period to reach from the U.S. to India. (In other words, it is Tata-AIG's internal matter whether they want to write a letter to the hospital, or send them a fax or put a request in United HealthCare system to get medical records). Other than that, United HealthCare has nothing to do with this matter. In short, United HealthCare acts as an 'very fast courier service' for them only to get the medical records. Hospitals don't see any United HealthCare connection and you should not mention anything about United HealthCare.

I asked several times and she very clearly mentioned that it is not the same as having United HealthCare insurance. In fact, it is no way near that. She said that this is a self-pay travel insurance policy and should not be confused with any domestic insurance provided by United Healthcare.

I also went to their web site and I don't see any information related to this matter. Therefore, I don't know why the agent you talked to would point you to UHC web site.

I hope this information helps you in making a right decision.

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Tata AIG

Thanks for the follow up. I am just posting this for other's information. I called them up today again and parts of what you said are correct which were indicated to me yesterday as well but here is the gist from my call today (different person, name- Ramon). You can talk to him directly and may be we will know what is going on here. I am hoping they are being genuine. This guy seemed to be very clear about everything. I am definitely leaning towards Atlas America but this has been an interesting and frustrating journey at the same time!! Interesting because of what I was told again today, which is..

1) all outpatient has to be claimed in India (unless it goes into the big leagues like > $5000)- this I was told yesterday also.

2) No insurance card. Just your policy print out. However, TATA AIG does have a contract with UHC. You go to hospitals in the UHC ppo plan and the hospital calls the 1-866-866-2619 number and they take it from there.

3) He specifically said that the hospitals will be asked to send bills to the UHC address as they have negotiated prices with UHC

4) Yes, you are right that it is not the same as having UHC insurance for US residents. In fact this guy said general customer service reps from UHC probably dont even know about TATA AIG but they have contracts with UHC that they will fax to the hospitals as soon as they are alerted that the patient has joined certain hospital.

5) So to summarize, UHC wont stick out on the TATA AIG policy but based on what they are saying they have contracts with UHC. If one thinks about it, if they dont have any contracts with a health care network here, only way they can operate in US is to have the patient bear everything out of pocket (In patient as well) and then deal with the claims back in India. As that is not the case, they do need to have a tie up with a local network.

I am not vouching for TATA AIG. Just trying to understand the process. I doubt you have the time to follow up on this further but if you by any chance do, please talk to the same person, Ramon.

Best Regards
AST

[insubuy]

I absolutely have no idea regarding who is right and who is wrong in their company and up to what extent. I simply narrated my conversation with them, for your benefit. I have already gone out of my way a lot trying to find out the information about the plans that we don't even offer.

I am not sure why you continue to ask me how exactly another company operates that we don't even work with. And even when I tried to find out by going out of the way, if you would like to continue to dispute that until you hear from me what you want to hear, I feel it is not a worthwhile discussion.

If you are so inclined to buy from them, and if you find their offer more attractive, go for it by all means. To further understand the process of their insurance plan, please ask further questions directly to them. All I can say is that ask them to give everything in writing and you try to independently verify that. If you end up buying from them anyway and if God forbid, if you end up using their insurance, let us know how exactly it worked for you so that it would help others.

It would be up to you to make the decision.

If you have any questions about the plans we offer, we would be glad to help you.

[insubuy]

I just came to know that you called our office earlier today and bought Atlas America over the phone for your visitors.

Thank you for your business and I am glad that you have made the excellent choice.

If you need further help at any time, please feel free to contact us at any time.