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Health insurance with pre-existing conditions

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wilsonworld
5/31/2018 11:55 EST

I know health insurance has been discussed over and over in this forum, but I've yet to get actual verification of someone who successfully obtained private insurance thru Medis, Medal, or Allianz that had pre-existing conditions. We are being told by them that it will not be covered. My wife has been (breast) cancer free for 10 years and we've always had continuous coverage with no issues.
I've read a few posts that claim they will cover, but no actual verification from someone who has a policy.
Allianz has replied that we need to send a full medical report to their Dublin office for underwriters review, so that may be promising. I would love to hear first hand from someone who has conquered this.

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Countga
5/31/2018 12:08 EST

Hello wilsonworld.
I have health insurance thru my membership in AFPOP/Medal. I had pre-existing conditions and all I had to show them was my Medicare card or in your case, a policy showing continuous coverage. Medal ( a broker) actually issues a policy by Allianz. I have had a policy since August 2016. Does this help?
countga

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wilsonworld
5/31/2018 12:19 EST

Hi Countga,

Yes, this helps tremendously, but we need to figure out how to get to that point. So far all we're received is a brief email from Medal saying pre-existed conditions are not covered. That's why we contacted Allianz. Did you go to their office or do this by mail/email?

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realspear
5/31/2018 12:56 EST

Medal will cover pre-existing conditions, or did a few months ago, if you provide documentation of continuous coverage. We gave two years of statements.

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wilsonworld
5/31/2018 13:05 EST

My wife said I wasn't clear in my post :(
It's not that we cant get the policy at all, it's that preexisting conditions won't be covered. So if her issues were ever to return it wouldn't be covered. We'd be on our own for treatment.

Is that your case or am I still off track?

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sepharad
6/2/2018 10:02 EST

I would go to a different provider. Mine simply charges mere because of my Pre existing condition. As a medical care giver, I would say that sounds like useless insurance.

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nycath
6/6/2018 08:03 EST

I moved to Portugal from New York in January.. I was diagnosed with breast cancer at age 52 in 2014 and completed treatment in January 2016. I joined AFPOP and then emailed their Health Insurance contact. I had to show very specific proof of insurance back to 2014, not only that I was covered but specifically that cancer treatment was covered. I am paying 63 euro a month for Allianz Insurance. I have already had 2 appointments with an oncologist at a private hospital here with a 12,50 euro copay. So, yes, if you get all the necessary documentation together and use AFPOP insurance, it can be done. It is such a relief. And living in Portugal is absolute wonderful. Good luck to Bobby of you.

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craigandmicki
6/6/2018 08:42 EST

to nycath's message about getting health insurance: THANK YOU for such a clear, concise explanation about how to handle pre-existing conditions. So many people ask about this, so many times misunderstandings are created (often because people think they were denied insurance here but they just didn't provide the correct info), and the pricing is misunderstood. Your post is very important to this forum.

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wilsonworld
6/6/2018 09:28 EST

nycath,

Thank you so much for this. Since posting we've heard similar stories, all which contradict the *lead representative* from Medal who told us in writing that pre-existing conditions were absolutely not covered. My wife has been cancer free for 10 years, always covered by excellent insurance. We now have an alternate contact that we are reaching out to. If I run into another dead end I may ask you to PM me your contact.

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nycath
6/7/2018 08:53 EST

I am happy to help in any way I can.

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GeoffK
6/8/2018 15:42 EST

Is there a standard definition of a pre-existing condition? Or are there different definitions depending on the insurer? Or are they defined at all?
Specifically, if one takes a blood pressure pill and/or a cholesterol pill but has no history of requiring any other treatment related to those, does that constitute a pre existing condition?

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Countga
6/8/2018 18:01 EST

Most insurance companies use one of two definitions to identify such conditions. Under the "objective standard" definition, a pre-existing condition is any condition for which the patient has already received medical advice or treatment prior to enrollment in a new medical insurance plan. Under the broader, "prudent person" definition, a pre-existing condition is anything for which symptoms were present and a prudent person would have sought treatment.
Does that explain pre-existing condition for you?

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GeoffK
6/8/2018 19:13 EST

Yes and very clearly. Thank you.
GeoffK

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dancebert
7/11/2019 10:04 EST

>we've heard similar stories, all which contradict the *lead representative* from Medal who told us in writing that pre-existing conditions were absolutely not covered.

When you contacted Medal did you state you were either an AFPOP member or planning to join? It's possible pre-existing conditions are only covered under that group plan.

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craigandmicki
7/12/2019 06:56 EST

Why does the representative at Medal tell you that pre-existing conditions are not covered? Because he is Portuguese and is quoting to you from the rules...pre-exisiting conditions are NOT covered UNTIL you get a waiver for them. The waiver is requested from your Medal rep after you agree to purchase the insurance; the waiver requires that you submit proof of having been continuously insured while having the / those pre-existing conditions (so, statement of coverage with name and dates from your provider and perhaps proof of reimbursement for related treatment within the last year or two). The Medal rep will tell you this if you ask, but he will not guarantee pre-existing coverage on his own volition. This is based on working with about 60 people in the last year who are doing the same thing....afpop to Medal to Alliance to pre-existing coverage.

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Wallvestor
7/12/2019 07:09 EST

Craigandmicki, I think you meant afpop to medal to Allianz....

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craigandmicki
7/12/2019 07:17 EST

Yep! Thank you, Wallvestor.

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vernanjohn
7/12/2019 12:44 EST

This is a zombie thread over a year old

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dancebert
7/12/2019 13:26 EST

Zombie? The OP was active in this forum last week, so he can respond to a question if he wants. Zombie? Questions about insuring pre-existing conditions are common. Correcting misconceptions and filling in the blanks are a service to current and future readers.

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realspear
7/12/2019 13:40 EST

In addition to what dancebert said, it's worth noting that many things in Portugal are moving targets and it's important to keep adding fresh information.

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Lucaluca
7/12/2019 23:08 EST

Very much

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Lucaluca
7/12/2019 23:08 EST

Very much

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vernanjohn
7/13/2019 08:15 EST

Dancebert,my apologies then. the last post showing on this thread before your post was dated 6/8/18. apparently there are posts since then which have been deleted or for some reason aren't showing on my screen.

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GeoffK
7/13/2019 10:20 EST

I have not been following this thread and my two bobs worth might be worth two cents. But I just enrolled through Medal. I am 71. My paperwork says pre-existing conditions are covered after one year. Middle range cover cost 975 Euros for 6 months. I didn't have private cover anywhere immediately prior to signing with them so don't know if there would have been any different result if I had.

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GeoffK
7/13/2019 10:20 EST

I have not been following this thread and my two bobs worth might be worth two cents. But I just enrolled through Medal. I am 71. My paperwork says pre-existing conditions are covered after one year. Middle range cover cost 975 Euros for 6 months. I didn't have private cover anywhere immediately prior to signing with them so don't know if there would have been any different result if I had.

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Jarsten
7/28/2019 18:01 EST

It would be great to hear directly from people with pre-existing conditions who have gotten health insurance. I’ve just been diagnosed with a blood cancer which is at an early stage and per the experts won’t kill me— life expectancy is measured in decades but I’ll need monitoring and possibly treatment at some point. I plan to keep BOTH of my US plans and be followed in the US, but of course i’ll need Schengen insurance. I’d also want a Portuguese oncologist for routine monitoring, which i could could pay for out of pocket. So any guidance would be great!

Since this has been discussed to death in the public forums, I’d rather communicate privately.

By the way. If you develop cancer in Portugal, there is a world famous oncology center in Madrid. It’s a branch of the renowned MD Anderson center in Houston—possibly the leading center in the world. Hopefully none of you will ever need it!!

Até breve!

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realspear
7/29/2019 02:54 EST

If you read everything above, you will see there are comments from people who have pre-existing conditions and are covered in Portugal. You need to find a company (many of us use Allianz/Medal through AFPOP) that will cover them and provide documentation of continuous prior coverage.

I don't understand why anyone would keep a plan in the US when they live here. The Allianz/Medal plan gives coverage in the US for a limited trip and you can supplement with travel insurance.

There are plenty of excellent doctors and facilities here. Healthcare is better than in the US. They run far more tests here than US insurance would ever cover.

I have lymphoma, which is a blood cancer, and I wouldn't go back to the US or to Spain for treatment. Given that a lot of cancer treatment means ongoing coverage, why would I move to Madrid for treatment?

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Jarsten
7/29/2019 10:26 EST

Hi Realspear!

Thanks for your response. I appreciate the information. As I wrote, I know how much this is been discussed in the forums and how annoying it is to have repetitive questions, so I was soliciting private responses to protect other users from more annoyance.

But to answer your questions: I keep my insurance because it’s a retirement benefit If I ever give up my retirement healthcare, I cannot get it back. If I had to move back to the United States, that would be catastrophic.

I can’t transfer the benefit to Europe but I can keep it, and maintain contact with my existing healthcare team. Continuity is very important in managing the condition I have. Since I have elderly parents and in-laws, I’ll be coming back to the United States at least 2 to 3 times per year, and could maintain continuity of care at least for the first 2 to 3 years I’m in Europe. And my oncologists do a lot of “virtual“ Internet video visits, and they are happy to collaborate with a Portuguese colleague.

I’m eager to check out Allianz because CIGNA has told me I’m not eligible for insurance for at least four years and that it would not cover cancer care thereafter. And I love Portugal so much that I’m not willing to wait that long. And honestly, after spending months in Lisbon trying to master the “infinitivo pessoal” vs the subjunctive verb conjugations, my Portuguese can’t afford such a delay!

Again, thanks for taking time to respond to me. I always enjoy your posts

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dancebert
7/29/2019 16:22 EST

@Jarsten

PM sent. Post here if you don't receive it.

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Titimejias
1/21/2020 15:26 EST

Could you please share your agent that you bought the insurance from?
Thank you so much

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