Have a condition you want covered with international insurance? Check out this guide
The first thing to say is that if you do have a preexisting condition, you may not be able to get coverage for it abroad. Insurance by definition is for covering unknown risk, not realized risk.
Whether you can insure a preexisting condition will depend on:
Your citizenship country
Your destination country's local offerings
How severe your current condition is
Your ability to show documents related to your condition
Before you leave your home country
Collect your medical records
If you are still in your planning stage of moving abroad, you should get a copy of your medical file(s). This for one is just good to have abroad regardless. Foreign countries won't have access to this, which can be important for hospitalization and claims. Old medical files can be very hard to get after you leave your home country due to medical privacy laws. For example, many people take Prozac for minor depression. If you declare this to an insurer, they will need a written record from your doctor saying what your diagnosis is and why. People suffering from may be denied insurance from some providers. Reach out to an agent at firstname.lastname@example.org and we may have options for you.
Get a checkup if you're still covered under old insurance
If you have insurance already that will cover a checkup on your condition, go get it done. Recent medical records showing the current state of your condition may be requested abroad. If you're not currently insured, you may consider waiting to do it more cheaply abroad. This is also generally a good practice; don't move to a foreign country not knowing your current health status. You don't want to waste money moving abroad and have to go right back due to an unexpected diagnosis.
Give yourself plenty of time
Please do your research before moving abroad; many policies will give you better benefits if you are coming from another insurance plan or have good documentation for your condition. If you have a set date planned, contact us about 30 days before you leave, and that will give us plenty of time to find a good solution for you.
Strategies for preexisting conditions coverage
Self-Insure - This is obviously a risky proposition, but also unfortunately what many people end up doing due to lack of preparation, lack of options due to the severity of a condition, or lack of funds. If you are coming from a place like the USA, you will find that care abroad is surprisingly inexpensive! If you are Canadian or European, you might be shocked at the higher cost!
In Mexico, labor is cheap but medical supplies and equipment are still quite pricy, at least the modern supplies and technology that is many times imported from countries like the US. Things like doctor visits, generic medications, and routine surgeries often can be paid out of pocket. Catastrophic claims can quickly escalate however.
Below are some common claim costs we see in Mexico. Do note, these vary drastically depending on the situation and location. For example, a high-cost tourist hospital is usually going to be a lot more expensive than a rural general hospital. Also note, these costs may be a bit inflated as insurers are often charged more than if you are paying cash up front. Many places will negotiate costs with you if you get second medical opinions beforehand.
If someone is planning on self-insuring completely, I recommend they have at least $50,000 saved. This will handle the majority of medical events we see abroad. We rarely see claims go over $100,000, but that's not to say they don't happen. Try to have backup options in place listed below. (If you are going to be living in a higher medical-cost area, these rates will not be relevant.)
Sample Claim cost in USD for Mexico.
Doctor Visit - $25-$60
Hospital Room - $200-$700 per day
ICU - $1,000-$3,000 per day
Evacuation - $15,000-$100,000
Surgeon Fee - $2,000-$15,000
Heart Stent Equipment - $8,000
Average Minor Surgery cost: $3,000-$15,000
Average Total Major surgery: $25,000-$150,000
Our largest 2021 claim - $850,000
There are many countries that offer partially- to fully-public healthcare. Do your research in the country to see what options are available. It is also important to look at the insurance requirements. Many times they will require a resident visa or citizenship to qualify, and many times these processes are started in your home country. In the example below, we will take a look at Mexico’s current government options.
The landscape in Mexico has changed a lot over the last few years. Mexico used to have a public health system called Seguro Popular that covered pre-existing conditions, but that plan has been rolled into the new INSABI program that the Mexican president Lopez Obrador implemented. There is also the IMSS program, which is a large social security insurance system that also administers a network of hospitals and regulates drugs on the Mexican market. Typically workers qualify for IMSS insurance through employment benefits. While Seguro Popular often covered preexisting conditions, neither of the current public options (hampered by insufficient resources and no small amount of corruption) do so.
I am going to reference our partner mexperience.com article on this subject, they always stay up to date and have great content: How to access the public healthcare system.
In our experience, the quality of public healthcare in Mexico can vary drastically. We have heard many horror stories from the public hospitals, but we have also heard much praise for the dedicated and highly-trained doctors working in some public hospitals. Many times it comes down to how strained the facility's resources are currently. If you are willing to work through the system this maybe a solid option for you.
If you have a government plan in your home country, here are some guides on common options:
How does the Canadian provincial system work if you are living abroad?
Travel Insurance / Evacuation
If you are self-insuring, we recommend at least having an evacuation policy and/or a travel health insurance policy in place.
A standalone evacuation policy is generally needed to get you back to your home country to treat your preexisting condition. Most evacuation policies cover preexisting conditions like any other condition, and there is also no differences in cost based on your age. This makes it a really good proposition for people that are either priced out of policies, are uninsurable, or have coverage of their preexisting condition in their insurance plan at home.
You may think your travel policy, or perhaps even your credit card benefits, may cover evacuations. However, these benefits will usually only evacuate you to the nearest facility that can treat you. This means that you are only "evacuated" as far as the nearest hospital that can treat you. This is why we recommend a standalone evacuation plan if looking into this method.
Two companies we recommend are the following:
When comparing evacuation companies, we generally recommend Airmed. They have their own fleet of air ambulances and lenient terms on when you are evacuated which make it a great options.
Another carrier we enjoy working with is TME Travel Medical Evacuation (formerly Travel MedEvac). This carrier allows you to add on emergency travel insurance for when you can't be evacuated, which can help out in certain claims. Do note for this plan you must have a US billing address for your credit card, and only up to 180 days per policy.
Travel or Vacation Insurance
You may find that travel policies will sometimes say they cover pre-existing conditions. If you are buying a policy for this, make sure to read the fine print. Many times coverage is for the acute onset of a preexisting condition. This does not mean you have comprehensive coverage; this is mostly stabilization just for the onset of that medical event and does not provide ongoing or outpatient care. Every travel insurer is different, however, and some are more comprehensive than others.
Here are some products we recommend:
One good option if you are a US citizen, is to check out GeoBlue from BlueCross/BlueShield. Their Voyager plans have more comprehensive benefits than most carriers we have found, and they do not use the "acute onset" wording as most carriers do.
If you are keeping your US primary healthcare plan, they will cover preexisting conditions under the policy for up to 180 days. This is a good option for people that are just testing out living for extended periods abroad. This plan is common for our US nomads that may have comprehensive plans through employers or parents.
Similar to the plan above, but for people without a primary healthcare plan in the US. This plan covers preexisting conditions for evacuations only. Do note if you are in this position, GeoBlue has more comprehensive long-term medical plans we mention below.
IMG / Trawick / HTH / Cigna
These are carriers that have the acute onset of preexisting conditions coverage I mentioned. All plans have their own unique benefits and target markets; I would recommend exploring them all and seeing which company you like. For a more comprehensive guide on our travel carrier options check out this guide.##
Long Term Major Medical
These plans are simply the long term health policies you would normally apply for. Most will require underwriting and different carriers maybe good for your unique situation. We recommend talking to one of our brokers to help match a plan. Here are some common options we sell.
Covers Preexisting Conditions Normally
This plan is the only long term health provider that truly covers preexisting conditions. It is only for US citizens however, and can get expensive as you age, due to the increased risk the insurer is taking on. Also note they can still deny applications, but if you are approved, you will not receive any exclusions.
Has minor Pre-Existing Benefits
You should also consider
Any of our other providers. Different carriers have different risk they may accept. It is worth submitting your medical history to a few carriers as some may accept your conditions.
Here is a list of commonly uninsurable risks. If you have one of these conditions, it will be hard to get you coverage, your best chance would be with GeoBlue above as they are the most lenient with preexisting risk.
Want to see if we have insured your condition before? Check out our ongoing offers list here.