Pre-Existing Conditions

Author: Sara B.

Published: September 15th, 2021 | Updated: September 13th, 2022
Read time: 6 mins

When talking about travel insurance, one phrase that commonly comes up is “pre-existing conditions.” This can determine what travel insurance you purchase, how much you pay for your insurance and what type of coverage you will receive.

Having a pre-existing medical condition is very common. It’s important to consider any pre-existing conditions you may have when making decisions about travel health insurance. Even if a close family member is not travelling with you but has a pre-existing condition, it’s important to be aware of how it can affect travel insurance coverage before you purchase a plan.

What is considered a pre-existing condition?

According to The Travel Health Insurance Association of Canada a pre-existing condition is a health condition that is known to you before you travel. This may include a diagnosis or symptoms you experienced prior to your trip.

A pre-existing condition is usually defined as any health or medical condition that, prior to your effective date:

• you have experienced symptoms for
• you have received treatment for
• you have been hospitalized for
• has either deteriorated or become more frequent
• requires a change of medication type or dosage
• you have consulted with a medical professional for

Does travel insurance cover pre-existing medical conditions?

It depends. Coverage may be available for those with pre-existing conditions if their medical conditions are under control and stable for a specific period, as specified in the policy, prior to travel. However, some policies may not cover pre-existing conditions at all. Therefore, it is very important to review the details of your policy and understand how it defines pre-existing condition. Policies will vary by provider.

While the words “pre-existing conditions” are used in all travel insurance policies, the way these words are defined and the time frames requiring that condition has been stable may differ from policy to policy. As an example, for trip cancellation most policies require you to be stable 90 days prior to purchase of insurance yet for emergency medical you may need to be stable 90, 180 or 365 days prior to the departure date. And, with some policies, pre-existing conditions are not covered.

When reviewing your policy, you will also particularly want to consider terms such as “treatment” and “stable” as they relate to your personal medical history. Insurance companies may define these terms differently, but generally they will not cover conditions or symptoms that have, within a certain time frame prior to your departure:

• deteriorated or become more frequent
• been treated by a medical professional
• required change of medication type or dosage
• been recommended for consultations or tests

It’s also important to note that even the policies that include pre-existing condition coverage do not reimburse expenses to maintain the condition, but may cover complications that require medical attention, hospitalization, or death from that pre-existing condition. Refer to your policy for exclusions and details.

Above all, it is necessary to be completely honest and disclose all details for your pre-existing medical condition if you have one prior to purchasing your policy. Be aware that if there are any changes in your medical status between the time you purchase the policy and the time you leave on your trip, you need to notify the insurance company as this may affect your eligibility for coverage and your rate. Also, remember that providing inaccurate or incomplete answers to the questions may cause your claim can be denied, or, in some cases, your policy to be void, even if the question that is answered incorrectly is not related to the cause of the claim.

Understanding your travel insurance policy is key. Reading through your personal policy documents to familiarize yourself with the terminology and coverage limits may feel daunting, but it is incredibly important to understanding coverage. If you are unsure about changes to your health you may have experienced during the time frame outlined in your policy, or don’t understand the terminology in your policy, check with your doctor to understand your medical status and make sure it is reported correctly. Our Customer Care team of licensed Canadian Representatives can assist you with reviewing this information and explain how it will be used to determine your coverage and your premium.

What is a pre-existing condition exclusion?

Every travel insurance policy includes a list of situations in which coverage is not provided. When purchasing a plan, travellers are encouraged to carefully review this list, referred to as ‘Exclusions,’ to ensure they fully the coverage available.

Pre-existing conditions are often included in the list of exclusions, as losses due to a known medical condition that existed prior to the purchase of the policy are often not covered.

What is a look-back period?

When determining the result of a claim, the travel insurance company will “look back” at the medical records of the traveller or non-traveller to whom the claim refers. The period of time for this medical review that is specified will vary by plan and provider. Your provider may only be able to approve your claim if your pre-existing condition was stable within the look back period. “Stable” typically means that the condition has not changed or worsened in any way – no new diagnoses or treatments, no new medications, no treatments of any kind, and no pending or initiated treatments, scans, or test results. Travellers are reminded to review your specific policy documents to understand how a pre-existing condition may be covered.

FAQs

Is diabetes a pre-existing condition for travel insurance?

Diabetes may be considered a pre-existing condition. Review the specifics of your policy for terms and exclusions related to diabetes and speak to a licensed customer care representative with any additional questions you may have.

Is pregnancy a pre-existing medical condition for travel insurance?

Pregnancy itself is not considered a pre-existing condition, though conditions that arise due to the pregnancy may be considered a pre-existing condition. However, travel insurance plans generally may not provide coverage for pregnancy complications, childbirth or related situations if they occur in a certain time frame before or after the expected delivery date. Review the specifics of your policy for exclusions and speak to a licensed customer care representative with any additional questions you may have.

Is asthma a pre-existing condition for travel insurance?

Asthma may be considered a pre-existing condition. Review the specifics of your policy for terms and exclusions related to asthma and speak to a licensed customer care representative with any additional questions you may have.

Is high cholesterol a pre-existing condition for travel insurance?

High cholesterol may be considered a pre-existing condition. Review the specifics of your policy for terms and exclusions related to high cholesterol and speak to a licensed customer care representative with any additional questions you may have.