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Pre-Existing Medical Conditions’ Coverage

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.”

Here’s How the Pre-Existing Medical Conditions’ Exclusion Waiver Works in a Travel Insurance Policy

Many travel insurance policies exclude coverage for Pre-existing Medical Conditions. You can waive the exclusion associated with a pre-existing condition with any of the plans offered through TripInsuranceStore.com by following the rules below.
A Pre-Existing Medical Condition is any medical condition, 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 (this includes being referred to a medical professional for any reason); 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, 90 or 180 day Lookback Period prior to the day you buy a travel insurance policy.

This is important: Here’s how the Travelex Select and Travelex Max plans define a medical condition that is not stable: “a diagnosed sickness from which no recovery is expected and which only palliative treatment is provided and which carries a prognosis of death within 12 months of your Effective Date; Sickness, Injury or Death if insurance is purchased after entering a hospice facility or receiving hospice treatment.” The reason this is important is because the Travelex Select and Travelex Max plans’ waiver of the pre-existing medical conditions exclusion does not override this General Exclusion. General Exclusions are important because they always apply to an insurance policy.

Are you a Canadian, not in Quebec, age 79 and under looking for travel insurance with pre existing medical condition coverage? I have a plan that can cover you with no medical questionnaires if your trip isn’t more that 30 days in length. Click here to see the details.

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 requirements when you buy your travel insurance plan:

  1. 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. Five of my plans don’t require the full prepaid trip cost to be insured as long as you insure a trip cost of at least $1: Global Alert Preferred & Plus, Travelex Max, Travelex Select and TravelSafe Classic; and
  2. You must get your travel insurance in the first 14, 15, 21 or 30 days after you pay your earliest trip payment (Global Alert Preferred & Plus, Travelex Select, Travelex Max, Travel Guard Gold, Travel Guard Platinum, Travel Insured and TravelSafe Classic) or no later than 24 Hours after you make your final Trip payment for CSA Freestyle & Freestyle Luxe and
  3. You have to cover your trip’s full length and
  4. The insured travelers must be able to take the trip on the date they purchase the travel insurance. If you are one of the travelers, you must be “medically able to travel when you pay your premium (get your travel insurance)”. In other words, your doctor says you can travel. If your doctor’s saying you can’t travel, but you insist you can travel, the insurance company will always side with your doctor. Something else that can affect you is are you 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. and
  5. Your trip must be “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, prepaying refundable deposits or even writing a check for a deposit even if the check is held for a few weeks.

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:

  • Their Initial or Final payment date
  • Meeting all the pre-existing condition rules including medical stability and being medically able to travel when they buy the travel insurance

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 medically stable and the lookback period fit together:

  • Any medical condition (no matter how minor) existing in the 60, 90, 180 or 365 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, 90, 180 or 365 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.
  • 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.

Your Deadline To Waive The Pre-Existing Medical Condition Exclusion

Provider & Plan Details The Pre-existing Conditions Waiver Deadline
CSA Freestyle Prior to or within 24 Hours of your final trip payment date
CSA Freestyle Luxe Prior to or within 24 Hours of your final trip payment date
Global Alert Preferred & Plus 15 calendar days after your initial trip deposit
Travelex Select 21 calendar days after your initial trip deposit
Travelex Max 30 calendar days after your initial trip deposit
Travel Guard 14 calendar days after your initial trip deposit
Travel Insured WTP 21 calendar days after your initial trip deposit
Travel Insured Plus 21 calendar days after your initial trip deposit
TravelSafe Classic 21 calendar days after your initial trip deposit
Note: this is annoying and ugly to get your attention: Are you past all the Pre-existing Conditions deadlines, don’t live in Indiana, Kansas, Montana, New Hampshire, New York, Puerto Rico or Washington 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 may be 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. With this plan, the pre-existing medical conditions exclusion waiver may be available if plan is purchased not later than 20 days after initial trip payment or up until final trip payment depending on your state of residence. Get the details.
Provider (the link goes to our summary page) The Lookback Period (calendar days) Maximum Trip Value for Pre-existing Condition coverage
CSA Freestyle & Freestyle Luxe 180 days $20,000 to $50,000 depends on insured’s age
Global Alert Preferred & Plus 60 days $50,000
Travelex Select 60 days $25,000
Travelex Max 60 days $50,000
Travel Guard Gold 180 days (365 days for Indiana residents) $30,000
Travel Guard Platinum 90 days $100,000
Travel Insured WTP & Plus 60 days $100,000
TravelSafe Classic 60 days $50,000

CSA Freestyle & Freestyle Luxe Plans

Here’s what the CSA Freestyle & Freestyle Luxe Plan Certificates of Coverage say:

Pre-Existing Condition
means an illness, disease, or other condition during the 180-day period immediately prior to your effective date for which you or your Traveling Companion or Family Member is scheduled or booked to travel with you:
1. received, or received a recommendation for, a diagnostic test, examination, or medical treatment; or
2. took or received a prescription for drugs or medicine. Item 2 of this definition does not apply to a condition which is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the 180-day period before coverage is effective under this Policy.

Pre-Existing Condition Exclusion
This exclusion applies to Trip Cancellation, Trip interruption, and Emergency Medical Expense Coverages. It applies to you, your Traveling Companion(s) or Family Member(s) who are scheduled or booked to travel with you.

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:

  1. You must purchase the CSA Freestyle or Freestyle Luxe Plan plan prior to or within 24 Hours of your final Trip payment; and
  2. All insured travelers must not be disabled from travel at the time they pay their premium; and
  3. You insure 100% of your prepaid Trip costs that are subject to cancellation penalties or restrictions.

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

 

Global Alert Preferred & Preferred Plus Plans

Here’s what the Global Alert Preferred & Preferred Plus Plan Certificates of Coverage say:

Pre-Existing Condition
means any injury, sickness or condition (including any condition from which death ensues) of You, 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.

This Pre-Existing Condition Exclusion applies to Trip Cancellation, Trip interruption, and Emergency Medical Expense Coverages. It applies to you, your Traveling Companion(s) or Family Member(s) who are scheduled or booked to travel with you.

The Pre-Existing Condition Limitation does not apply to the Emergency Medical Evacuation or Return of Remains coverage; or a mental or nervous condition, unless hospitalized.

Pre-Existing Condition Exclusion Waiver:
Global Alert Preferred & Preferred Plus will waive the Pre-existing Condition exclusion if you meet the following requirement:

  • a) the policy is purchased within 15 days of the initial deposit for Your Covered Trip;
  • b) the booking for the Covered Trip must be the first and only booking for this travel period and destination; and
  • c) You are not disabled from travel at the time You pay the premium;

Click here to go to our Global Alert Preferred & Preferred Plus plans’ detailed description page

Click here to go to the Global Alert Preferred secure online quote & order page or click here to go to Global Alert Preferred Plus’s secure online quote & order page.

 

Travelex Select & Travelex Max Plans

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 Travelex Select secure online order page

Click here for the Travel Max secure online order page

 

Travel Guard’s Platinum and Gold

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 90 day period, for the Cruise, Tour & Travel Platinum plan, or the 180 day period (365 days for Indiana residents), for the Protect Assist Gold plan, immediately preceding and including your coverage effective date: (a) first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; (b) for which care or treatment was given or recommended by a Physician; (c) required taking prescription drugs or medicines, unless the condition for which the drugs or medicines are taken remains controlled without any change in the required prescription drugs or medicines.

PRE-EXISTING MEDICAL CONDITION EXCLUSION WAIVER:
The Insurer will waive the pre-existing medical condition exclusion up to a maximum of the first $50,000 (Platinum) / $30,000 (Gold) of Trip Cost per person if the following conditions are met:

1. This plan is purchased within 15 days of making the Initial Trip Payment;
2. The amount of coverage purchased equals all prepaid, nonrefundable payments or deposits applicable to the Trip at the time of purchase, and the cost of any subsequent arrangement(s) added to the same Trip are insured within 15 days of the date of payment or deposit for any subsequent Trip arrangement(s);
3. All Insured’s are medically able to travel when plan cost is paid.

Plan Name Pre-Existing Medical Condition Lookback Period
Platinum 90 Days
Gold 180 Days

Click here for the Platinum’s secure online order page. Click here for the Gold’s secure online order page

 

Travel Insured

“Pre-Existing Condition” mmeans an illness, disease, or other condition during the 60 day period immediately prior to the date Your coverage is effective for which You or Your Traveling Companion, Business Partner or a Family Member : 1)received or received a recommendation for a test, examination, or medical treatment for a condition which first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; or 2) took or received a prescription for drugs or medicine. Item (2) of this definition does not apply to a condition which is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the 60 day period before coverage is effective under this Policy.

Travel Insured Worldwide Trip Protector:
GENERAL EXCLUSIONS AND LIMITATIONS
Benefits are not payable for any loss due to, arising or resulting from: The Company will not pay for any expense as a result of any illness, disease, or other condition during the 60 day period immediately prior to the date Your coverage is effective for which You or Your Traveling Companion, Business Partner or Family Member scheduled or booked to travel with You : 1) received or received a recommendation for a test, examination, or medical treatment for a condition which first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; or 2) took or received a prescription for drugs or medicine. Item (2) of this Exclusion does not apply to a condition which is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the 60 day period before coverage is effective under this Policy.;

Travel Insured Plus:
GENERAL EXCLUSIONS AND LIMITATIONS
Benefits are not payable for any loss due to, arising or resulting from: The Company will not pay for any expense as a result of any illness, disease, or other condition during the 60 day period immediately prior to the date Your coverage is effective for which You or Your Traveling Companion, Business Partner or Family Member scheduled or booked to travel with You : 1) received or received a recommendation for a test, examination, or medical treatment for a condition which first manifested itself, worsened or became acute or had symptoms which would have prompted a reasonable person to seek diagnosis, care or treatment; or 2) took or received a prescription for drugs or medicine. Item (2) of this Exclusion does not apply to a condition which is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the 60 day period before coverage is effective under this Policy.;

Click here to go to our Travel Insured detailed description page.

Click here to go to Travel Insured’s secure online order page

 

TravelSafe Classic Plan

TravelSafe’s Certificates of Coverage

“Pre-Existing Condition” means any injury, sickness or condition (including any condition from which death ensues) of You, 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 or treatment was recommended by a Legally Qualified Physician.

“Stable” means any medical condition or related condition for which there has been: no new treatment, new medical management, or new prescribed medication; and no change in treatment, change in medical management, or change in medication; and no new symptom or finding, more frequent symptom or finding, or more severe symptom or finding experienced; and no new test results or test results showing a deterioration; and no investigations or future investigations initiated, or recommended for Your symptoms; and no hospitalization or referral to a specialist (made or recommended).

The Waiver of the Pre-Existing Condition Exclusion requires:

  • The exclusion for Pre-Existing Conditions will be waived if this plan is purchased within 21 days of the date Your initial Trip deposit is paid.

Click here to go to our TravelSafe detailed description page.

TravelSafe’s Trip Cancellation Travel Insurance Plans:

Click here to go to the TravelSafe Classic plan (no CFAR) secure online order page or

click here to go to the TravelSafe Classic Plus plan with CFAR secure online order page




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