All travelers who are headed abroad, or otherwise outside their personal health insurance network, have a lot to gain by purchasing travel medical insurance. After all, most health insurance plans do not extend their coverage beyond the borders of their home country and medical emergencies aren’t cheap anywhere – it costs money to get good medical care.
What most travelers don’t know is that pre-existing conditions are automatically excluded from travel insurance plans, which means that medical care, trip cancellations, and trip interruptions due to a pre-existing medical condition are not covered by default.
Travel insurance claims denials for pre-existing medical conditions is one of the most often complained about issue on this website, and this post should help.
What Trips Travelers Up
What sometimes trips travelers up is this scenario: they went to the doctor for some nagging issue or for a regular checkup and haven’t gotten the results yet. They schedule a trip and buy travel insurance thinking they’re healthy. Then, they get the results and realize that their diagnosis will be considered a pre-existing medical condition if they have to make a claim on their travel insurance. Sometimes, they’re even told to cancel their trip because their illness will require medical care and travel is not recommended.
In these cases, the travel insurance company will deny your cancellation claim because of the pre-existing condition you didn’t even know you had.
Two important things to think about before you buy your travel insurance:
Have you visited a doctor within the last 60, 90, or 180 days? These are the standard look-back periods for various travel insurance plans.
If, so has the doctor verified that you’re healthy as a result of that visit?
If you don’t have confirmation from your doctor after a visit, a quick call to speed things along might be a good idea, but you also have a free review period with your travel insurance policy. The review period is typically around 10-14 days and during that time, you can make changes to your policy or cancel it for a refund if it’s not the policy for you. Use this review period to read the travel insurance document carefully and determine whether you have the coverage you need.
Know these Travel Insurance Terms Before You Buy
According to travel insurance plans, a pre-existing condition is any injury, illness, disease or other medical condition that occurs prior to the travel plan’s effective date and for which you had symptoms and sought diagnosis, medical treatment, and/or new prescription medications or a change in your current prescription.
The term medically stable means that you’ve had no new medical conditions and no changes in your regular prescription medication during the look-back period. The look-back period is the amount of time prior to your travel insurance policy’s effective date that a travel insurance company will review for evidence of a pre-existing medical condition should you end up filing a claim.
Here’s how to determine whether you have a pre-existing medical condition as defined by the typical travel insurance plan:
Any medical condition or change in prescription medications that occurs during the look-back period is considered a pre-existing condition.
If you were medically stable and had no changes in your prescription medications during the entire look-back period, you’re all clear.
For some travelers, like those with diabetes and other medical conditions where the medications change from day to day, they will always need travel insurance with coverage for pre-existing conditions. For other travelers who have recovered from an illness or who take a regular unchanging amount of medication to stabilize their health, they won’t need travel insurance with pre-existing medical condition coverage.
Important Things to Understand about Pre-existing Condition Coverage
As you might expect, there are certain rules and restrictions surrounding the purchase of travel insurance with coverage for pre-existing medical conditions, including the following:
You must purchase the coverage soon (within 10-14 days) after making your first trip payment.
You must cover the full length of your trip (not just a portion of it).
You must be medically stable when you purchase the travel plan.
You must purchase an amount of coverage that equals your total pre-paid costs.
Travel insurance companies will adhere to the first rule, which automatically excludes coverage for pre-existing medical conditions. Only travel insurance plans that give the traveler the option to purchase a waiver to the exclusion will cover a traveler with a pre-existing condition as long as the traveler follows the rules for purchasing their plan within the appropriate time frame and covering the full length and cost of their trip. If you make a claim, the travel insurance provider will examine your health records over the look-back period.
How to get the Right Insurance with a Pre-existing Condition
If you’re one of the many people with a pre-existing medical condition who travel every year, don’t despair. Travel insurance companies allow travelers to purchase pre-existing medical condition coverage in the form of an exclusion waiver. If you have a pre-existing medical condition, you can purchase this waiver and your travel insurance coverage, including coverage for medical emergencies, cancellations and more, will be in effect because the exclusion is waived.
The key to getting the right travel insurance if you have a pre-existing condition starts with understanding your current health. If you have a pre-existing condition you’ve been managing for years, you know the drill – get the pre-existing medical condition waiver if your medication changes regularly or you’ve visited the doctor for any other condition in the last 60, 90, or 180 days (depending on the plan).
If you believe you’re healthy but have visited a doctor in the last 60, 90, or 180 days (depending on the plan) for any issue, get the diagnosis before you purchase your travel insurance – indeed, before you start making trip payments.
If you’ll need medical treatment for a condition such as cancer, for example, you may have to cancel your travel plans. If your condition is not such that you’ll need to cancel your plans, get the pre-existing medical condition waiver to ensure that whatever happens on your trip is covered.
See our review of pre-existing medical condition coverage for more details.