How does Claim Process works for Pre-existing Conditions Coverage?

Premier and network based (80/20 plans with pre-existing) plans offered by India Network Health Insurance provide coverage for pre-existing conditions. The premier plan with $100,000 policy maximum for new problems offer a maximum coverage of $40,000 for pre-existing conditions with $5000 deductible for below 70 years old and $25,000 with $5000 deductible for above 70 years old.

The premier plan with $150,000 policy maximum for new problems offer a maximum coverage of $60,000 for pre-existing conditions with $5000 deductible for below 70 years old and is not available for 70 plus.

Recently enhancements to the program effective November 10, 2012 treat pre-existing conditions on par with new problems and accidents in  terms of their coverage and benefits paid. This is the most significant achievement for India Network. Now, the only difference would be that pre-existing condition related out-patient care (such as office visits, labs, tests etc) and in-patient care (hospitlizations, surgeries, intensive care etc) are subject to special deductible chosen  by the policy holder (either $1,000 or $5,000) and a separate policy maximum ($40,000 for below 70 years old and $25,000 for above 70 years old).

How the claims are handled? All claims for the new program are handled by Administrative Concepts, Inc. in Wayne, PA, USA. It is reassuring to our members that all claims are handled by US Trained and licensed staff in the United States and your claim forms do not roam around the world. All providers can now submit claims electronically to claims office using electronic payer ID provided on the ID card.

4 Comments

  1. Prof K. Madhavan

    I am 74 years old , enjoying good health, ;leading a active life. Had a by pass surgery in 1998 . I am getting my yearly check up and my physicals are under control. I am again travelling to US ( Boston ) for a month between Dec. 25th Jan 27th. I will appreciate your assistance in suggesting a policy , just in case of any emergency. Regards , Prof Krish Madhavan , Bangalore , India

    • Support Desk

      Dear Professor Madhavan, Congratulations on maintainging good health at the age of 74. Since you have had a bypass surgery, you may be on some kind medication and hence it will be considered a pre-existing condition. India Network Foundation sponsors coverage for pre-existing conditions with a separate policy maximum. Our recommendations is to take cover with pre-existing conditions, preferably network benefit plan (also known as comprehensive plan). These plans require minimum 90 days enrollment but it is worth event cent of it because of the risk it covers for elderly visitors. Please feel free to call our office at 407-243-8760 to discuss your other options.

  2. Sakunthala

    Hi
    I am 73 years old and have hypertension and diabetes (mild). I am visiting the US this month and expect to stay for at least 6 months
    what is the best policy for me and what are the costs involved?
    would appreciate your input
    Thanks
    Sakunthala

Leave a Reply to Support Desk Cancel reply

Your email address will not be published. Required fields are marked *