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Pre-existing Medical Condition Coverage

22 March 2011
Pre-existing Medical Condition Coverage

This coverage addresses the needs of travelers who have pre-existing medical conditions. The coverage is actually in the form of an exclusion waiver because travel insurance plans automatically exclude coverage for pre-existing medical conditions.

Contents (click to jump down)
What does the Pre-existing Condition Waiver cover?
What is the ‘Look-back Period’ and ‘Medically Stable’?
Pre-existing condition examples
Important notes about this coverage
How much coverage does each company provide?
Summary

Let us tell you a story

Michael was traveling to Mexico to learn to surf. Months before his trip, he’d suffered through a cluster of migraine headaches, but he’d been treated by his doctor, prescribed medicine, and was considered fully recovered. When Michael landed in Mexico, he was surprised by a severe headache followed by nausea and dizziness.

Michael had purchased trip insurance coverage and paid for the pre-existing condition waiver, so he felt comfortable visiting a local medical facility. Because Michael had been medically stable with no changes in his health condition and no new medications for the duration of his policy’s look-back period, the costs for his treatment were covered.

What does the Pre-existing Condition Waiver cover?

Travel insurance plans have an automatic exclusion for pre-existing conditions, which means they do not cover costs related to a pre-existing condition.

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.

Some travel insurance plans cover medical costs relative to pre-existing conditions by offering a waiver to the exclusion. Having pre-existing coverage means that the medical coverage provided by your policy is in effect because the pre-existing exclusion is waived.

What is the ‘Look-back Period’ and ‘Medically Stable’?

The look-back period is the amount of time prior to your travel policy’s effective date that the insurance company will review for pre-existing conditions if you end up filing a claim. If you were medically stable during the look-back period, it is not considered a pre-existing condition.

The term medically stable means that you’ve had no new medical condition and no prescription medication changes during the look-back period. You must be medically stable when you purchase the travel plan and if a claim is made.

The amount of time in the look-back period varies from plan to plan, but is typically between 60 and 180 days. Any medical condition that existed during the look-back period is considered a pre-existing condition if you had symptoms and/or were treated or had a change in your prescription medications.

Pre-existing condition examples

If a medical condition is defined as a pre-existing medical condition and you don’t purchase the pre-existing condition exclusion waiver, you will have no effective medical coverage for losses caused by the pre-existing condition on your trip (ther medical losses would be covered if unrelated to the pre-existing condition). In addition, you won’t have trip cancellation or trip interruption coverage if your trip is canceled or interrupted due to the pre-existing condition.

So, what qualifies as a pre-existing condition?

SITUATIONIS THIS A PRE-EXISTING CONDITION?
You have high cholesterol. You’ve been under medical care and have been prescribed medication. There have been no changes to your medication and you have not sought additional medical treatment during the look-back period.No, because you were considered medically stable throughout the look-back period. Your travel medical coverage will be in effect without having to purchase a pre-existing condition waiver.
Your daughter has type 1 (juvenile) diabetes. She’s doing well, but her insulin requirements fluctuate on a daily basis. This is normal for diabetics.Yes, because insulin is medication and the fact that the dose changes often means she’s not considered medically stable. You’ll need to purchase the pre-existing coverage waiver to have medical coverage on your trip.

Important notes about this coverage

  • You must purchase an amount of coverage that equals all pre-paid non refundable payments applicable to the trip.
  • Your health must be medically stable when you purchase your travel plan.
  • Nearly all plans require you to purchase your travel insurance soon after making your first trip payment. If you buy it early and the trip is fully insured, there is often no extra charge.
  • You must cover the full length of your trip (not just a portion of it).
  • Pre-existing condition limitations do not apply to the following coverage (which means a pre-existing condition can’t be used to deny these claims):
    • Emergency Medical Evacuation
    • Repatriation
    • Baggage and Baggage Delay
    • Accidental Death and Dismemberment
    • Collision Damage waiver

You may be asking, “What happens if I book a trip that starts within that 10-14 day time frame?” That’s OK too as long as the window from the purchase of your trip insurance doesn’t exceed the time limit, the pre-existing medical condition coverage will apply.

What type of policy covers this?

Travel insurance medical plans adhere to the first rule that coverage automatically excludes pre-existing conditions. Only travel insurance package plans offer the ability to waive the pre-existing condition exclusion as long as the insured follows the rules for purchasing it within the appropriate time frame and covering the full length and cost of the trip.

How much coverage does each company provide?

POLICYCOMPANYIF PURCHASED WITHINLOOK-BACK PERIODPOLICY LIMIT
BasicAllianz14 days120 days$10,000
DeluxeAllianz14 days120 days$50,000
ClassicAllianz14 days120 days$20,000
Custom LuxeCSA1 day (24 hours) of final payment180 days
No coverageFrontierMEDEX
Global Alert PreferredGlobal Alert15 days60 days
Global Alert Preferred PlusGlobal Alert15 days60 days
No coverageGlobal Underwriters
No coverageHTH Worldwide
Advantage CompleteMH Ross15 days60 days
Advantage AssetMH Ross15 days60 days
Advantage BridgeMH Ross15 days60 days
RoundTrip ChoiceSeven Corners10 days60 days
RoundTripSeven Corners10 days60 days
Travel BasicTravelex15 days60 days
Travel SelectTravelex21 days60 days
Sportsman’s TravelTravel Guard15 days180 days$30,000
Platinum (Cruise, Tour & Travel)Travel Guard15 days60 days$50,000
My Travel GuardTravel Guard21 days180 days$50,000
GoldTravel Guard15 days180 days$30,000
Adventure TravelTravel Guard15 days180 days$30,000
Savvy TravelerTravel Guard15 days180 days$15,000
SilverTravel Guard15 days180 days$15,000
Select EliteTravel Insurance Services21 days60 days$60,000
Select PlusTravel Insurance Services15 days60 days$60,000
Select BasicTravel Insurance Services15 days60 days
Trip Protector Lite ExpandedTravel Insured14 days60-180 days *
Worldwide Trip ProtectorTravel Insured14 days60-180 days *
Worldwide Trip Protector GoldTravel Insured30 days60-180 days *
Protect-a-GroupTravelSafe15 days60 days
VacationTravelSafe15 days60 days
Vacation ClassicTravelSafe15 days60 days

* Subject to your state of residence.

Summary

  • No travel plan covers pre-existing conditions, but you can purchase a package plan that offers an exclusion waiver
  • You must purchase your plan within a certain number of days of the initial trip deposit (typically 14-21 days) or final payment (in some cases), and you must insure the full cost and length of the trip
  • You must be medically stable when you purchase the travel plan and if a claim is made, the travel insurance provider will examine your health records over the look-back period
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Damian Tysdal
Author
DamianTysdal

Damian Tysdal is the founder of CoverTrip, and he believes travel insurance should be easier to understand. He started the first travel insurance blog in 2006.

Damian Tysdal is the founder of CoverTrip, and he believes travel insurance should be easier to understand. He started the first travel insurance blog in 2006.