Meow

Hope someone can give me some help on this.

I have an American client, currently resident in the UAE, for whom I am arranging medical insurance. The plans we arrange here are not suitable for US citizens living in the US, so when he eventually returns he will have to replace the plan.

My question therefore, is would he be likely able to obtain some sort of continuous cover upon his return? Full claims history would be available for medical underwiting, but he would want a plan where any existing conditions would be covered on what is called 'no worse terms'. I simply require an 'in principle' answer, not any recommendations.

Many thanks for your assistance.

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Duncan Roberts

It's a little more complicated than a short and sweet answer.

You would need to check if the the policy he is on out of the US qualifies as creditable coverage under HIPAA. If it does then he can use that to credit against any blackout period when he gets back to the US, assuming that he picks up qualifying insurance within 63 days of the other policy expiring. If it doesn't count as creditable coverage or the US policy is not qualifying or he doesn't get qualifying insurance within 63 days of the policy expiring then he will be out of luck regarding pre-existing conditions. The coverage would be based on the insurance selected so could be a whole lot worse than he has or it could be a whole lot better. Generally the qualifying plans are group ones and there is very little choice in what coverage is. My guess based on what you have said is that his policy will not be creditable and when he moves back the policy he gets probably wont be qualifying. But there are so many factors involved that's just a guess.

This is something that really needs a lot of research into, especially if pre-existing conditions are involved.

Meow

That is very helpful. What is HIPAA?

Thanks

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Noorah101

A quick google search got me this: http://www.hhs.gov/ocr/privacy/index.html

Rene

Duncan Roberts

It's the Health Insurance Portability and Accountability Act. Basically a whole bunch of federal laws that are designed to bring up healthcare quality, access and accountability. One of the major parts to it is coverage of pre-existing conditions when switching insurance. It's very complicated but useful.

md95065

Note that many of the provisions of HIPAA only apply to group health plans - ie those provided by an employer for its employees - policies purchased by an individual may have much more restrictive terms about pre-existing conditions.

On the other hand individual policies are more flexible - you can probably get just about any of the terms and conditions varied, but might cost you a lot of money to do so.

Bob

Another thing to look into, which state he plans to return to, because some states have their own group plans for those unable to get their own coverage, but that doesn't mean it'll be cheap though.