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Old 04-15-2012, 08:20 AM   #81
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OBY @ G4G, I think one piece of info missing is if the IMG policy is considered individual or group coverage. If it is group, when the insured returns permanently to the US he/she is entitled (by regulation) to a conversion type policy.
I think the answer is that it is individual (although they don't provide full details on line. They send a packet after you buy the insurance )

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Also, this insurance is not subject to certain portability, access, renewal or other requirements of the Health Insurance Portability and Accountability Act of 1996.
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Old 04-15-2012, 08:33 AM   #82
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Originally Posted by Gone4Good View Post
I think the answer is that it is individual (although they don't provide full details on line. They send a packet after you buy the insurance )
I suspect you are correct, and if that is the case, returning to the US and buying new coverage would likely require underwriting, unless the state has a risk pool that is open. Another option (lousy) is wait for 6 months and then get a PCIP plan.

In the current health case insurance scheme in the US, group coverage is the key.

Edit: One thing that IMG would do is meet requirements for continuous coverage that most plans request. This means that pre-existing conditions are not subject to exclusionary periods.
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Old 04-15-2012, 09:17 AM   #83
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Good points worth discussing further. Traveling now, and typing from iPhone , sorry for typos. I will answer more fully later. Have a good Sunday everyone.
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Old 04-15-2012, 11:59 AM   #84
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This doesn't sound right to me. Mostly it depends on which state he resides in.

In some states he may not be able to get insurance at all when he comes back after an illness, in others he may be able to get coverage in a very high cost risk pool (although I know TX requires you to be a resident of the state for 3 years before you can get risk pool insurance), in others he may be able to get insurance at "guaranteed issue" rates but without coverage for his pre-existing conditions, and elsewhere he might get guaranteed issue coverage with only a limited exclusion for his pre-existing condition. So it depends.

If he keeps his US insurance, he doesn't have to worry about not having his medical conditions covered or paying a dramatically higher price for coverage. I think in all 50 states (or at least everyone I'm aware of) insurers can't raise your premiums because you get sick. But many can charge different rates, or deny coverage altogether, for new applicants. So your hypothetical person would likely pay significantly more for insurance having left the US market then if he had stayed insured.

On the other hand, if he lives in a high cost "guaranteed issue" state IMG probably makes a lot of sense, although I'd still want to dig into the details of how pre-existing conditions get treated.
What about rescission? Come down with a serious illness and the insurer decides they're not going to cover it?
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Old 04-15-2012, 12:15 PM   #85
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What about rescission? Come down with a serious illness and the insurer decides they're not going to cover it?
I believe the trade association that represents health care insurance companies (AHIP) announced an end to that practice except in case of outright fraud.
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Old 04-15-2012, 12:41 PM   #86
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I believe the trade association that represents health care insurance companies (AHIP) announced an end to that practice except in case of outright fraud.
That is a relief!
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Old 04-15-2012, 01:49 PM   #87
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Hello Dreamer
Not sure what you mean with "...but heaven help them, if they have developed any major health problems. They will be paying through the nose for health insurance and might not be able to get it for the pre-existing conditions." Let's take an example : a 47 year old early retired guy can go overseas 6 months a year, get IMG worldwide coverage for $150 a month, makes sure he pays his annual premiums to have continuity of insurance. He gets throat cancer at age 52 but survives. Age 53, he decides to stay in the US full time to take care of his mother. He decides to get coverage from United Healthcare now - he can still do it, even with a higher premium, correct ?

Now what difference would there be with another 47 year old early retired guy living in the US, buys United healthcare coverage for $240 / month, makes sure he pays his annual premiums to have continuity of coverage. He gets throat cancer at age 52 but survives. Age 53, he would still have to pay a higher premium even if he had stayed in the US full time, correct?
I am no expert on insurance and I am covered under Federal Blue Cross/Blue Shield, but our insurance did not go up with my DH's disabling condition, thank goodness. Also, when my DS was no longer covered under my insurance and he was still in college, we kept him covered under Cobra. I asked the BC/BS rep that I was talking with whether he would be able to keep it after Cobra and she said that he would have to pay a much higher premium, since he was born with a ventricular septal defect, even though it had not caused him any problems.

One other type of insurance that I bought (I already know that it was not a wise financial decision) was Cancer Insurance and it also was for intensive care in the hospital. My son was excluded for the intensive care in the hospital, if I remember correctly. I can't remember if the exclusion was just for heart related matters or everything. I am supposed to get my premiums back after 20 years, which is this October. I wonder if the company will go under before that time. LOL. I am not planning to keep the insurance after October 2012.
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Old 04-15-2012, 02:03 PM   #88
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Originally Posted by explanade

What about rescission? Come down with a serious illness and the insurer decides they're not going to cover it?
The Affordable Care Act (through Public Health Service Act section 2712) limits recission to fraud or misrepresentation.
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Old 04-15-2012, 02:11 PM   #89
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But the status of the ACA is in question until the SCOTUS rules.

ACA also outlaws exclusion of preexisting conditions yet people are assuming for now that we'll have to deal with current policies by insurers on preexisting conditions.
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Old 04-15-2012, 02:26 PM   #90
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Originally Posted by explanade
But the status of the ACA is in question until the SCOTUS rules.

ACA also outlaws exclusion of preexisting conditions yet people are assuming for now that we'll have to deal with current policies by insurers on preexisting conditions.
The recission limitation is current law, in effect since September 23, 2010. The ban on pre-existing condition exclusions is currently in effect only for children under the age of 19, as of September 23, 2010. Under the current law, persons 19 and older with pre-existing conditions may be covered by a special pool after having no coverage for 6 months or more.

The ACA ban on pre-existing condition exclusions doesn't go into effect until 2014, at the time the insurance exchange programs are scheduled to start. As you note, changes may take place between now and then. A prudent early retiree should plan and budget accordingly.
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Old 04-15-2012, 04:04 PM   #91
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Hello Michael - can you see anything under this link that would indicate whether IMG's coverage is considered individual or group coverage ? I can't find any confirmation one way or the other: https://purchase.imglobal.com/PlanDescription/GLOBAL_MEDICAL/BenefitsContent
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Originally Posted by MichaelB View Post
OBY @ G4G, I think one piece of info missing is if the IMG policy is considered individual or group coverage. If it is group, when the insured returns permanently to the US he/she is entitled (by regulation) to a conversion type policy. If IMG is considered individual coverage, the insured will be subject to underwriting and individual state regulations, which we already know are of little help. The key is not returning to the US with proof of coverage but instead proof of group coverage.
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Old 04-15-2012, 04:14 PM   #92
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Some more details I got under "International health insurance" at ehealthinsurance.com. Please let me know what you think. This is an important topic as many of us plan to travel during retirement but do not want to be wiped out financially because of inadequate healthcare coverage....

Premium : $105.50 a month.
Applicant: Male/47
Coverage Start Date: 05/01/2012
Citizen SecureDetails At a GlancePlan Type: PPO
Lifetime Maximum: $5,000,000
Deductible: Individual:$5,000
Coverage area: Most countries
Coinsurance: None for in-network. 20% after deductible for out of network.
Office VisitPrimary Doctor:
Find Doctor Usual, Reasonable and Customary
Specialist: Usual, Reasonable and Customary
Chiropractic/Physical Therapy: Usual, Reasonable and Customary if prescribed by a primary physician. Physical Therapy - $50 maximum per visit per day.
Mental Health: $10,000 per certificate period, $25,000 Maximum, $50 Maximum per visit per day (After 12 months of continuous coverage)
Prescription Drug CoverageGeneric Prescription Drugs: Usual, Reasonable and Customary
Brand Prescription Drugs: Usual, Reasonable and Customary
Non-Formulary Prescription Drugs Coverage: Usual, Reasonable and Customary
Hospital Service Coverage
Lab/X-Ray: Usual Reasonable and Customary
Ambulance Services: Usual Reasonable and Customary when covered injury or illness results in hospitalization as inpatient.
Emergency Room: Usual, Reasonable and Customary for illness, however charges for use of the ER itself will not be covered unless the member is directly admitted to the hospital as inpatient for further treatment of that illness. Usual Reasonable and Customary for injury even if not hospitalized.
Outpatient Surgery: Usual, Reasonable and Customary
Hospitalization: Average Semi-private room rate, including nursing services
Other Coverage
Out-of-Network Coverage: Yes
Out-of-Network Authorization Required: No
Out-of-Network Deductible: Same as standard chosen deductible
Out-of-Network Coinsurance: Inside the US - 20% / Outside the US - None
Out-of-Network Out-of-Pocket Limit: Individual - $5000 plus deductible / Family - $15,000 plus 3 deductible
Substance Abuse Coverage: None
Maternity Coverage: Maternity Coverage - After the Deductible, policy will pay 50% of the next $100,000 of Eligible Medical Expenses, then 100% to a Lifetime Maximum of $250,000. Covered Maternity expenses include pre-natal, Delivery, and post-natal care (after 12 months of continuous coverage)
Newborn care: Included as part of Maternity benefits for a maximum of 60 days
Intensive Care Unit: Usual, Reasonable and Customary
Child Wellness: Members under age 19: $50 per visit (including immunizations), maximum of 3 visits per certificate period (Available after 12 months of continuous coverage - Not subject to deductible or coinsurance)
Adult Wellness: Members age 30 and older: $250 per member per certificate period. Females age 40 and older or 'qualifying woman at risk' - $100 per member per certificate period for a mammography screening. (Available after 12 months of continuous coverage - Not subject to deductible or coinsurance)
Additional Information
A.M. Best Rating: A+ as of 10/01/2010
Application Fee: HCC Medical Insurance Services requires a $20 One Time Enrollment Fee
Electronic Signature for Application Available: Yes
Will insurance company obtain and pay for medical records? N/A
Additional information about this health insurance plan is available in the documents below.

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I think the answer is that it is individual (although they don't provide full details on line. They send a packet after you buy the insurance )
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Old 04-15-2012, 04:46 PM   #93
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Originally Posted by obgyn65 View Post
Hello Michael - can you see anything under this link that would indicate whether IMG's coverage is considered individual or group coverage ? I can't find any confirmation one way or the other: https://purchase.imglobal.com/PlanDescription/GLOBAL_MEDICAL/BenefitsContent
Oby, I agree with G4G. It looks like a individual plan. The only way to know for sure is to call and ask. The same plan can be both group and individual, the difference being how the buyer is qualified when signing up.

If you travel providing medical care there could be a group plan available through a professional association. You may want to look into this.
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Old 04-15-2012, 05:14 PM   #94
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Originally Posted by explanade View Post
What about rescission? Come down with a serious illness and the insurer decides they're not going to cover it?
Quote:
Originally Posted by MichaelB View Post
I believe the trade association that represents health care insurance companies (AHIP) announced an end to that practice except in case of outright fraud.
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Originally Posted by M Paquette View Post
The Affordable Care Act (through Public Health Service Act section 2712) limits recission to fraud or misrepresentation.
The potential for recission is alive and well, and is a deeply troubling aspect of our health care system. The ACA does not outlaw it, nor may it be possible to.

Fraud and misrepresentation is in the eye of the beholder. To obtain our health insurance we needed to complete a detailed application including 5 years of medical history. Some insurers require 10. Any omission or mistake in that lengthy application could be seen as either fraud or misrepresentation on our part and used as grounds to cancel our insurance.

It's a very bad system we have here.
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Old 04-15-2012, 05:45 PM   #95
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The potential for recission is alive and well, and is a deeply troubling aspect of our health care system. The ACA does not outlaw it, nor may it be possible to.

Fraud and misrepresentation is in the eye of the beholder. To obtain our health insurance we needed to complete a detailed application including 5 years of medical history. Some insurers require 10. Any omission or mistake in that lengthy application could be seen as either fraud or misrepresentation on our part and used as grounds to cancel our insurance.

It's a very bad system we have here.
Well, there is that. Failing to report being treated for acne as a teenager could cause a loss prevention specialist to decide you have misrepresented your health condition. For policies issued after September 23, 2010, though, there is an explicit internal and external appeal process for denied claims, and errors or technical mistakes are insufficient to permit an insurer to rescind coverage. An act must constitute fraud or intentional misrepresentation. (Those terms have a rather precise meaning in law.)
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Old 04-15-2012, 05:52 PM   #96
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Well, there is that. Failing to report being treated for acne as a teenager could cause a loss prevention specialist to decide you have misrepresented your health condition. For policies issued after September 23, 2010, though, there is an explicit internal and external appeal process for denied claims, and errors or technical mistakes are insufficient to permit an insurer to rescind coverage. An act must constitute fraud or intentional misrepresentation. (Those terms have a rather precise meaning in law.)
Very nice. Thank you!
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Old 04-15-2012, 06:07 PM   #97
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Idle thought. If I get one of these international medical policies while traveling, it obviously becomes my primary coverage when outside the USA. (That's why I bought it, right?). I wonder if any domestic insurers have some sort of rate break when they become a secondary policy for a period of months, or even offer a break in rates if I explicitly request a suspension in coverage while under an international policy and outside the country?

Probably not. The chance to push me into a new policy with fresh underwriting and condition exclusions is probably too good to pass up. And it would be a hassle for them, what with having to make a note for the policy holder and process all those smaller payments...
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Old 04-15-2012, 06:12 PM   #98
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So that list that obgyn refers to in-network. Does the policy identify doctors and other care providers in various countries?

Or do you pay out of pocket and get reimbursed?
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Old 04-15-2012, 07:58 PM   #99
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This is the full brochure I found on their site. I like it but still need to call them and ask about the valid points raised by Michael, Gone4good, Alan and others above. http://producer.imglobal.com/Produce...ocumentId=1804

I am traveling next week but look forward to continuing this discussion after my return.

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So that list that obgyn refers to in-network. Does the policy identify doctors and other care providers in various countries?

Or do you pay out of pocket and get reimbursed?
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Old 04-16-2012, 08:32 AM   #100
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All the American Health insurance stuff might be interesting to some but what does it really have to do with the OP question ? Shouldn't it be in its own thread ?
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