Patriot America Plus Pre-Existing Conditions Explained

Patriot America Plus does not cover pre-existing conditions as such. IMG excludes charges related to any condition that existed before your coverage started, within the look back period the certificate sets, with one exception: the acute onset of a pre-existing condition, meaning a sudden, unexpected flare that needs urgent care. According to the plan listing in Ombrela's quote system, that exception pays up to your policy maximum only for travelers under 70, and the certificate adds further conditions, such as prompt treatment after the flare starts.

A note on names: Ombrela's quote results list this IMG plan as Patriot Plus, while IMG markets its US visitor version as Patriot America Plus. Check the plan name on the certificate shown at checkout, since that document is the one that governs your coverage.

Key facts at a glance

• IMG's certificate treats a condition that existed during its look back period before the effective date as pre-existing, whether or not it was diagnosed or known.
• Charges related to a pre-existing condition are excluded unless they result directly from an acute onset, according to the certificate.
• Acute onset is covered up to the policy maximum only for travelers under 70, and the plan listing in Ombrela's quote system shows no acute onset cover from 70.
• Acute onset clauses of this type require prompt treatment after the sudden outbreak and exclude care that was known or expected before the trip, so read the certificate's exact conditions.
• Maximum choices narrow with age, and the plan listing in Ombrela's quote system shows a $10,000 maximum for travelers over 80.
• Hospital admissions require pre-certification with IMG, and the certificate reduces what it pays when pre-certification rules are not followed.

What does Patriot America Plus count as a pre-existing condition?

The definition is broader than most families expect. Travel medical certificates of this type describe a pre-existing condition as any injury, illness, disease, or physical or mental condition that, with reasonable medical certainty, existed at the time of application or during a set look back period before the effective date. Trawick's comparable wording, for example, uses three years; check the period in the IMG certificate you receive. It applies whether or not the condition was symptomatic, diagnosed, treated, or disclosed, and it includes later complications of that condition.

In practice this means high blood pressure managed with one tablet a day, type 2 diabetes, asthma, a heart stent placed two years ago, or thyroid disease will all be treated as pre-existing. A condition nobody had named yet can still be judged pre-existing if records show it was present, and the assessment happens at claim time.

How does the Patriot America Plus acute onset benefit work?

IMG's plan documents describe an acute onset as a sudden and unexpected outbreak or recurrence that is of short duration, is rapidly progressive, and requires urgent medical care. Three kinds of situations are carved out by the definition itself:

• Chronic or congenital conditions, and conditions that gradually worsen over time, do not count as an acute onset.
• Known or expected care is excluded: anything you knew or reasonably foresaw you would receive, knew you should receive, had scheduled, or were told you must or should receive before the effective date.
• Ongoing management is outside the benefit: routine prescriptions, monitoring visits, and follow up care for the underlying condition stay excluded.

So the benefit is built for the unexpected event, not the condition. A traveler whose blood pressure has been stable on the same medication for a year and who suddenly develops severe symptoms may be assessed under the acute onset rules. A traveler who flies to the US with a knee replacement already recommended, or whose kidney function has been declining for months, falls outside it. IMG decides each claim after reviewing records, so the outcome is never automatic. For a wider look at how carriers use the term, read our guide to acute onset of pre-existing conditions.

What conditions must you meet for acute onset coverage?

Acute onset clauses on visitor plans, including the wording published for comparable plans by Trawick and WorldTrips, list conditions along these lines. Read the Patriot America Plus certificate issued with your plan for the exact list:

• Treatment is obtained within 24 hours of the sudden outbreak or recurrence.
• The insured person is under 70 years of age.
• The trip is not against, or in disregard of, a doctor's advice or an established treatment program.
• The trip is not taken to seek treatment for the pre-existing condition.
• The traveler is not waiting for, starting, or recently advised to start a new or changed treatment program for that condition.
• Many versions also require the condition to have been stable for a set period, often 30 days, before the effective date, with no change in treatment.
• The insured is traveling outside their country of residence.

Stability rules are the ones families most often overlook. Where the certificate includes one, a dose change shortly before departure, a new prescription, or a specialist referral that is still pending can each mean the condition was not stable in the way the certificate requires.

Why does the under 70 rule matter so much?

Patriot America Plus has a hard age line. Under 70, acute onset is covered up to the maximum you chose. From 70, the plan listing in Ombrela's quote system shows no acute onset coverage at all. Maximum choices also narrow with age, and the same listing shows a $10,000 maximum for travelers over 80. If a traveler will have a birthday during a long stay, check in the certificate how age changes are handled at extension.

For a parent aged 68 or 69 planning a six month visit, that means checking the birthday against the renewal date before you buy. For a parent who is already 70 or older and has any chronic condition, Patriot America Plus offers no acute onset protection. Trawick's Safe Travels USA Comprehensive, by contrast, keeps a reduced acute onset limit of $35,000 from age 70 and $20,000 from age 80, according to Trawick's product page. Our Patriot America Plus vs Safe Travels USA Comprehensive comparison sets the two side by side, and our guide to visitor insurance for parents over 70 covers the wider choice.

What should you do in the first 24 hours of a flare?

The 24 hour rule makes timing part of the claim, so plan ahead.

• Seek care promptly. For symptoms that could be life threatening, such as chest pain or signs of a stroke, call 911. Waiting a day to see whether symptoms settle can put the claim outside the 24 hour window.
• Choose the right setting. Visitor plans commonly charge a copay at urgent care and add an extra deductible for an emergency room visit for illness that does not lead to admission, so check the amounts in your IMG summary before you need them.
• Call IMG if you are admitted. Emergency admissions need pre-certification within the deadline set in the certificate, so call as soon as reasonably possible. Use the number on your ID card, or ask the hospital to call.
• Describe the history accurately. Tell the treating doctor when symptoms began, which medicines you take, and when doses last changed.

What documents will IMG ask for after an emergency?

Expect IMG to ask for a signed claim form for each new illness or injury, an authorization to release medical information, itemized billing statements from every provider, and receipts for anything you paid, showing dates, procedure codes, and diagnosis codes. The certificate sets a deadline for submitting claims, so note it when the policy arrives and file promptly.

IMG may also ask for your home doctor's records from the months before the trip, to check that the condition was stable. If IMG denies all or part of a claim, the certificate describes a written appeal process with a time limit, so send any additional records that support the claim without delay. Our guide on how to file a visitor insurance claim covers the general process.

To make that easier, download our free Acute Onset Evidence File Checklist below. It lists what to gather before departure, what to tell the emergency team, which records to request on discharge, and a short cover note you can adapt when you submit the claim.

How to get covered

If the traveler is under 70 and has stable, well documented conditions, Patriot America Plus is one of the plans worth comparing. Set the maximum with our medical cost estimator, then compare visitor insurance quotes on Ombrela with the same maximum and deductible across plans. According to the plan listing in Ombrela's quote system, Patriot Plus is not available to residents of several countries, including Nigeria, Ghana, and Venezuela, or to citizens of a few, including Nigeria and Ghana, so the quote form will show only plans the traveler can buy. Premiums depend on age, trip length, maximum, and deductible, so live quotes are the only reliable price.

Frequently Asked Questions

Does Patriot America Plus cover pre-existing conditions?

Not in the ordinary sense. IMG excludes charges related to any condition that existed during the certificate's look back period before the effective date. The exception is the acute onset of a pre-existing condition, which the plan listing in Ombrela's quote system shows covered up to the policy maximum for travelers under 70, subject to the certificate's conditions, such as prompt treatment after the flare begins.

What happens to acute onset coverage at age 70?

It ends. The plan listing in Ombrela's quote system shows no acute onset coverage from age 70, so a sudden flare of a known condition would fall under the general pre-existing exclusion. Travelers aged 70 and over who want some acute onset cover should compare other plans.

Does a chronic condition like diabetes ever qualify as acute onset?

The underlying condition does not qualify, because IMG's definition excludes chronic conditions and conditions that gradually worsen. A sudden, unexpected complication in a traveler whose condition was stable may still be reviewed under the acute onset terms, but IMG decides based on the records. Routine medication, monitoring, and gradual decline are not covered.

How quickly must treatment start for an acute onset claim?

Promptly, within the window the certificate sets after the sudden and unexpected outbreak or recurrence. Comparable acute onset clauses from Trawick and WorldTrips use 24 hours. If symptoms start at night, do not wait for a routine appointment. Go to urgent care or the emergency room, or call 911 when symptoms could be serious, and contact IMG for pre-certification if you are admitted.

Patriot America Plus can suit travelers under 70 who understand where the acute onset benefit stops. Build the evidence file before you fly, then compare Patriot America Plus with other visitor plans on Ombrela.