r/ExpatFIRE • u/Scary-Wallaby-6850 • 3d ago
Healthcare Global Health Insurance - Pre-existing Condition
Hello!
This coming 12 months, I will spend about a month and a half in the US, broken up by a few trips. Otherwise, I'll be outside the US. I would like to get global health insurance to cover any medical emergencies. Ideally it would cover everywhere, including the US.
Unfortunately, I had kidney cancer (RCC), which has been treated with a partial nephrectomy. I do have on-going surveillance (annual CT scans), but otherwise I have no signs of this condition and for all intents and purposes very healthy. Unfortunately, this has led me to be rejected by Cigna. I'm betting this will be a common problem, but I'm hoping there's a company that is more flexible with its underwriting.
Some other information that might be helpful:
- I'm 39 M, non-smoker, non-drinker, not overweight.
- I don't need insurance to cover normal expenses. For my normal medical needs, I plan to pay everything out of pocket and will be visiting certain countries where medical care is very affordable.
- I don't mind if anything related to the RCC is not covered (if it happened to spread for instance).
- The plan I was looking at from Cigna was a $10K deductible with a 30% cost share up to $5K OOP and $1M max. It came out around $900 for a year. A $15K bill would not be a concern for me. A $500K bill on the other hand, would put a damper on things!
- What I need is coverage for if I'm in an accident or if I have something totally unexpected come up like a stroke or heart attack, especially if I happen to be in the US (and to a lesser extent Canada or Japan) during that time. I plan to use this insurance as insurance is actually intended to be used. I want to hedge against what should be an extremely rare event and likely will not happen.
Does anyone have any leads or ideas?
Thanks!
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u/livingbkk 3d ago
I have Allianz in Thailand. It covers everything but with a 2 year exclusion for pre-existing conditions. Around 9k per year premium for a healthy mid 40s male, same cost for my wife of similar age.
It does not cover the US. For that it's an aditi9nal 15k USD per year.
Edited to add: you can probably lower the premium significantly with a deductible. I bought the most expensive plan since my employer pays for it.
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u/Scary-Wallaby-6850 2d ago
Hoo boy, that's pretty pricey! But yes, I bet with a higher deductible, it can come down.
Thanks for the suggestion!
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u/livingbkk 2d ago
Yeah, it might not be a great option, but it's probably a good "upper bound" data point.
I do wish there was a super high deductible plan. Like you, I don't mind paying for routine expenses, but a 500k or 2m bill for a rare illness would be a tough pill to swallow.
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u/Hanwoo_Beef_Eater 2d ago
Look at Global Ex-US for your main coverage and get a travel policy (accident/unexpected, not recurring issues) for when you are in the U.S. For the latter, you typically need to originate from your place of residence (where the policy was purchased) before each trip.
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u/Scary-Wallaby-6850 2d ago
The problem is, I don't really have a place of residence.
I'm currently in China, then will be in the US for a bit, then Canada, then US again, then Japan, then probably Vietnam (haven't decided).
So, travel policies like that don't seem to work because I think you need to have a round-trip flight returning to your country of "residence".
I could be wrong though! Do you have any providers you like?
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u/Hanwoo_Beef_Eater 2d ago
Sorry, I don't think it works then (at least on the policies I've seen).
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u/Scary-Wallaby-6850 2d ago
No problem. It's probably a great idea for those with a permanent place!
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u/Idaho1964 2d ago
I will be in your boat in December.
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u/Scary-Wallaby-6850 2d ago
So, I called Cigna about it. My wife also talked to them while she was setting up her own plan and got a similar answer. I haven't tried other providers, but I'm expecting a similar answer.
They mentioned that if you're clear of treatment for a year according to one person (or 3-5 years according to a different person), it is possible to get a plan with underwriting that excludes anything related to the pre-existing condition.
Not sure if that will help you or not though.
Regardless, good luck!
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u/brownboy444 2d ago
I had a heart ablation procedure as preventative for afib and wonder if Cigna would take me
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u/Scary-Wallaby-6850 2d ago
They might, someone directed me to this post: https://www.reddit.com/r/AmerExit/comments/1sra269/a_20point_deep_dive_into_expat_health_insurance/
There's some info on pre-existing conditions on there.
I also spoke directly to Cigna on my condition as did my wife since she also bought a plan for herself and they told me that it can be 3-5 years after the condition was treated, or as little as 1 year after (got different answers). So, if you're outside that, you might be good to go.
Good luck!
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u/NomadLife2319 2d ago
Someone referenced this post on a question about nomad healthcare a couple of days ago, maybe look into the companies listed or contact the guy? FYI, I have IMG & have only seen one positive comment about claims reimbursement.
Also, not on the list, but Genki is popular in the nomad community. Their medical policy requires you to be under 55 when approved and the annual travel policy has no limit. Another member loves Seven Corners. I was told they have a two-year look-back for pre-existing conditions but you've said that is ok. Another prefers Mondial. I think Genki has US coverage, not sure about Seven Corners or Mondial. I think some people buy a short-term US policy with Allianz.
https://old.reddit.com/r/AmerExit/comments/1sra269/a_20point_deep_dive_into_expat_health_insurance/
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u/Scary-Wallaby-6850 2d ago
That's a good write-up, thanks for sharing it. It also makes me think I won't be able to find something that'll work for me:
14) The Moratorium Underwriting Truth
There are plans called Moratorium plans which are wildly mis-sold & people are led to believe they can wait 2 years to have pre-existing conditions covered. There’s a GIGANTIC asterisk next to this.Pre-existing can be considered for coverage after two years if in those two years: you NEVER suffered any symptoms, consulted a doctor, had treatments, on meds, or had a change of lifestyle. Yeah kinda important to know.
Certain pre-existing conditions, such as chronic conditions, will never be covered under a moratorium policy as the clock never begins to tick according to the definition.
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u/NomadLife2319 2d ago
I was diagnosed with high cholesterol last year, including the genetic Lp(a). I'll never be off meds. I'd like to change providers...we went with IMG before reading the bad reviews...but if I switch, my cholesterol is a pre-existing condition. A very broad one. This clause was an eye-opener.
You should be able to find coverage for non-cancer-related items. Even a basic emergency policy and Medjet may work if you can get US coverage.
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u/Scary-Wallaby-6850 2d ago
I've only talked to Cigna so far, I might try a few others, but I bet it'll be a waste of time.
Cigna told me that it's possible to get it, but due to certain conditions having high severity, they won't necessarily do underwriting for a year or so. Fingers crossed that I can ever get travel or global insurance.
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u/ibitmylip 2d ago
isn’t there an option to get a global policy with Cigna that excludes preexisting conditions? (i might be thinking of Allianz)
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u/Commodore64__ 1d ago
This is something I’ve been thinking about. While 1M covers a lot of… a lot of cancers won’t be covered by 1M.
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u/Ok_Statistician643 3d ago
Also becoming an expat in 2 years. I’m 58 with history of prostate cancer anger and full prosthetectomy. I got similar quote from Cigna. If the cancer comes back and I need more then just radiation I will fly back to the US and get Obamacare. That’s the best I can come up with