I’ve been busy working on travel insurance claims for a few of my trips this year, and documentation for a few clients situations. One of the confusing elements of travel insurance inspires the article of this week…
It doesn’t mean what you think it does – Pre-existing Conditions in Travel Insurance
I have been working on my travel insurance claims as I’ve had two situations so far this year. Travel insurance comes up with every type of trip and provides a variety of benefits. But travel insurance also has a number of gotchas and details that can impact your coverage and benefits.
In particular I wanted to talk about one of the most misunderstood terms in travel insurance, because it’s used in a completely different way in regular medical insurance.
You’ve probably heard the term ‘pre-existing conditions’ as it’s a significant issue related to health insurance coverage. But for travel insurance, it is a has a totally different meaning.
Thinking about the concept of pre-existing conditions and how it can affect people’s understanding of travel insurance reminds me of the movie, The Princess Bride, when Inigo Montoya says to Vizzini, “You keep using that word. I do not think it means what you think it means.”
Definitions
So, let’s start with some general definitions:
Pre-existing conditions in Health Insurance: A health problem you had before the date that new health coverage starts, such as diabetes, asthma, or cancer.
Pre-existing conditions in Travel Insurance: A condition which was first diagnosed, had a change in diagnosis or required a change in medication during the specified ‘look back period’ immediately preceding the purchase of the travel insurance. The ‘look back period’ is typically one to six months, depending on the specific travel insurance company and plan type.
For travel insurance, the health condition doesn’t have to be one you’ve had for a long period of time, or a serious illness. It can be a recent occurrence and one that will go away in the future. A month before purchasing your travel insurance you might go to the doctor after cutting your foot. Later on, if that cut doesn’t heal and gets infected so that you need to cancel a trip because you can’t walk, that would be considered a pre-existing condition.
In the world of travel insurance, a pre-existing condition can be any type of medical condition that may be identified as the insurance company looks at any and all medical visits, tests, diagnoses, or prescriptions as they look backward one to six months from the date you purchased the insurance.
So, while you may not have any pre-existing conditions based on the health insurance definition, you could easily have pre-existing conditions based on the travel insurance definition.
Exclusion and Waiver
The other thing you should know about pre-existing conditions is that pretty much every travel insurance policy excludes pre-existing conditions for coverage.
That’s the standard policy language. Understand that any plan you read will show pre-existing conditions as excluded from coverage.
However, some, but not all, policies provide a way to get a waiver of that exclusion.
This is the important part – in order to get the waiver of the exclusion, most plans have three requirements to earn the waiver:
1) Purchase your travel insurance within a specific window of time after paying your initial trip deposit (usually 10-21 days) or, with a few specific plans, prior to making your final trip payment.
2) You are physically able to travel at the time you purchase the insurance.
3) You fully insure all the non-refundable pre-paid costs of your trip,
You want to make sure you meet all the requirements so you can get that waiver and have pre-existing conditions covered.
This is a huge topic to understand when it comes to the timing of purchasing your travel insurance.
Clarify the Waiver Requirements
Pay attention to the first deposit you make toward a trip and think about the travel insurance implications. If the payment is non-refundable, that will be the initial payment for the trip, even if you’re doing a deposit on a promotional offer and it’s only $25.
Regardless of the amount, that initial payment “starts the clock” for the timeframe of when you should purchase travel insurance.
You must be physically able to travel at the time you buy the insurance, so you need to be aware of that, which could affect the timing of when you book a trip if you are sick or hospitalized.
You must be physically able to travel at the time you buy the insurance, so you need to be aware of that, which could affect the timing of when you book a trip if you are sick or hospitalized.
The next point is that you insure the full non-refundable prepaid cost of your trip. That means that if your non-refundable trip cost is $5043, and you purchase insurance for $5000, thinking the extra $43 doesn’t matter, if you file your claim related to a pre-existing condition, it will be denied because you did not insure the full non-refundable cost of the trip.
It is very important to include coverage for pre-existing conditions as a best practice because there are very often times where you don’t even remember that you went to the doc in a box a few months ago, or that you started a new blood pressure medication.
I personally had a situation where something that seemed like a very minor visit to the ‘doc in a box’ turned out to be a very serious problem many months later. Had I not purchased my travel insurance within that 10–21-day window after making a trip deposit, that ‘minor’ visit could have prevented me from being reimbursed if I had to cancel the trip.
Not all plans offer the option of a waiver – so it’s crucial that you actually do read the terms and conditions for your travel insurance to see if they have a way to cover pre-existing conditions.
It’s important to have a travel insurance plan that will provide an option to cover your pre-existing conditions, because there is more to it than just your own medical condition.
It’s Not Just About You
Your travel insurance extends beyond you, as the typical plan covers illness or death of family members or traveling companions as covered reasons for cancellation or trip interruptions.
If you have a family member that is ill or gets ill that could cause you to cancel your trip or to interrupt your trip to come home, the insurance company will look at the pre-existing conditions associated with that person if you do not have the waiver of the exclusion.
While you may know with certainty that you haven’t been to a medical visit or changed medication, it isn’t just about you. You don’t know about your family members and what they have going on medically that could affect your ability to be reimbursed if you had to cancel or interrupt a trip because your family member got sick.
Delay in Medical Treatment
Another important consideration in regard to pre-existing conditions is the timeliness of your own medical treatment if something happens while you are traveling.
Let’s say that you buy your travel insurance for an international trip, but not within the timeframe to have pre-existing conditions covered. You figure it’s not an issue because you know with certainty that you have not been to the doctor or changed medication in the last six months.
You take your trip and while you are traveling, you have heart pain and you end up in the hospital, and they have to do some type of surgery. The hospital will check with your travel insurance company to make sure the cost will be covered.
The fact that you don’t have pre-existing conditions covered in your travel insurance plan can mean a delay in medical treatment. Before the insurance company will agree to pay the hospital bill, they have to make sure that your current situation is not related to a pre-existing condition, because they won’t cover the surgery if it is.
While you know your situation is not pre-existing per the definitions of the travel insurance plan, the insurance company does not, and they will take the time to go verify that you had no visits to your doctor or any medical situations in the months before you bought your plan. Your treatment could be delayed until the insurance company can confirm to the hospital that the bill will be paid.
Plan to Purchase Travel Insurance within the Time Sensitive Period
One of the concerns I have is that people think “I don’t have a medical pre-existing condition, so I don’t need to worry about buying insurance right now, I can wait.” But then they end up with an unexpected situation going to the doctor for an issue, and that just created a pre-existing condition.
Reading your travel protection plan documents is the best way to understand how pre-existing conditions will be covered.
The simplest way to avoid any type of problem with covering pre-existing conditions is to make sure that you buy a travel insurance plan within 10-14 days after you make your first deposit on a trip, and fully ensure the non-refundable costs of the trip. As you add components to the trip, increase the coverage amount accordingly.
There’s no extra cost for the coverage of pre-existing conditions – it’s just paying attention to the timing and taking action.
Thinking about the concept of pre-existing conditions and how it can affect people’s understanding of travel insurance reminds me of the movie, The Princess Bride, when Inigo Montoya says to Vizzini, “You keep using that word. I do not think it means what you think it means.”
Pre-existing conditions in Travel Insurance: A condition which was first diagnosed, had a change in diagnosis or required a change in medication during the specified ‘look back period’ immediately preceding the purchase of the travel insurance. The ‘look back period’ is typically one to six months, depending on the specific travel insurance company and plan type.
That’s the standard policy language. Understand that any plan you read will show pre-existing conditions as excluded from coverage.
Pay attention to the first deposit you make toward a trip and think about the travel insurance implications. If the payment is non-refundable, that will be the initial payment for the trip, even if you’re doing a deposit on a promotional offer and it’s only $25.
It is very important to include coverage for pre-existing conditions as a best practice because there are very often times where you don’t even remember that you went to the doc in a box a few months ago, or that you started a new blood pressure medication.
If you have a family member that is ill or gets ill that could cause you to cancel your trip or to interrupt your trip to come home, the insurance company will look at the pre-existing conditions associated with that person if you do not have the waiver of the exclusion.
One of the concerns I have is that people think “I don’t have a medical pre-existing condition, so I don’t need to worry about buying insurance right now, I can wait.” But then they end up with an unexpected situation going to the doctor for an issue, and that just created a pre-existing condition.