Senior travelers are usually quite unhappy when their insurance claim is denied due to a pre-existing condition and that’s understandable. After all, you buy the travel insurance plan and you expect it to pay out when you run into trouble.
Unfortunately, the topic of pre-existing conditions can be complicated, but we’ll make it easier to understand in this post.
First, let’s start with a definition: A pre-existing condition is an illness, injury, or disease occurring before the plan’s effective date and for which the traveler had symptoms or sought treatment.
So, let’s review what senior travelers need to know about pre-existing conditions.
Pre-existing conditions are initially an ‘exclusion’
Pre-existing medical conditions, or pre-ex, are automatically excluded from nearly all travel insurance plans (unless you buy your plan shortly after making your first trip arrangements).
Insurance companies need to exclude pre-existing conditions…otherwise you could wait until something goes wrong to buy insurance.
Still, travel insurance companies understand that medical conditions occur throughout your life, and they have designed a way to get coverage even if you have a pre-existing condition.
Many plans can cover Pre-ex with a waiver to the exclusion
Seniors – and non-senior – travelers can get travel insurance coverage for pre-existing conditions by purchasing the right plan and buying it on time.
Insurance companies have designed plans that allow you to have coverage even if you have a pre-existing condition.
They do this by adding a ‘waiver’ to the pre-existing condition exclusion.
This waiver overrides the exclusion, and essentially covers pre-existing conditions as long as certain conditions are met.
Specific conditions must be met to have coverage
The pre-ex waiver has conditions that must be met for coverage to be valid.
1. You must be healthy, or ‘medically stable’, during the plan’s ‘look-back period’
Just because you’re feeling fine doesn’t mean you’re medically stable. Medically stable means that you have not had a new medical condition and there were no recent changes in prescription medications. It also means that your health is stable – that you’re not expecting surgery or
The look-back period is the amount of time (typically between 60-180 days) prior to your travel policy’s effective date that the insurance company will review for evidence of pre-existing conditions should you file a claim.
2. You need to be healthy when you buy your insurance
Again, this is to prevent travelers from getting sick and trying to buy insurance after the fact.
3. You need to buy your plan soon after your initial trip payment
Companies require that you buy insurance with a certain number of days (usually 10-15, but some as long as 30) of your initial trip payment.
This is another way the insurance company verifies that you are not buying insurance after you know you need to cancel. You are essentially buying insurance when you buy your trip.
4. You need to insure the full amount of your trip
Finally, the company requires that you purchase insurance based on the full amount of your trip.
Since the cost of travel insurance is largely based on the trip cost you are insuring, this condition prevents fraudulent travelers from buying a cheap plan based on a $1 trip cost and getting the full benefits of the insurance plan.
Medical records will be examined if there is a claim
There are no medical exams required before purchasing travel insurance…it is a policy that is issued on the honor system.
If you file a claim, medical records will be examined during the claims process.
If your trip is cancelled due to the health of a covered family member, for example, their medical records will be examined for evidence of a pre-existing condition.
This is an important part of the claims process and it cannot be avoided.
Pre-ex affects both medical and cancellation coverages
This is a critical factor to pre-ex coverage: pre-ex affects both your medical and your trip cancellation coverage.
For example, if you have to cancel your trip because a covered family member is ill due to a pre-existing condition, you must have a plan with pre-ex coverage to be able to cancel your trip and get your money back.
See a full review of pre-ex coverage.