Medical insurance USA with existing conditions

Ralph-y

Hi, every one .... new to this forum but not MSE

I have done some forum searching but as of yet not found the answers to my questions .......

OK brief history we are due to travel end of this month to Seattle so that my Son in Law and daughter can do a trip of a like time .... motorbike ride from Rotterdam to the arctic circle in Norway ....

my wife and I both have medical pre existing conditions some of the more normal things like high blood pressure , A Fib .... I have prostate cancer ... early stage low risk 'watch and wait' treatment.

My wife has not long since had a cancerous kidney removed , but the real problem seams to be that she is on a list (prob 6 months) for a probable gallbladder  removal due to gallstones.

most UK quotes have come in at £5,000+ we have had one for £3500 ....

So first question has any one had any dealings with buying medical short (3-6 months) term direct from the USA?

we have seen a few quotes for $200 - 800 

if we go with that we would look to take a UK based insurance out for all the more normal  travel insurance things. and would need to find a company that would exclude all the medical stuff   ...

any suggestions / help ?

Thanks ralphy

DullGreyGuy

So you are going to be house sitting?

Just make sure you understand the coverage fully including deductibles, contributions etc. A friend took this route but misread it and had to pay the first $10,000 of any claim (he thought it was $1,000) and 20% of anything over that 

Ralph-y

Yes just house dogs rabbits sitting

yes it is confusing with different terminology ....

one or two quotes state $50 deductibles ( which I gather means excess)   some more but nothing like the horror figures you stated.

any clues as to what

In Network:Pays fixed amount.

Out of Network:Pays fixed amount.

Direct Billing: Through First Health PPO Network

means ?

BarelySentientAI

Ralph-y said:

one or two quotes state $50 deductibles ( which I gather means excess)   some more but nothing like the horror figures you stated.

Deductible means excess, so the first bit you pay from any claim, but there's also another important thing that happens in american insurance - which is sort of like another unlimited excess.

The one to worry about is a fixed dollar plan.  With those, the insurer pays a particular amount for each item - like "Ambulance - $500".  If the bill for the ambulance happens to be $5000, then first you pay the deductible ($50), next the insurer pays $500, and then you have to pay the bill for the rest ($4450).

From the link you pasted: "For example, if the plan pays $3,000 (fixed benefit amount) for a covered surgery and the total cost is $15,000, the insurance would only pay a maximum up to $3,000. If you choose a $100 deductible, the deductible would apply to the total bill owed to the medical provider. Any amount over the fixed benefit will be the responsibility of the insured person."  That example would mean the insurer pays $3000 and you have had to pay $12000.

Ralph-y said:

In Network:Pays fixed amount.

Out of Network:Pays fixed amount.

Direct Billing: Through First Health PPO Network

means ?

In & Out of Network is because the USA doesn't have a single hospital system.  Each hospital is independent, and they group together in chains and networks.  An insurer will make deals with some networks and not others.  If you happen to turn up at a hospital that your insurer doesn't have a deal with, then either you'll pay more, or the insurer will apply a bigger deductible / smaller limit / smaller fixed amount, or in the worst case the insurer will just not pay and you'll either have to move hospital (paying again for transport, arrival, triage, check out, room allocation, initial consultation, anything elsethat's already happened at the first hospital...) or pay the entire bill yourself.

Again, from your link:  "The ChoiceAmerica® plan participates in the First Health network. However, an insured person can visit any doctor or hospital of their choice. By visiting an in-network provider, rates for medical treatments and services may be lower."

Ralph-y

OK thanks for that ... I need to digest ... re read ... and then ask more questions tomorrow

DullGreyGuy

Ralph-y said:

Direct Billing: Through First Health PPO Network

means ?

Direct Billing means that they will pay their share of the bill directly to the hospital/doctor, so like the $15,000 surgery they pay the $3,000 to the hospital and you pay the remaining $12,000.

Without direct billing you pay the full $15,000 up front and then have to reclaim the $3,000. As noted with this policy the direct billing only applies to the First Health network and so other hospitals/doctors you'd be paying first and reclaiming. 

Ralph-y

OK ... so that's all beginning to make sense ....... and there a few quotes  that may work ..

it seams strange that the US companies do not appear to ask what existing conditions we have ...

any one any ideas re UK general travel insurance that will cover the normal stuff just not existing conditions

DullGreyGuy

There are some insurers that have a blanket exclusion on any pre-existing conditions. If you do the medical screening over the phone more insurers also give you the choice on a condition by condition basis on if to cover or not. Search on here you'll find some of the options as its a frequent question.