Acute Onset of Pre-Existing Conditions - Covered up to Policy Maximum for Ages Below 70 Years; 70 - 79 covered up to Policy Maximum or $100,000 (whichever is lower)
The Atlas America plan provides coverage in very specific circumstances for the acute onset of pre-existing conditions to people below the age of 80. Understanding what a pre-existing condition is will help you understand what the acute onset coverage provides.
A pre-existing condition could mean any of the following explanations:
- Condition for which medical advice, diagnosis, care, or treatment (includes receiving services and supplies, consultations, diagnostic tests or prescription medicines) was recommended or received during the 2 years immediately preceding the certificate effective date; or
- Condition that had manifested itself in such a manner that would have caused a reasonably prudent person to seek medical advice, diagnosis, care, or treatment (includes receiving services and supplies, consultations, diagnostic tests or prescription medicines) within the 2 years immediately preceding the certificate effective date; or
- Injury, illness, sickness, disease, or other physical, medical, mental, or nervous conditions, disorder or ailment (whether known or unknown) that, with reasonable medical certainty, existed at the time of application or within the 2 years immediately preceding the certificate effective date. For the purposes of the Complications of Pregnancy coverage offered hereunder, pregnancy will not be included within the definition of a pre-existing condition.
If you are under age 70, you may be covered for an acute onset of a pre-existing condition up to the overall policy maximum; for ages 70 - 79, you may be covered up to the policy maximum or $100,000, whichever is lower. This benefit is available under Atlas America for non-US citizens traveling anywhere outside their home country including the U.S.
Acute Onset of a Pre-existing Condition
Acute Onset of a Pre-Existing Condition(s) is a sudden and unexpected outbreak or recurrence of a pre-existing condition(s) which occurs spontaneously and without advance warning either in the form of physician recommendations or symptoms, is of short duration, is rapidly progressive, and requires urgent care. The acute onset of a pre-existing condition(s) must occur after the effective date of the policy. Treatment must be obtained within 24 hours of the sudden and unexpected outbreak or recurrence. A pre-existing condition that is a chronic or congenital condition or that gradually becomes worse over time will not be considered acute onset. This benefit does not include coverage for known, scheduled, required, or expected medical care, drugs or treatments existent or necessary prior to the effective date of coverage.