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’ Waiver Works:
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
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 60 day (Travel Insured Lite, TripAssure) or 180 day (Travel Guard) 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 the 60 or 180 days prior to buying the travel insurance.
- 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, then it has to be “medically stable”. This means that the person with that pre-existing condition hasn’t already taken a turn for the worse. Medically Stable also means that no medical condition is known, foreseen or expected to “take a turn for the worse”. And the person must be able to travel when they buy the insurance.
- If the traveler has the pre-existing condition, they have to be 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.
- 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:
- 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
- The person with the medical condition must be medically stable when you get your insurance, and
- You must get your Travel Guard Silver plan within the first 14 days or the TripAssure Asset within the first 15 days after your first trip payment date, and
- You have to insure your trip’s full length
In addition, trip insurance policies 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 inital 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.
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