Your Guide to Pre-Existing Conditions & Visitors Insurance
Travel with a pre-existing medical condition can be a minefield. There are many questions to answer. Can you get travel insurance with a pre-existing medical condition? Are certain conditions covered and certain conditions not? Who insures you if you have a pre-existing condition?
The good news is you can travel with a pre-existing condition, provided you are cleared by your doctor. You just need to find the right visitors insurance plan, and the right insurance company. Before you start looking, check out some facts and the answers to these frequently asked questions about pre-existing conditions and travel insurance.
The exact consideration of what is a pre-existing condition differs between different insurers although all visitor insurance follows the same general procedure, stating that a pre-existing condition is something that existed at the point of buying travel insurance or some time before.
Pre-existing conditions are defined as any illness, disease, injury, or other type of medical condition which you experienced before you bought travel insurance, and for which you sought medical advice or received a diagnosis, experienced symptoms, had treatment, or took prescription medication.
A pre-existing condition, as described above, is a condition which has been experienced or diagnosed at the point of application for travel insurance or in a specified time beforehand. This specified time beforehand that is under consideration is the look back period – Each policy has a look back period and an illness/injury that falls in the look back period will be considered a preexisting condition. Therefore any medical condition could be pre-existing, but the most common conditions include heart disease, cancer, high blood pressure, diabetes, breathing conditions, kidney conditions, stroke, epilepsy, liver conditions, or psychological conditions including depression and anxiety. Usually the “look back” period ranges from anything around 180 days up to 2 years, depending on the plan, and if a medical condition existed in that timeframe it is classed as pre-existing if it was treated or symptoms were experienced. The time frame varies between insurers.
Typically chronic conditions like heart condition, high blood pressure, diabetes, AIDS, pregnancy, cancer, etc. would be considered pre-existing conditions even if they do not fall in the look back period, as they would not have manifested overnight. There is no fixed rule and it is extremely difficult to say what is be considered a pre-existing condition. Listing all medical conditions are impossible and it would be wise to say if it exists at the time of application it will be considered a pre existing condition.
Visitors insurance and travel insurance automatically exclude pre-existing conditions. This means that a travel insurance plan will not cover the costs of treating a pre-existing medical condition. Therefore, an insurance company can deny a claim for treatment arising from a pre-existing condition.
However, some insurance plans offer benefits for acute onset of pre-existing conditions. This means that an insurer might not deny a claim for a pre-existing condition which is considered an acute onset and is as per the schedule of benefits.
Certain health and travel insurance companies offer plans that can cover acute onset of a pre-existing medical conditions. These include plans that come up when you get a quote, for example, plans like the Inbound Guest plan , the Patriot American Plus and Atlas America can protect an acute onset of a pre-existing conditions up to the chosen policy maximum for individuals below the age of of 70. In order to get the best plan for your needs you must check the pre-existing exclusion criteria as it affects your age and your particular medical condition.
Clients often ask the following:
- Is high blood pressure a pre-existing medical condition?
High blood pressure or hypertension is a dangerous condition and can contribute to other conditions. It is usually defined as a pre-existing condition for travel insurance applications.
- Is pregnancy a pre-existing medical condition for travel insurance?
An existing pregnancy is considered a pre-existing condition and is therefore not covered. Most plans exclude benefits for maternity however you can consider a plan that can extend to treatment for complications of pregnancy.
- Is diabetes a pre-existing medical condition?
Yes, diabetes is usually defined as a pre-existing condition.
- Is a stroke considered a pre-existing condition?
Yes, stroke is also usually considered to be a pre-existing condition.
- What medical conditions affect travel insurance?
Pre-existing medical conditions like the ones described above, and many others, affect your travel insurance. If you take out cover, or you purchase a plan that doesn’t include a protection for an acute onset of a pre-existing condition, you are effectively traveling uninsured for that health condition. If any problems occur which are related to the pre-existing condition then you will need to pay for them yourself.
- Can I claim on travel insurance if pregnant?
You can generally claim for any unexpected complications of pregnancy (as per the schedule of benefits for that policy) when you are traveling under a travel insurance policy that includes cover for pregnancy. You can however claim for a eligible medical condition not related to pregnancy.
- Who are the best travel insurance companies?
It’s difficult to answer that as many insurance companies have a variety of excellent plans to cater to different needs. You want to find a plan that meets your needs (i.e. depending on your age, coverage time period, and need for coverage for pre-existing conditions or sports). Once you have a shortlist you can narrow them down. The underwriting company’s financial standing is another important criterion to look out for as they are the ones paying the claims. All the plans listed here on this site are underwritten by companies that have good to excellent financial ratings. If you have a pre-existing condition, it is good to be aware of the look back period also. It is often helpful to talk with an insurance professional if you have questions.
Tips for those visiting the US with a pre-existing condition
- Get a comprehensive health check up done before you leave home and carry these medical records with you while travelling though not necessary to buy the insurance but a good practice to have it done so you can have the medical records in case of a claim.
- Bring medication to last twice the length of your trip
- If your condition flares while in the US, give the attending doctor your complete history and your medical history.
- If your claim regarding a non pre-existing condition is denied, you can submit an appeal When you submit an appeal, you will have to write to the insurance substantiating why you think this claim needs to be paid along with supporting documents. These supporting documents typically are the medical records you have from the past health checks ups from your country and also detailed records/letter from your doctor with whom you sought treatment .
- If the appeal is denied on the pre existing condition exclusion clause, then it would be up to the insured to pay the bills. In such cases, it can be difficult for the insured to pay these high amounts. You can talk to the hospital/provider to see if there are any payment options or discounts that they offer so that the billed amount can be reduced. Hospitals typically do offer various options in such situations.
- Insurance companies can ask for medical records up to 5 years ago.
- How to submit a claim