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Pre-existing conditions and Pt health insurance

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NearlyThere
1/30/2017 00:04 EST

Hello all.

Can anyone shed light on the Portugal health insurance situation and pre-existing conditions? We are expecting to apply for a Type 1 visa in the US and arrive in Lisbon in September.

I am a young(ish) retiree and a breast cancer survivor and, as expected, must be surveilled on a regular basis. I also take a daily medication.

Will I be able to get private health insurance?

Is it going to cost me an arm and a leg?

Anyone using the public system for this type of situation? Is that even possible?

Any thoughts, ideas, options?

So many questions...oy! Any and all information and consideration appreciated. Cheers...

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beeg1234
1/30/2017 12:45 EST

I too had breast cancer surgery Dec 2014, and now living in the Algarve. I'm 51 years old and have full coverage private medical insurance with Allianz through Medal (insurance broker) for 600 euros a year. You can send me a PM if you want further details.

Please note I do not have any experience with public health care system in Portugal. I actually do not think you can be eligible if you're just moving to Portugal.

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BigWorld
1/30/2017 18:11 EST

Thanks so much for this information. I too have a pre-existing condition that prevented me from getting health insurance in the U.S. for a number of years until the passage of Obamacare. The downside is that Obamacare does not cover me outside of the U.S.

Does Allianz or another insurer provide coverage for Portugal as well as the U.S. when visiting? Does any insurer in the E.U. or U.S. provide full worldwide coverage for expats who reside in multiple countries?

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captdave51
1/31/2017 09:53 EST

It is my experience that pre-existing conditions are not covered by Alliance. Did you have the insurance prior to your cancer diagnosis?

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beeg1234
1/31/2017 10:38 EST

Pre-existing is covered if one can provide documentation that he/she has had coverage for a 12month period. For example, Oct 2016 I applied for full coverage with Allianz through Medal (as a member of afpop so I received substantial discount as a member). All I need to provide Medal/Allianz is a letter from BlueCross BlueShield of California that I have been covered on their plan for the past 12 months. My premium full coverage is ~600 euros a year.

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Countga
1/31/2017 11:16 EST

Hello. I have Allianz coverage through Medal. I showed them my Medicare card and that was sufficient to cover me for pre-existing conditions. I have had Medicare coverage for 5+ years. Here is exactly what I was told by Medal:
"Regarding the waiting period, Allianz can cancel the 60 days waiting period, we explain how you can do it:
· if you are insured with a valid Health Insurance (the insurance can be from any country) you can send us the Insurance certificate (where must be mentioned the start of the insurance and the coverages), and we will ask Allianz to accept your pre-existing conditions since the beginning of your health insurance."
This is from an email received on 24 August 2016. Hope this helps.
countga

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captdave51
1/31/2017 11:23 EST

Thanks for the reply. That is what I thought. Unfortunately I do not currently have insurance so I will have a problem with my pre-existing conditions and with high blood pressure, I imagine almost everything would be a pre-existing condition according to the health insurance companies!

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captdave51
1/31/2017 11:31 EST

I have had Medicare for about a year but my pre-existing condition was present before that started so I guess I am out of luck. Perhaps the public health system will pick up what the insurance company denies.

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OldPro
1/31/2017 14:01 EST

I can't comment on pre-existing conditions in regard to Portuguese public healthcare.

But I do find it interesting how this differs from country to country. If you try to find info on it for someone moving to say the Province of Ontario in Canada who would become eligible for Ontario government healthcare after being resident for 3 months, you will not find any mention of pre-existing conditions It simply doesn't exist in Canada. If you are covered by provincial healthcare there in any province, you are covered period.

It speaks to the basic beliefs followed in a country regarding healthcare. Canada follows the belief that healthcare should be provided to all residents for any need they have. Something that some countries still can't seem to figure out.

I believe that if you moved to the UK as another example, once you became eligible for government healthcare, they too would not see any difference with a 'pre-existing' condition.

For the term 'pre-existing condition' to exist, there has to be a difference in what would be covered to exist.

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NearlyThere
2/3/2017 13:51 EST

Thank you to everyone that commented on this thread. Such an interesting discussion.

OldPro, wow, pre-existing conditions are so lodged into the American psyche that it's mind-blowing to consider the position of other countries.

Special thanks to beeg1234 and Countga for the details. So appreciated and important, especially a continent away.

See you in Portugal this fall - cheers.

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LovetheBeach
2/3/2017 16:34 EST

Big World, you may want to check out Cigna and BUPA. They both have world wide insurance, but may or may not offer coverage in the US. Most insurers outside the US will not cover anything in the US because the cost is anywhere from 2-10 more than in other countries. And, I don't know what their policies are on pre-existing conditions.

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MaskedMarauder
2/3/2017 18:09 EST

Bcbs will cover you coverage worldwide, at least my policy will. They have a website that gives you a list of approved doctors and hospitals. You need to pay first and then get reimbursed by bcbs, unless the hospital has a special arrangement worked out before hand. Cigna quoted me $350 a month, yikes.

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BigWorld
2/4/2017 10:05 EST

Thanks Masked. Did you buy the BCBS policy through an agent? If so, please let me know who.. This might be a very good option for me as I don't mind getting reimbursed. What is your premium?

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MaskedMarauder
2/4/2017 11:47 EST

I'm a retired fed, so not sure if the same options are available to general public.

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KevinfromKinsaleviaNYC
2/8/2017 13:16 EST

Cigna quoted me $796 per month. GeoBlue (BCBS) quoted me $772 with a $5,000 annual deductible.

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Ironfoot2009
11/19/2017 23:28 EST

I wonder if the pre-existing acceptance is based on a more minimal set of conditions though ? We are actively looking to retire in Portugal coming from the States-just the wife and I in our 60's. I have been on Medicare and medicare Advantage through Blue Cross of ID for several years now. My Salto Talaris artificial ankle joint is all loose and its a very complicated issue on top of having Diabetes 2--so will need a Transtibial amputation and an artificial lower limb and foot since another replacement is not viable either

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Lucaluca
8/16/2019 16:31 EST

Hi. Did you have a one year waiting period. I keep getting conflicting info. I have applied with Allianz with an afpop membership. But they are saying I had to have the condition while I was insured by insurer at time of condition. And I ve changed insurers many times in that time and now just starting. Medicare. Any insight ? I also can t wait a year as I have needed medication. Thanks in advance.

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Lucaluca
8/16/2019 16:35 EST

Hi I was covered by anthem but just this month went on Medicare and they would no longer cover me when o became elegible for
Medicare. So will this be a problem. Do you think. As I be only had Medicare for a month. ? Thank s in advance.

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Lucaluca
8/16/2019 16:35 EST

Hi I was covered by anthem but just this month went on Medicare and they would no longer cover me when o became elegible for
Medicare. So will this be a problem. Do you think. As I be only had Medicare for a month. ? Thank s in advance.

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Countga
8/16/2019 17:10 EST

Hello LucaLuca
Option A of the Medal / Allianz insurance is the best and most expensive group coverage option. The medication limit is 150 euros per annum. So, if you are or will be in need of medication it seems to me it will be mostly out of pocket anyway. Have you checked to see what your medication costs here?
Countga

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GeoffK
8/16/2019 21:12 EST

I insured through AFPOP membership and Medal in July. I have not been insured for the past couple of years. I was told there was a one year wait on pre existing conditions. No other limitations were mentioned. I joined in person in Almancil.

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GeoffK
8/16/2019 21:12 EST

I insured through AFPOP membership and Medal in July. I have not been insured for the past couple of years. I was told there was a one year wait on pre existing conditions. No other limitations were mentioned. I joined in person in Almancil.

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dancebert
8/17/2019 10:12 EST

>The medication limit is 150 euros per annum.

Perhaps this is obvious from the Medal/Allianz brochure. I had to ask because I was concerned about Medal coverage for meds. Their 2016 brochure states for Medicine:
Maximum Person / Year - €150
Refund - 80%
Excess - €5 per medicine

'Refund' and 'Excess' were unfamiliar terms to me, so in 2019 I asked Medal using a hypothetical example of a €20 medicine purchase. Received this reply from their Portamão office:

"You paid € 20 for medicine. Allianz refund €12 ((€20€ - €5) * 80%).

We also can confirm that after, the sum of your refunds in a year reach €150, Medicine coverage cannot be longer applied for the year."

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tspring0204
8/17/2019 15:33 EST

Point of interest, one month supply of my Mylan Telmisartan 49 mg blood pressure generic cost €1.38. My wife and I are constantly amazed at how inexpensive prescription drugs are.

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hjr1225
9/20/2019 13:06 EST

We are planning to move to Portugal next year in the very early stages. I did apply to Allienz for insurance, and was denied due to my prexisting conditions (type2 diabetic), was told that :

"We wish to advise that our underwriting process is based on risk assessment in terms of the expected medical requirements and future claims based on an applicants medical hirtory."

The you guys that have insurance delt with a independent Broker..I did all mine on internet.. I have been on Medicare and Supplemental insurance United Health Care for the last 8 years. iam 73..anyone with similar conditions and have insurance?
Thanks

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missymess
9/20/2019 13:59 EST

hjr1225: Did you contact Allianz directly? Try going to the AFPOP webpage, finding the area for health insurance and writing them an email. Generally if you can prove you have had coverage for year(s) they have been covering pre-existing conditions. Same company quoted me over 1,000 euro a month for coverage for my husband and myself, when through AFPOP they quoted 260 Euro a month.

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realspear
9/20/2019 14:24 EST

Policies for people over 70 are usually different than under 70, and this may be the issue. You should try the suggestion to contact through AFPOP and see if that helps. However, until recently, it was even difficult to get a new policy if you were over 70 (or 70 1/2 if I recall correctly).

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missymess
9/20/2019 14:28 EST

Realspear: wasn't MGEN the company that took over 70's? I missed that first reading.

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tmac100
9/20/2019 14:58 EST

I got my plan through AFPOP just before I turned 71 in June. The insurer insistedon a NIF, so I hired a lawyer in Portugal to go thru the bureaucracy to get my NIF issued. It is much easier if you are in Portugal, but I am offshore.

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Aranthama
9/20/2019 15:18 EST

Over 70 - through Insubuy, a insurance broker here in the Algarve (and possibly elsewhere), I was able to get insurance through MGEN. It was 2x the cost of my wife's Medal health insurance, which she was able to get through Medal, as she was under 70 years old.

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tmac100
9/20/2019 15:40 EST

Yup, increased medical insurance costs certainly increase in Portugal after one turns 71, BUT still inexpensive as compared to the USA. Not a criticism, just an observation and a fact.

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realspear
9/20/2019 15:41 EST

Just a clarification - it's different to turn 71 with insurance than to look for insurance at 71.

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realspear
9/20/2019 15:42 EST

I would add to the tmac100's comment that health insurance in Portugal is less than my Medicare Part B and Anthem supplemental in the US. I do have co-pays here but it still works out to be less expensive.

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DLBeers
9/21/2019 13:27 EST

Masked, I am also a fed who will be retiring in about 5 years. I’ve been with BCBS since I joined the Service. And I know from my retirement seminar that I can keep it. My question - is there anything special you had to do to “switch” from domestic to worldwide? I would like to travel around Western Europe for several years after retirement, not staying in one place long enough to consider becoming a resident. I’ve been concerned with how insurance will work with that plan. Thanks for any insight.

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bkkb
9/28/2019 07:26 EST

I have recently had a heart attack overseas about 6 months prior to our arrival in Portugal. We are AfPop members and did the insurance through Medal with Allianz and they accepted ALL pre-existing conditions, but we had to proove that we had active health insurance prior. They will insure anything pre-existing but only if at the time and throiughout untill now yuou had health insurance...

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missymess
9/28/2019 08:53 EST

bkkb: What kind of proof did you show. They are asking for a "Certificate of Insurance" which our (past) insurance companies have no clue. All they will send us is the initial letter they sent us welcoming us to the plan.

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realspear
9/28/2019 09:42 EST

You need a Certificate of Creditable Coverage (COCC), which the insurance company will give you for any terminated policy. Best to go back five years and get this document for any policy that ended in that time period.

For your current policy, if your insurance card shows when it began and that you are still covered, that can be used. The tax form for the ACA (form 1095-A) will also show coverage. And there's no reason your insurance company won't give you a letter stating when the policy began and if it is still in force. This is standard for them, I have obtained statements like that several times from Anthem and Blue Cross/Blue Shield. Just make sure you are specific as to what the letter needs to say.

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dancebert
9/28/2019 12:23 EST

>All they will send us is the initial letter they sent us welcoming us to the plan.

Does your state have a Dept of Insurance with an ombudsman office that handles complaints? California does, don't know about the other 49.

The yearly invoices from my most recent pre-Portugal health insurance company included an 'insured since´ date. That plus the year covered by the invoice showed continuous coverage.

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missymess
9/28/2019 17:08 EST

realspear: TWice I have written to the insurance company asking for a CCC with all the information I need spelled out. TWice I have only received a copy of our welcome letter which has only our names and the date of the coverage starting. No other information.

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missymess
9/28/2019 17:12 EST

Dancebert: We pay monthly so it only shows the name and that months dates of coverage. I have been putting them aside in a folder after I pay them so if necessary I can produce them. Has anyone used the IRS form showing coverage as proof? If I try and get five years of CCC's I will be dealing with 3 companies. Dan went on medicare in March, and I will be going on it this coming March. One insurer pulled out of the Healthcare.gov pool and one I am still insured by. Something that should be so simple has turned into something difficult.

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realspear
9/29/2019 07:49 EST

Call them instead of writing. Find someone who understands what a COCC is and will help with it. It doesn't sound like you're getting to the right people. Also, I mentioned above that you can try using your tax form (1095-A) also. I'm not sure if that is sufficient, so it would be good to have other evidence. Also, Medicare cards will show your start date.

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missymess
10/4/2019 09:38 EST

Realspear: Went back to my folder. One insurance company sent me the right information though it had no heading i.e. CoCC. One company sent me welcome letter, and then sent a letter with the dates, but only my husband's name, and no dates of birth. I approached them again today. The third company I am still with, but my husband went on medicare in March, so waiting until I go on Medicare next march to approach them about the CoCC for the both of us. And then we will have our Social Security letters that state that medicare fees are taken from our pensions. Why should something so simple become so difficult??

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realspear
10/4/2019 10:42 EST

Well it sounds like you've got it taken care of but I would get the CoCC for you now anyway.

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GeoffK
10/4/2019 10:47 EST

Try leasing a car through VW. They want everything but your first born.

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missymess
10/14/2019 16:59 EST

realspear: I have been talking every day with someone at my former insurance company. Finally today someone else calls me. They tell me that the CoCC is usually only used for confirming coverage for Medicare Part D. She informed me I needed to get the 1095 form from healthcare.gov. This despite the fact that one of our other former insurance companies gave me the letter with all the information on it! So I guess I will have to go with that and hope it is sufficient. It does have our names, the last 4 of our social and the dates of coverage though no company listed.

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craigandmicki
10/15/2019 07:37 EST

To 'missymess' .... the HIPAA act introduced this lovely little document, a CoCC, to confirm that a person had prior coverage and, along with proofs of reimbursement for existing conditions, has been used to obtain coverage with a new insurer due to a qualifying event, such as moving out of the area of coverage. Read about it here. Any insurer who does NOT provide this on request can be fined. https://help.zenefits.com/Medical_Dental_Vision/Enrolling_in_Coverage/FAQs_Applying_for_Insurance_as_an_Employee/Why_Do_I_Need_to_Provide_Proof_of_Loss_of_Coverage%3F/. Everyone is sad to read about the number of times you've had to ask for this so hopefully this bit will be the end to that.

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missymess
10/15/2019 16:52 EST

craigandmicki: I spoke, yet again with the woman at the health insurance company. I explained the 1095 does not have all the information requested. She FINALLY agreed that someone should just put all the information required in a letter on letterhead! Medal wants names, dates of birth, dates of coverage, and coverage limit (which there was none) Turns out that the company is no longer in the insurance business hence, no phone number or address online to contact them, only a fill in the blank form on their website which gets forwarded to them. I THINK we finally have this one licked. Now to follow up with my husband's former insurance company who promised to send me, in a couple days (two weeks ago) what I requested. I "may" have what I need by next May!

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Traveller19
11/13/2019 20:19 EST

bkkb And to everyone: I apologize for not reading ALL of the posts - but I am planning on moving to Portugal in the coming months. I have pre-existing conditions and wanted to have Private insurance (before I moved there) that would cover those conditions. I went through AFPOP and just got my Allianz policy. I gave them all of my letters from my insurance companies that prove continuous health insurance since before my conditions started. However, in my policy, it states pre-existing conditions will *not* be covered. Of course I emailed Medal (the broker) to ask them about it. Can someone assure me I should be covered for everything? Thanks for any info.

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Lucaluca
11/14/2019 00:16 EST

Depends on what the condition is.

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Lucaluca
11/14/2019 00:16 EST

Depends on what the condition is.

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realspear
11/14/2019 04:06 EST

We were not asked to list specific conditions and nothing has been denied when dealing with pre-existing conditions. So at least in our case, there was no "depends on what the condition is."

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Traveller19
11/14/2019 10:16 EST

realspear And others, I just got a FAST reply from Henrique at Medal (the broker for Allianz insurance) and he pointed out to me a line in my policy that has a date (way back in 2000 when I had nothing wrong with me - and that is the oldest date I could find of continuous health insurance coverage) - where I am covered from the year 2000 for pre-existing conditions.

It's hard to read the policy (being in Portuguese) - and all I could see earlier was all this about how pre-existing conditions aren't covered - but they are, from the year 2000 - when I was practically in perfect health. I'm pretty excited. Thanks to everyone on this board for all the valuable information I've read on this topic!

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Traveller19
11/14/2019 10:26 EST

Lucaluca Just responding to you about the "depends on what the condition is". For me, applying for Allianz, through Medal and AFPOP - I needed to answer a questionnaire listing all of my conditions and surgeries. Then I proved continuous health coverage (with letters from the companies) since the year 2000. I've had coverage since birth - but that's as far as I needed to go - which is BEFORE I started having any health issues. As long as you can prove continuous health insurance coverage since before any particular condition started (no matter what it is) - you will be covered - for everything. I am - I just got the policy. I'm very excited about it! I'm very grateful to this board for having such great information on it.

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Elalien
1/3/2020 02:35 EST

I am a retired fed and I am not sure if the worldwide coverage under BCBS meets the Schengen residency requirements. I believe that worldwide coverage would only apply to the BCBS PPO high option.. I just messaged the marauder myself. As far as traveling Europe for more than 90 days in a 180 day period, that would not normally be allowed under Schengen. Best to read up about that before you go.

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Joemabee1
1/6/2020 09:51 EST

Hello, if you have proof of coverage in the US pre-existing conditions will not be excluded.
Contact your carrier in the US and ask them for proof of coverage. Go back as many years as needed to pre date the breast cancer diagnosis. We had to get them from several former insurance companies since we changed jobs frequently. Once you obtain your residence card you can get the state coverage, SNS. we use it only for our medicine and use Allianz from Medal as our primary. The medicine is lower cost if you use the SNS coverage.

You can DM me if you need anymore information. Thx Joe

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bbrplex
1/16/2020 15:14 EST

Hello all. Does anyone know of people who obtained insurance having had a transplant??? Thanks,

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