Frequently Asked Questions:
- Pre-Existing Conditions
- Acute Onset of Pre-Existing Conditions
- Visitors Protect Pre-Existing Conditions Coverage & Exclusions
Due to the high demand for Pre-Existing Condition coverage, the underwriters have extended the coverage provided under many of the plans to allow for coverage under very specific circumstances. They call this coverage either 'Acute Onset of Pre-Existing Conditions' or 'Sudden and Unexpected Recurrence of Pre-Existing Conditions'. There are plans that provide some kind of further limited coverage of pre-existing condition coverage. Please carefully understand what a chosen plan incudes.
*While the acute onset may cover a sudden and unexpected recurrence, the reverse is not true.
Comprehensive Coverage Plans
Overview
After deductible, pays 100% to policy maximum.
Direct Billing
Through United Healthcare PPO Network 
Acute onset of pre-existing conditions
Coverage to policy max for ages <70; $35,000 for ages 70-79; $20,000 for ages 80+ Learn More
Overview
After deductible, pays 100% to policy maximum.
Direct Billing
Through United Healthcare PPO Network
Acute onset of pre-existing conditions
US Citizens: Maximum of $1,000,000 for up to age 64 with Primary Health Plan; $20,000 without. Ages 65-69: $2,500 maximum. Non-US Citizens: For ages < 70, up to $1,000,000 Learn More
Overview
After deductible, pays 100% to policy maximum.
Outside PPO network: After deductible, pays 80% to $5,000, then 100% to policy maximum.
Outside PPO network: After deductible, pays 80% to $5,000, then 100% to policy maximum.
Direct Billing
Through United Healthcare PPO Network
Acute onset of pre-existing conditions
Coverage for under age 70. $150,000 for policy maximums of $550,000 and over; $50,000 for policy maximums between $60,000 and $200,000 Learn More
Overview
After deductible, pays 100% to policy maximum.
Direct Billing
Through United Healthcare PPO Network
Acute onset of pre-existing conditions
Coverage to policy max for ages <80 Learn More
Overview
After deductible, pays 75% to policy maximum.
Outside PPO Network: After deductible, pays 60% to policy maximum.
Outside PPO Network: After deductible, pays 60% to policy maximum.
Direct Billing
Through United Healthcare PPO Network
Pre-Existing Conditions
$25,000 up to age 69; $20,000 for ages 70 and older Learn More
Overview
After deductible, pays 100% to policy maximum.
Outside PPO network: After deductible, pays 90% to $5,000, then 100% to policy maximum.
Outside PPO network: After deductible, pays 90% to $5,000, then 100% to policy maximum.
Direct Billing
Through United Healthcare PPO Network
Acute onset of pre-existing conditions
Coverage to policy max for ages <70 Learn More
Overview
After deductible, pays 100% to policy maximum.
Direct Billing
Through United Healthcare PPO Network
Acute onset of pre-existing conditions
Coverage to policy max for ages <80 Learn More
Overview
After deductible, pays 80% to $5,000, then 100% to policy maximum.
Direct Billing
Through United Healthcare PPO Network
Unexpected recurrence of pre-existing condition coverage
coverage to $1,000 for ages <70 Learn More
Overview
After deductible, pays 90% to $2,500, then 100% to policy maximum.
Direct Billing
Through United Healthcare PPO Network
Unexpected recurrence of pre-existing condition coverage
coverage to $1,000 for ages <70 Learn More
Overview
After deductible, pays 80% to $5,000, then 100% to policy maximum.
Direct Billing
Depends on provider. No PPO network.
Acute onset of pre-existing conditions
Non-US Citizens: to $10,000 for ages <70 Learn More
Overview
After deductible, pays 80% to $5,000, then 100% to policy maximum.
Direct Billing
Depends on provider. No PPO network.
Acute onset of pre-existing conditions
Non-US Citizens: to $10,000 for ages <70 Learn More
Overview
After deductible, pays 100% to policy maximum.
Outside PPO network: After deductible, pays Usual, Reasonable, and Customary to policy maximum.
Outside PPO network: After deductible, pays Usual, Reasonable, and Customary to policy maximum.
Direct Billing
Through United Healthcare PPO Network
Acute onset of pre-existing conditions
Coverage to $25,000 for ages <65; $2,500 for ages 65+ Learn More
Overview
After deductible pays 100% to policy maximum.
Outside PPO Network: After deductible, pays Usual, Reasonable, and Customary to policy maximum.
Outside PPO Network: After deductible, pays Usual, Reasonable, and Customary to policy maximum.
Direct Billing
Through United Healthcare PPO Network
Acute onset of pre-existing conditions
Coverage to $200,000 for ages <60; $20,000 for ages 60-64 Learn More
Overview
After deductible, pays 100% to policy maximum.
Outside PPO network: After deductible, pays Usual, Reasonable, and Customary to policy maximum.
Outside PPO network: After deductible, pays Usual, Reasonable, and Customary to policy maximum.
Direct Billing
Through United Healthcare PPO Network
Acute onset of pre-existing conditions
Coverage to $20,000 for ages <65; $2,500 for ages 65+ Learn More
Fixed Coverage Plans
Overview
After deductible, pays fixed amounts as per schedule of benefits.
Direct Billing
Depends upon provider No PPO. No contracted rates.
Acute onset of pre-existing conditions
Coverage to policy max for ages <70 Learn More
Overview
After deductible, pays fixed amounts as per schedule of benefits.
Direct Billing
Depends upon provider No PPO. No contracted rates.
Acute onset of pre-existing conditions
To policy max ($25,000 for cardiac or stroke) for ages <70; $25,000 ($15,000 for cardiac or stroke) for ages 70-79; $15,000 for ages 80-89 Learn More
Overview
After deductible, pays fixed amounts as per schedule of benefits.
Direct Billing
Depends upon provider No PPO. No contracted rates.
Acute onset of pre-existing conditions
Coverage up to the policy maximum or $100,000, whichever is lower, for ages <70 Learn More
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