INDIA NETWORK FREQUENTLY ASKED QUESTIONS AND ANSWERS

Pre-existing Condition Rider - Rev. 4/19/2010

1. Does the program cover doctor visits related to pre-existing problems?

No. However, every policy holder with pre-existing coverage can use the physician consultation service (on Phone) offered by India Network Foundation during their stay in the United States for a small fee of $35 per consultation. The consultation can be requested by completing the Consult A Doctor Form. The Physician consultation can be used for prescription refills, discussion of current medications, seeking second opinions, or non-emergency illnesses. All participating physicians are USA Board Certified and practicing physicians in USA.

2. What are pre-existing conditions? Can you provide some examples?

A health or medical condition is categorized as pre-existing condition if that condition is known to the insured, a Physician was consulted, or for which treatment or medication was prescribed prior to the effective date of an Insured Person's coverage. Diabetes, Blood Pressure (BP), chronic back pain, high cholesterol, kidney stones, skin problems are some examples of pre-existing conditions.

No insurance company can afford to cover these sure losses with few premium dollars. The insurance premiums are determined on the basis of probabilities, and not the sure or near certain probabilities obtained from  pre-existing conditions. Hence there is no insurance company that would cover the pre-existing conditions. Many insurance companies in the US will not even underwrite coverage if pre-existing conditions are found in medical reports. The Consult a Doc Program of India Network Foundation is designed to help visitors with non-emergency nature problems arising out of pre-existing medical conditions. President Obama's health care reform, when enacted, may help people with pre-existing conditions, who currently can not obtain private medical insurance.

Pre-existing condition rider is an add-on option to India Network members who wish to insure their visitors or themselves. This rider when purchased would cover life threatening emergency situations due to any pre-existing medical condition. The Rider DOES NOT COVER maintainence of pre-existing problems such as prescriptions, lab tests, x-rays or doctor consultations or any outpatient services. If you have non-emergency nature of sickness, you may make use of India Network Foundation Consult a Doc program.

5. Can you give some examples of when rider would be of help?

For example, say someone has blood pressure problem which is under control with medication. Suddenly the insured become sick with brain hemorrhage and rushed to hospital. This would be a scenario where rider would be of help. If the visitor want to see either a specialist or a family physician to checkup blood pressure problem in ordinary circumstances, the doctor visit is not covered either by the rider program or the medical insurance. The India Network Program also offers Medical Evacuation benefit and Repatriation benefit (see program link for details).

The Rider option would cost twenty five percent additional premium for 18-69 years old and 80 + visitors, and twenty percent for those 70-79 years old. The rider provides up to $15,000 with $100K; $20,000 with $150K policy; and $8,000 with $50,000 and $10,000 with $100,000 program for 70 plus old. The deductible for the pre-existing condition rider is $1,000 per incident for all age groups.

The Rider is NOT available with $50,000 program for 2-69 years old. For example, a member purchases the pre-existing condition rider with $150,000 policy for parents. Mom got suddenly sick and rushed to emergency room. She was treated and stabilized. The emergency visit is related to pre-existing high blood pressure problem. The insurance will pay U&C charges as given in benefits schedule. The Insurance will pay to services related to the visit until it reaches $20,000 for this sickness. IT IS NOT TEN PERCENT OF THE BILLS. ALL BILLS WILL BE SETTLED AS PER THE POLICY UNTIL THE AMOUNT REACHES $20,000 (with 150K policy).

India Network program offers up to $25,000 for medical evacuation (with $150K policy). This amount would still be available to the family should the family and attending physicians decide to shift the care to home country.

8. I am browsing various sites on internet and they authoritatively say that pre-existing conditions are not covered by any insurance company. Is that correct?

Unfortunately, there are many health insurance programs sold by insurance agents that do not serve consumer needs. These agents are contracted with various General Agents that DO NOT Offer any pre-existing coverage programs. No agent is allowed to sell or market India Network Health Insurance in the US or elsewhere. Hence Agents are not allowed to sell India Network Program on their web sites. There is no insurance program other than India Network Health Insurance that is designed based on member feedback and member welfare as the core of their program. India Network Program is the ONLY ONE that covers pre-existing conditions in case of life threatening emergencies for the elderly including 80 plus.

9. Are there any other companies that provide some coverage for pre-existing conditions for shorter durations ie less than 3 months?

Multinational Underwriters provide very narrow and limited coverage for pre-existing conditions with 2 year look back.. means that the pre-ex clause does not come into force unless someone is free from all medical problems for two years before the policy effective date. The India Network Rider Program is much broader and provides blanket coverage for pre-existing condition related emergencies.