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How To Avoid Waiver, Rider On Health Insurance Plan

Armen Hareyan's picture

Waivers and riders are insurance terms that explain special exceptions to coverage in health insurance plans. These are the method by which health insurance companies exclude certain pre-existing conditions from coverage.

Here is an example for consideration. Let's say years ago you played varsity football and injured your knee. You had surgery. You mention this in your health insurance application. The underwriters at the insurance company decide to place a rider on the knee because they believe they could lose money due to your knee problem. They will cover you for everything EXCEPT for your knee. This is especially true if your accident was recent because they fear re-occurrence of the knee injury.

"But that doesn't seem fair!" you may say. It seems that way because sometimes these riders or waivers are permanent.

There is the good news, however,

Sometimes the health insurance provider may issue a two-year, three-year or five-year rider. If the condition does not deteriorate or recur over a period of time, often the insurer will "lift" the rider and give you full coverage. The option of using "riders" is good for the insurance companies and for the general public because it enables the companies to insure people whom they would otherwise decline to cover.

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You can do something about it!

First, get a "rate-up." This means that the company will "rate-up" the amount of premium charged for the policy instead of using a rider. Find out if your insurance company will do that. You will pay more, but it may be worth it in the long run. Do note however that this is not a general practice with international insurance companies.

Second, get "capped coverage." The other method of covering pre-existing conditions is "capped coverage." In this situation the company does not cover the pre-existing condition for the first 24 months, and then limits coverage for the condition to $5,000 a year for the next ten years. This is better than no health insurance coverage on a pre-existing condition.

Third, accept a temporary rider. I think this is the best option. Often a company will remove a rider after 24 months if you have had no recurring problems with the pre-existing condition. Overall, a rider is preferable to capped coverage if there is a possibility the rider can be lifted at a later date.

It is not the end of the world if your health insurance provider puts a rider or a waiver on your insurance policy. There are things you can do to make the best of your pre-existing condition. However, it is advisable you talk this topic through with a reputable health insurance broker or agent.

Jeff Gulleson is the President of Good Neighbor Insurance that represents 10 international health insurance companies and provides international health and travel insurance for every country in the world. If you live overseas or are planning an international trip get good international travel insurance coverage for pre-existing conditions. Or email us and a friendly agent will walk you through the options.