Pre-Existing Medical Condition 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 Waiver of the Pre-Existing Medical Condition Exclusion Works in a Travel Insurance Policy
| Many trip insurance policies exclude coverage for Pre-existing Medical Conditions of yourself, traveling companions and non-traveling family members. But, you can waive this exclusion by following the rules below. If the Pre-existing Medical Condition worsens at least a day after you bought your travel insurance policy and fulfilled all the plan requirements, these four benefits may be needed: | |
| Trip Cancellation | Trip Interruption |
| Medical treatment | Medical transportation |
| A typical Pre-Existing Medical Condition definition (varies per policy) 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; during the 60 to 365 day Lookback Period prior to the day you buy a travel insurance policy. The condition doesn’t have to be diagnosed. |
| Regularly scheduled visits with routine tests when the the results are normal (EKGs, Stress tests, Blood tests, etc) do not necessarily cause a condition to be pre-existing. If the person sought treatment for a condition because they were having issues and / or felt they needed to be treated by the doctor then, yes, their condition is pre-existing. |
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:
- These plans require that you insure at least your trip’s full prepaid non-refundable trip cost (Do not round your trip cost down): CSA Freestyle and Luxe, Generali, Travelex Select, Travel Guard Preferred, Travel Guard Plus and Travel Insured WTP and Plus in MO, NY, PA and WA. The plans that do not require the full prepaid trip costs to be insured as long as you insure a trip cost are the IMG SE & LX, Travel Insured WTP in all States except MO, NY, PA and WA, Travel Insured Flex and TravelSafe Classic plans; and
- You must get your travel insurance in the first 14 to 21 days after you pay your earliest trip payment for IMG SE, Travelex Select, Travel Guard Preferred, Travel Guard Plus, Travel Insured and TravelSafe Classic or no later than 24 Hours after you make your final Trip payment for CSA Freestyle & Freestyle Luxe, Generali Premium and
- You have to cover your trip’s full length and
- 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 today. If your doctor says you can’t travel today, but instead says you will be able to travel in the future, don’t buy the plan today. The insurance company always sides 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
Any payment towards your travel arrangements 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 to 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 to 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 “stable”. “Stable”, in respect to our 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.
The Pre-Existing Medical Condition Exclusion Waiver Deadline
| Provider & Plan Details | The Pre-existing Conditions Waiver Deadline |
| CSA Freestyle | Your final trip payment date plus 24 Hours |
| CSA Freestyle Luxe | Your final trip payment date plus 24 Hours |
| Generali Premium | Your final trip payment date plus 24 Hours |
| IMG SE | 20 calendar days after your initial trip deposit |
| IMG LX | Your final trip payment date plus 24 Hours for most States and within 20 calendar days after your initial trip deposit for some States |
| Travelex Select | 14 calendar days after your initial trip deposit |
| Travel Guard Preferred | 14 calendar days after your initial trip deposit |
| Travel Guard Plus | 20 calendar days after your initial trip deposit |
| Travel Insured WTP | 21 calendar days after your initial trip deposit |
| Travel Insured WTP Plus | 21 calendar days after your initial trip deposit |
| TravelSafe Classic | 21 calendar days after your initial trip deposit |
| 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 Plan Limit depends on insured’s age |
| IMG SE and LX | 60 days | $50,000 in some States and $100,000 in most States |
| Travelex Select | 60 days | $50,000 |
| Travel Guard Preferred | 180 days | $100,000 |
| Travel Guard Plus | 180 days | $100,000 |
| Travel Insured WTP | 60 days | $100,000 |
| TravelSafe Classic | 60 days | $100,000 |
Ready to Purchase? It's easy and safe to purchase online or over the phone - just call Deanna, Kim or Steve at 888-407-3854 or 507-214-3854.
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PPS - Even though TripInsuranceStore.com is the world's most informative travel insurance website, you are still responsible to know the coverage terms, conditions, limitations, and exclusions of your plan. No comments or explanations confirm or deny coverage. You need to refer to each plan's policy wording.
PPPS - The Trip Cancellation coverage begins at 12:01 a.m. on the day after the date the policy is purchased. All other coverages begin when you leave home for your trip when your departure date is in the future.
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