What health insurance do my parents need when they visit the US?

Why the Marketplace is not the answer

Many families first look at HealthCare.gov. Federal rules make it the wrong tool for a visit, for a reason that surprises people.

A parent here on a visitor visa is, technically, lawfully present: federal rules count anyone in valid nonimmigrant status (45 CFR 155.20). But Marketplace coverage is for people who live in the state, and an adult's state is the one where they are living and intend to reside, or have come with a job or to look for one (45 CFR 155.305). A B-2 visitor visa is, by its legal definition, for someone with a residence abroad they have no intention of abandoning who is visiting temporarily (8 U.S.C. 1101(a)(15)(B)). A short family visit does not fit the residency rule.

Two further points close the door for most visits. Marketplace enrollment is limited to Open Enrollment or a qualifying life event, so it cannot start on the day a flight lands. And HealthCare.gov says that from 1 January 2027 the premium tax credit is limited to green card holders and a few other groups, so even someone who could enroll would pay the full premium. For a visit, families buy short-term visitor medical insurance.

What visitor medical insurance is

The National Association of Insurance Commissioners describes travel medical coverage as insurance that pays for short-term medical care if you get sick or are injured while travelling. It is not a full health plan. It covers new illnesses and injuries during the trip, usually not routine care, check-ups or ongoing treatment. In the US it is regulated by state insurance departments.

The rule that protects most Americans does not travel with it. HealthCare.gov's statement that no plan can refuse to pay for a condition you had before coverage started applies to health plans in the US market. The NAIC lists pre-existing conditions among the most common exclusions in travel policies. For parents in their sixties or seventies with diabetes, heart disease or high blood pressure, that exclusion is the single most important line in the policy.

Pre-existing conditions and "acute onset"

Read the policy's own definition of a pre-existing condition. Policies typically look back over a period before coverage starts and exclude any condition that was diagnosed, treated or showed symptoms in that period.

Some policies add limited cover for an "acute onset of a pre-existing condition": a sudden, unexpected flare-up of a known condition that needs immediate care. Where it is offered, it usually has its own lower limit, may be capped by age, and does not cover a condition the person already expected to need care for, or check-ups and refills for it. Ask the insurer for the exact wording, and for an example of a claim it would and would not pay.

The terms that decide what you pay

• Policy maximum. The most the policy will pay, often per illness or injury as well as in total. US hospital care is expensive, so a low maximum can run out in one admission.
• Deductible. What you pay before the policy pays. A higher deductible lowers the premium but raises the bill for a small claim.
• Coinsurance and an out-of-pocket maximum. Some policies pay a share of each bill after the deductible, up to a cap on what you pay.
• Fixed-benefit versus comprehensive. A fixed-benefit plan pays set amounts per service from a schedule, whatever the hospital charges. A comprehensive plan pays a share of the actual bill. For the same maximum, fixed-benefit plans usually leave much more of a large bill with the family.
• How claims are paid. Ask whether the insurer has a provider network that bills it directly, or whether you pay first and claim back. The NAIC also suggests asking whether you need the insurer's approval before getting care.
• Evacuation and return home. Some policies cover transport to a hospital that can treat the patient and later transport home.

A policy from India or one from the US

Families can buy an overseas travel policy from an insurer in India before departure, or a visitor medical policy sold in the US. Neither type is better by default; compare the same terms side by side:

• the maximum and deductible in dollars, and whether the maximum is per illness or for the trip;
• the pre-existing condition definition and any acute-onset cover, with its limit;
• how a US hospital gets paid, and a 24-hour claims contact in the US;
• whether it can be extended from inside the US if the visit runs longer, and whether a gap is allowed;
• age bands, since the price and the limits often change at set ages.

An Indian policy must normally be bought before the traveller leaves India. Check whether a US-sold policy can start after arrival and has a waiting period.