Whether—and how—travel insurance covers pre-existing medical conditions remains a source of uncertainty among many travelers. This recent question is a case in point:
“My husband and I will fly to Venice on October 6, where we will stay two weeks. I bought our airline tickets last February 8. My husband is diabetic, managing it with medication, and he just had surgery on his carotid artery, after which he is doing well. Can we still purchase trip-cancellation insurance including medical evacuation?”
The short answer is you can buy medical evacuation (medevac) insurance that will cover an evacuation required by your husband’s diabetes—as long as you can show it was totally controlled up to the time of departure—but probably not for potential complications following the surgery. It would cover both of you for any other health problems that arise during your trip. Here are the pertinent details.
What Is a “Pre-Existing Condition?”
Most travel insurance, including medical evacuation and trip cancellation, excludes pre-existing medical conditions as a “covered reason” for paying on a claim. Here’s how one insurance company defines that exclusion:
“Pre-Existing Condition” means any injury, sickness or condition for which medical advice, diagnosis, care or treatment was recommended or received within the 180-day period ending on your date of departure. Conditions are not considered pre-existing if the condition for which prescribed drugs or medicine is taken remains controlled without any change in the required prescription.
Another company says it this way:
“An illness or injury that you, a traveling companion or family member were seeking or receiving treatment for or had symptoms of on the day you purchased your plan, or at any time in the 120 days before you purchased it. You, a traveling companion or family member are considered to have an existing medical condition if you, a traveling companion or family member:
- Saw or were advised to see a doctor
- Had symptoms that would cause a prudent person to see a doctor
- Were taking prescribed medication for the condition or the symptoms, unless the condition or symptoms are effectively controlled by the prescription, and the prescription hasn’t changed.
Some policies do not even include the allowance for conditions controlled by medication, but many do. The typical exclusion period ranges from 90 days to 180 days. In my reader’s case, as I noted, a typical policy would cover her husband’s controlled diabetes but not complications from his recent surgery.
Insurance companies are serious about the definition of the “medical advice, diagnosis, care, or treatment” limitation. If you so much as called a doctor about a possible problem, the insurance bean counters could deny a claim.
Waiving Pre-Existing Conditions
The good news about pre-existing conditions is that many travel insurance companies waive that exception if you buy the insurance shortly after making your initial travel arrangements. Here’s how one company puts it:
“If your plan includes this coverage, you, a traveling companion or family member can have an existing medical condition and you will still be eligible for all coverage and assistance services, as long as:
- You purchased your plan within 14 days of making your first trip payment or first trip deposit
- You purchased trip cancellation coverage that covers the full cost of all your nonrefundable trip arrangements
- You were a U.S. resident and medically able to travel on the day you purchased the plan, and
- The total cost of your trip is $20,000 per person or less.
Depending on the company, the purchase deadline for buying the insurance ranges from seven to 14 days. As far as I can tell, you don’t have to pay anything extra to get pre-existing conditions waived: Just buy the insurance on time.
Pre-existing conditions are apparently the biggest source of problems between insurance companies and travelers. Given how easy it is to have the whole problem waived, it seems to me to be a no-brainer that anyone interested in medevac or trip-cancellation insurance should buy the insurance within the specified seven- or 14-day period after making the first trip payment.
Beyond that, I continue to recommend that travelers check one or more of the travel insurance agencies’ comparison sites, enter their trip details and coverage requirements, and select the least expensive policy that meets their needs:
- One Travel Insurance
- Global Travel Insurance
These independent agencies sell policies written by all the major insurance underwriters. Price comparison and policy selection is a snap: The site displays a long list of policies and their detailed terms.