Tips For Picking Visitors Insurance For Indian Parents Traveling To The US

We know that healthcare in the U.S is expensive and elderly people are more susceptible to illnesses. Bills can quickly add up if you run into a medical emergency. Depending on the treatment, visiting an urgent care or the emergency room can cost anywhere between $150 to $1,000,000. Ambulance or helicopter services is beyond the afforadable limits of middle-class people like me if I have to pay for it out of pocket. You must realize that even if you are healthy at this moment, you can still encounter unexpected emergencies like sudden illness, accidents, hurting yourself or falling down, etc. This is where having a travel insurance policy can help in avoiding a bankruptcy. 

You can either buy the travel insurance from an Indian company in India or a US company. The pros and cons for both these options are listed below:

#	Indian Insurance Company	US Insurance Company
1	It is way cheaper to buy insurance from an Indian company in India as opposed to a US based companies.  For e.g.: Insurance for 70+ years old traveler Insurance provider: Bajaj Allianz  Premium: $80 Deductible: $100 Policy period: 30 days  Coverage max: $50,000	It is very expensive to buy insurance from a US based insurance provider. For e.g.: Insurance for 70+ years old traveler Insurance provider: Cover America Gold Premium: $ 238 Deductible: $1000 Policy period: 30 days  Coverage max: $50,000
2	You already know most of the Indian insurance companies and if things don't work well you can sue them in India or complain about them. You may be able to easily seek first hand information about them from the people you know.	You don't know this company, never heard of except that they are suggested on sites like visitorscoverage.com, insubuy.com, immihelp.com, path2usa.com. You have to trust whatever information is available on the internet. You don't know if they are genuine companies or scams.
3	You pay your medical bills first in the US and then claims are filed upon your return to India. This may prohibit a cashless transaction as US health providers do not accept Indian insurance or they are not willing to bill a company in India.	Direct cashless billing locally.
4	Since the claim is filed after returning to India, there is no state restrictions here.	Every state has specific rules involving insurance policies that will restrict you from purchasing the insurance.
5	Most plans are for the travelers below 70 years of age. And, even if they are available, they come with stringent sub-limits.	Fixed and comprehensive plans are availble for all ages.
6	No PPO network available in the US.	No PPO network available in the US.
7	Customer care is based in India and it is difficult to reach them from the US. Their US numbers are mostly not available.	Local customer care service available.
8	Some companies exclude OPD benefits.	OPD benefits available.
9	Online purchase option may not be available.	Easy purchase option available.
10	Not many options for pre-existing medical conditions or acute onset of pre-existing medical conditions are available for senior travelers. Even if it is available, the coverage limit is very low for any practical use.  For e.g.: Bajaj Allianz's pre-medical coverage limit is $ 300.	Pre-existing medical conditions or acute onset of pre-existing medical conditions are available for senior travelers but expensive.  For e.g.:Cover America Gold's acute onset of a pre-existing condition coverage is up to $125,000 is available for travelers under age 70 and up to $30,000 for travelers age 70-79.

My parents came to visit me in February 2020 and she has carried a travel insurance policy with her from India (Reliance), but my father has come without any travel insurance. They are supposed to return in May, however due to the coronavirus breakdown they might have to extend their stay. We don't know that yet. In case that happens, we will have to extend or renew her policy. 

We reached out to Reliance, it was very hard to get in touch with their customer service as their US number turned out to be a Direct TV toll free number. We had to wait for their offices to open the next business day and then call up on their landline. Their policy cannot be renewed online. Their customer care agent sent us an email and we had to extend it by sending a reply to that email. 

On the other hand, my father (he is 70) has been a bit under the weather for the past few days and we have been relying on OTC medicines to keep his condition stable. Unfortunately, if we have to get him hospitalized, I can only imagine how much that would cost him without an insurance. I hope I don't have to witness that ever.

Recently, I was looking online to see if Indian travelers who are already in the US, can buy insurance from an Indian based insurance company? Moreover, I wanted a policy that is catered to senior citizens and covers pre-medical conditions/acute onset of pre-medical conditions. I reached out to a number of Indian based insurance provides via www.nrioil.com. However, Bajaj Allianz was the only company that agreed to give him an insurance policy.  

The other alternative is to buy a travel insurance from a US based company. Ironically, the best selling policies on popular websites had negative reviews. Moreover, they were very expensive. The last things that anybody would wan to do is to spend money and buy a scam. But if you need insurance, you have to buy one. Hence, based on  my research, I am listing down a few things that you must know before buying a travel insurance from a US insurance service provider:

1. Understand basic US healthcare terms: Do not assume that meaning of the terms is the same as India. As insurance policies and terms differ from one country to another, it is important to know the meaning of terms such as deductible, copay, in-network vs out-of-network, pre-existing medical conditions, acute onset of the pre-medical condition 
2. Read reviews: Safe travels the USA, Cover America Gold, Patriot Liason Travel Choice, Choice America, Patriot America, Atlas America are the best selling travel insurance policies from popular sites such as VisitorsCoverage, InsuBuy, ImmiHelp, Path2USA. However, you need to read their reviews before buying them. Refer to websites like TrustPilot, Yelp, Better Business Bureau, ConsumerAffairs, to know if these insurance providers are running scams. Ask around if anybody has bought insurance from these companies and received the claim money without any hassle.
3. Fixed versus comprehensive coverage: Fixed coverage policies are cheaper but they have stricter sub-limits for every procedure. This is ideal for small ailments, but you will pay more for major medical expenses. Therefore, it is highly recommended to purchase only comprehensive plans as it covers expenses up to the plan maximum less co-insurance and deductible.
4. Check if pre-existing medical conditions and acute onset of pre-medical conditions are covered: For visitors insurance, you don’t have to undergo any medical examination. Your insurer will ask you to fill in a 'good health declaration form' and will rely on the information you provided to approve your insurance. Usually, there is a "look back" period which is usually from 30 to 180 days. The underwriter considers this period as relevant to your state of health. Most visitor insurance plans do not cover pre-existing conditions, but they may cover the acute onset of pre-existing conditions. 
5. Understand the state restrictions: Every state has specific rules involving insurance policies. Maryland, for instance, prevents state residents and people whose mailing address is in the state from buying insurance plans like VisitorsCare and Patriot America. The restriction will only prevent you from purchasing the insurance. You can still use it within the state. If your billing address is in a restricted state or when you are visiting the restricted state and you are not purchasing the plan while in the state, you will still be able to avail of the plan.

I strongly recommend that you buy an insurance policy before traveling to the US as most Indian insurance companies will not provide you a policy after you have stepped out of India plus US insurance is expensive. Whether you buy travel insurance from an Indian company or US, you need to thoroughly go through their policy details and terms and conditions before and after buying the policy. Always read the fine print!