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Here's How the Pre-Existing Medical Conditions' Exclusion Waiver Works in a Travel Insurance Policy
Carol G., Rockville, Maryland says, "Steve, I have really appreciated the service I received for figuring out if my son's pre-existing medical condition would be covered and advice on the best plan for us. I already did the comment form at your website and have written posts on some cruise and disney boards (we're doing a Disney cruise) about how happy I was with your service and recommended www.TripInsuranceStore.com. Thanks for all of your help."
Technically, all travel insurance policies exclude coverage for Pre-existing Medical Conditions. You can cover pre-existing conditions with any of our plans. You can waive the exclusion associated with a Pre-existing Condition by following the rules below. |
A Pre-Existing Medical Condition is any medical condition (no matter how minor), which manifested itself, became acute or exhibited symptoms which would have caused one to seek diagnosis, care or treatment; or which medical advice, diagnosis, care or treatment was recommended or received; or required taking prescribed drugs or medicine, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or required medical treatment or treatment was recommended by a Legally Qualified Physician during the 60 or 180 day Lookback Period prior to the day you buy a travel insurance policy. |
Until there's a claim, everything is on the honor system. The insurance company assumes the travel insurance purchaser is following the rules, but they have no way of knowing if they are.
Instead, at claim time the travel insurance purchaser must prove everything including:
It's more accurate to say that the travel insurance purchaser has a conditional promise from the travel insurance company that they have certain benefits.
Pre-existing conditions coverage is complicated. Here's how pre-existing conditions, medically stable and the lookback period fit together:
Any medical condition (no matter how minor) existing in the 60 or 180 day Lookback Period is defined as a Pre-Existing Condition if you've had symptoms, it's been treated, consulted on or had a change of medication during those 60 or 180 days prior to the travel insurance policy's effective date.
A Pre-Existing Medical Condition includes any condition that's been tested, treated, examined, consulted with, received advice on or had symptoms of. This also includes any adjustments or changes in any prescriptions or medication. If a pre-existing condition exists, it must be "medically stable".
"Medically Stable", in respect to www.TripInsuranceStore.com's travel insurance plans, means that the person with the pre-existing condition:
Has not already taken a turn for the worse;
Is not in a state where any changes are foreseen, known, or expected that could cause the person to "take a turn for the worse".
This varies from company to company. For example, Stage 4 cancer will not have pre-existing conditions coverage with Travelex and Travel Insured, but CSA, Travel Guard & TravelSafe can cover it.
If the traveler has the pre-existing condition, they have to be medically able to travel when they get their travel insurance. Don't call us or order a policy if you're being treated now (and can't currently travel), yet your doctor says you'll be able to travel later. You will not be covered at all. Learn more about Medically Stable here.
If the person has a stable pre-existing condition, then the only way the pre-existing condition exclusion can be waived is to buy the travel insurance by the deadline. Important: Keep in mind that the pre-existing condition exclusion is being waived when you buy the travel insurance by the deadline.
You Must Follow These Rules To Waive The Pre-Existing Medical Condition Exclusion
If you want to waive the pre-existing medical condition exclusion for cancellation, interruption & medical treatment, you have to fulfill these 4 requirements when you buy your travel insurance plan:
With 3 exceptions (CSA Freestyle & Freestyle Luxe and TravelSafe), you have to insure at least your trip's full prepaid, non-refundable cost (you can't round it down). If you don't know your final trip cost, estimate it high to be safe. You can always lower to the correct trip cost prior to your departure date. If it drops you to a lower trip cost range, you'll get a partial refund; and
You must get your travel insurance in the first 14, 15, 21 or 30 days after you pay your earliest trip payment (Travelex Select, Travelex Max, Travel Guard, Travel Insured and TravelSafe) or no later than 24 Hours after you make your final Trip payment for CSA Freestyle & Freestyle Luxe and
You have to cover your trip's full length and
The person with the medical condition has to be medically stable when you get your insurance - this means that person cannot have already taken a turn for the worse. This also includes having surgery or other medical procedure(s) scheduled just before you leave. Read Steve's blog post "Will Travel Insurance Cover My Scheduled Surgery?" for more information.
In addition, you'll see that CSA, Travel Guard, Travel Insured and TravelSafe all include wording like "this is the first and only booking for this same destination and dates of travel" as a condition of waiving the pre-existing medical condition exclusion. The reason is that you cannot cancel your trip & re-book it to just reset your initial trip deposit date. Read Steve's Blog post to find out more.
Any payment on your trip is considered the first payment. This includes the tax you pay when you redeem frequent flyer tickets, refundable deposits or even a trip planning consultation fee if that fee is later credited toward your trip costs.
Your Deadline To Waive The Pre-Existing Medical Condition Exclusion
Are you past all the Pre-existing Conditions deadlines and you absolutely need a Pre-existing Conditions Exclusion Waiver? If so, you may qualify for another plan. The reason you can't easily find it on TripInsuranceStore.com is because its pricing is so complicated. Therefore, I (Steve) built a completely different website for this plan. Note: the price is higher, but, then again, it's probably your only choice. This plan's deadline is the date you pay the last prepaid expense you pay before you depart on your trip. Get the details. |
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Here's what the CSA Freestyle & Freestyle Luxe Plan Certificates of Coverage say:
Pre-Existing Condition
means any Injury, Sickness or condition of the Insured or Traveling Companion, or Family Member for which within the 180-day period prior to the Insured's Effective Date under this Policy which a) manifested itself, became acute or exhibited symptoms which would have caused one to seek diagnosis, care or treatment; or b) required taking prescribed drugs or medicine, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or c) required Medical Treatment or treatment was recommended by a Legally Qualified Physician.
Pre-Existing Condition Exclusion This exclusion applies to Trip Cancellation, Trip interruption, and Emergency Medical Expense Coverages. It applies to you and all family members.
A Pre-existing Condition, as defined in this policy. The Pre-existing Condition Limitation does not apply to: a) Emergency Medical Evacuation, Medical Repatriation and Return of Remains coverage, Accidental Death & Dismemberment (Coverage A), Baggage and Personal Effects, Baggage Delay and Collision Damage Waiver; or b) to coverage purchased prior to or within 24 hours of the final payment for the Covered Trip and if the Insured is medically able to travel when payment is made for the insurance;
Pre-Existing Condition Exclusion Waiver
CSA will waive the Pre-existing Condition exclusion if you meet the following requirements:
You must purchase the CSA Freestyle or Freestyle Luxe Plan plan prior to or within 24 Hours of your final Trip payment
All insured travelers must not be disabled from travel at the time they pay their premium.
The booking for this trip must be the first and only booking for this travel period and destination
Click here to go to our CSA Freestyle & Freestyle Luxe detailed description page
Click here to go to CSA Freestyle & Freestyle Luxe's secure online quote & order page |
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Here's what the Travelex Select & Max Certificates of Coverage say:
Travelex Select Plan:
The following exclusions apply to Trip Cancellation & Trip Interruption, Trip Delay, Missed Connection, Emergency Accident & Sickness Medical Expense, Emergency Evacuation & Repatriation of Remains, Accidental Death & Dismemberment and Optional Flight Accidental Death & Dismemberment: Loss caused by or resulting from:
1. Pre-Existing Conditions, as defined in the Definitions section (except Emergency Evacuation and Repatriation of Remains) unless the insurance is purchased within twenty-one (21) days of the initial Covered Trip deposit
Pre-Existing Condition: means any injury, sickness or condition of You, or Your Traveling Companion for which within the sixty (60) day period prior to the Effective Date of Trip Cancellation coverage under the Policy (a) first manifested itself or exhibited symptoms which would have caused one to seek diagnosis, care or treatment; (b) required taking prescribed drugs or medicine, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or (c) required medical treatment or treatment was recommended by a Physician. The Pre-Existing Conditions exclusion is waived for You if You enroll in the Plan at the time You pay the deposit required for the Covered Trip (or within twenty-one (21) days of the initial deposit) and You purchase the coverage under the Plan for the full cost of the Covered Trip.
Travelex Max Plan:
The following exclusions apply to Trip Cancellation & Trip Interruption, Trip Delay, Missed Connection, Emergency Accident & Sickness Medical Expense, Emergency Evacuation & Repatriation of Remains, Accidental Death & Dismemberment and Optional Flight Accidental Death & Dismemberment: Loss caused by or resulting from:
1. Pre-Existing Conditions, as defined in the Definitions section (except Emergency Evacuation and Repatriation of Remains) unless the insurance is purchased within thirty (30) days of the initial Covered Trip deposit.
Pre-Existing Condition: means any injury, sickness or condition of You, or Your Traveling Companion for which within the sixty (60) day period prior to the Effective Date of Trip Cancellation coverage under the Policy (a) first manifested itself or exhibited symptoms which would have caused one to seek diagnosis, care or treatment; (b) required taking prescribed drugs or medicine, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or (c) required medical treatment or treatment was recommended by a Physician. The Pre-Existing Conditions exclusion is waived for You if You enroll in the Plan at the time You pay the deposit required for the Covered Trip (or within thirty (30) days of the initial deposit) and You purchase the coverage under the Plan for the full cost of the Covered Trip.
If You do not meet the above criteria, You will still be covered for Trip Cancellation/Interruption and Emergency Medical Benefits caused by reasons other than those related to the pre-existing condition.
Also, you'll see that Travelex doesn't include the wording "this is the first and only booking for this same destination and dates of travel" as a condition of covering a pre-existing medical condition.
Travelex's Family Member definition says "provided the Family Member resides in the United States, Canada or Mexico". In other words, you are not covered if your Family Member resides outside the United States, Canada or Mexico
Click here to go to our Travelex Select detailed description page or click here to go to our Travelex Max detailed description page.
Click here for the Travex Select secure online order page - the Travelex Select plan is not available for New Hampshire State residents.
Click here for the Travel Max secure online order page - the Travelex Max plan is not available to residents of New Hampshire, New York & Washington State residents |
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Both Travel Guard plans have the same definition for a Pre-Existing Medical Condition:
PRE-EXISTING MEDICAL CONDITION EXCLUSION:
The Insurer will not pay for any loss or expense incurred as the result of an Injury, Sickness or other condition of you, traveling companion, business partner or Immediate Family Member which, within the 60 day period (Platinum plan) or the 180 day period (Gold plan) immediately preceding and including your coverage effective date: first manifested itself or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; or for which care or treatment was given or recommended by a Physician; or required the taking of prescription drugs or medicines, unless the condition for which the drugs or medicines are taken remains controlled without any change in the prescription drugs or medicines.
PRE-EXISTING MEDICAL CONDITION EXCLUSION WAIVER If insurance was purchased within 14 calendar days of "initial trip payment", the Pre-Existing Medical Condition Exclusion will be waived. (Day one is the date the "initial trip payment" is received.) This is applicable to all coverages contained in the policy. In order to receive the waiver of Pre-Existing Conditions, the amount of Trip Cancellation coverage purchased must equal the full pre-paid nonrefundable portions of all trip arrangements.The Insured must be medically able to travel when he/she pays his/her premium. In the event that a claim is filed, the Injury or illness must be substantiated to Travel Guard's Claims Department.
The Exclusion for Pre-Existing Conditions will be waived if:
The Insured purchases the plan within 14 calendar days of making his/her "initial trip payment"
The amount of Trip Cancellation coverage purchased must equal the full cost of all pre-paid non-refundable Trip arrangements;
The booking for this Trip must be the first and only booking for this travel period and Destination;
The Insured must be medically able to travel when he/she pays his/her premium.
Click here to go to our Travel Guard detailed description page.
Click here for the Cruise, Tour & Travel's secure online order page. Click here for the Protect Assist secure online order page |
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"Pre-Existing Condition" means any Injury, Sickness or condition of You, a Traveling Companion or Your and/or Your Traveling Companion’s Family Member for which medical advice, diagnosis, care or treatment was recommended or received within the 180 day period ending on the Effective Date. Sicknesses or conditions are not considered pre-existing if the Sickness or condition for which prescribed drugs or medicine is taken remains controlled without any change in the required prescription.
Travel Insured Worldwide Trip Protector:
The following exclusions apply: This policy does not cover Loss caused by or resulting from:
1) Pre-Existing Conditions, as defined in the Definitions section (except Emergency Evacuation and Repatriation of Remains), unless the policy is purchased within 21 days of the initial Trip deposit. The booking for the Trip must be the first and only booking for this travel period and destination, You are not disabled from travel at the time You pay the premium, and You must purchase this policy for the full non-refundable cost of Your Trip;
Travel Insured Gold:
The following exclusions apply: This policy does not cover Loss caused by or resulting from:
1) Pre-Existing Conditions, as defined in the Definitions section (except Emergency Evacuation and Repatriation of Remains), unless the policy is purchased within 30 days of the initial Trip deposit. The booking for the Trip must be the first and only booking for this travel period and destination, You are not disabled from travel at the time You pay the premium, and You must purchase this policy for the full non-refundable cost of Your Trip;
Click here to go to our Travel Insured detailed description page.
Click here to go to Travel Insured's secure online order page |
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A brief description is below. For complete coverage, terms, conditions and exclusions click here to view or download Travel Safe's Certificate / Policy.
"Pre-Existing Condition" means any injury, sickness or condition (including any condition from which death ensues) of You, or Your Traveling Companion, or Your or Your Traveling Companion’s Family Member traveling with You which within the 60 day period prior to the effective date of Your Trip Cancellation coverage under the Policy: (a) manifested itself, became acute or exhibited symptoms which would have caused one to seek diagnosis, care or treatment; (b) required taking prescribed drugs or medicine, unless the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription; or (c) required medical treatment or treatment was recommended by a Legally Qualified Physician.
The Waiver of the Pre-Existing Condition Exclusion requires:
Click here to go to our TravelSafe detailed description page.
Click here to go to the TravelSafe Vacation plan's secure online order page |
Ready to Order? It's easy (and safe) to order online or over the telephone - just call Steve, Deanna, Becky, Teresa or Mary toll free at 1-888-407-3854 (US & Canada) or 507-214-3854.
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Can't find what you need? Try TripInsuranceStore.com's Search Page:
PS - Even though TripInsuranceStore.com is world's the most informative travel insurance website, you are still responsible to know what's in your policy's Certificate of Coverage. Click here to get each plan's Certificate of Coverage.
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