Is this preexisting?

[parrotfeathers]

This preexisting condition wording really confuses me. DH is going to Israel in December. He has a pacemaker and high blood pressure but is not clinically "ill"--his health is really very good. He did not get insurance within the required time frame after his deposit and there are only a couple of companies that will cover preexisting conditions. Money for the insurance is not an issue. He has not been to the doctor or changed medication other than his regular check ups. I think he had a chest x-ray that showed one spot of emphysema 2 years ago. Are his health issues considered preexisting?

 

After reading what I typed I guess my question becomes pretty foolish?

[patseacruiser]

I'm not an insurance expert but I'm going to take a stab at it and say yes they are pre-existing conditions. There are some companies that will still cover you for pre-existing conditions especially if as you say he is quite healthy otherwise.

[cherylandtk]

Most companies define pre-existing as any condition for which you saw a doctor (or should have seen a doctor) in the last some number of days, known as the lookback period. Conditions which are stable and require medication (such as his HBP) that have not had a change in medication in the lookback period are usually not considered pre-existing.

 

So the question becomes how long ago did your husband last see his Dr. and for what reason(s)? When you do pick an insurance company, you can pose your question to them, and ask for an answer in writing as to what is pre-existing and what is not.

[cruiseco]

Every plan will have a definition in the wording somewhere. This is from a Travelex plan:

 

"

Pre-Existing Condition: means any injury, sickness or condition of You, or Your Traveling Companion for which within the sixty (60) day period prior to the Effective Date of Trip Cancellation coverage under the Policy

 

(a) first manifested itself or exhibited symptoms which would have caused one to seek diagnosis, care or treatment;

 

(b) 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; or

 

© required medical treatment or treatment was recommended by a Physician."

 

Next, find the plan's definition of "Effective Date:

 

"WHEN YOUR COVERAGE BEGINS

All coverage (except Trip Cancellation) will take effect at 12:01 A.M. local time, at Your location, on the Scheduled

Departure Date provided:

 

(a) coverage has been elected; and

 

(b) the required premium has been paid.

 

 

Trip Cancellation coverage will take effect at 12:01 A.M. local time at Your location, on the day after the required premium for such coverage is received by the Company or its authorized representative."

 

So, if you're wondering about whether or not a medical situation is a pre-existing condition or not with regards to trip cancellation you now know that the insurer will only be looking at the 60 day period prior to one minute after midnight following the day you buy the policy. Using that time period and the definition of "pre-existing" shown above you'd ask yourself the following questions about the high blood pressure situation:

 

1) In that 60-day period did your husband exhibit symptoms which would have caused one to seek diagnosis, care or treatment?

 

Answer: Probably NO. He's just taking his meds and getting regular checkups. Nothing has popped up that would cause him to think "hey, I should get this checked out."

 

2) Is the condition being controlled by the taking of prescription medications?

 

Answer: YES

 

Now, here's the important part: "UNLESS the condition for which the prescribed drug or medicine is taken remains controlled without any change in the required prescription."

 

So, according to Travelex's definition, if the high blood pressure is controlled through the taking of prescription medication and there have been NO changes in the prescription in that 60-day period, it is NOT considered to be a pre-existing condition. So if the high blood pressure problem flared up and caused you to cancel the trip you'd be covered even if you did not buy the policy in the time frame needed to get the waiver of this exclusion.

 

Go back and do the same for the pacemaker. Have there been any symptoms in that 60-day period that have caused him to seek treatment? Probably NO. Is he taking prescription meds for this condition? Probably NO but if YES, have there been any changes to the prescription? You'll probably find that this is not a pre-existing condition either.

 

You can use this same method to find out where you stand with any travel insurance plan. Find the definitions of "pre-existing condition" and "effective date" and go from there. If you're unsure of the answers be sure to call the insurer itself to get an explanation. Better yet, email them to get a written response to your question.

 

Most important -- don't try to apply the above info to any other plan. They're all different and if you try to assume that one plan works the same as another you might get burned.

 

Also note, that with regard to the medical coverage, the 60-day period they're looking at is the 60 days prior to your departure. So, if you get some illness just before you leave they will not pay for treatment of that illness while you're on the trip (unless you have the waiver of the pre-existing condition exclusion).

[sirwired]

Pre-existing? Yes.

 

Excluded from coverage? Maybe not, depending on policy.

 

On another note: If you haven't yet reached Final Payment, CSA offers policies that will still give you a pre-ex waiver.

 

SirWired

[parrotfeathers]

I appreciate all the replies to my post. I think I will go ahead with the policy offering the preexisting waiver through HTH Worldwide. CSA is almost twice as high, with virtually the same coverage. Both are underwritten by the same insurance company. These are the only 2 companies available. If anyone knows why CSA would be twice as high, please post.

 

Squaremouth.com is much easier for me than insuremytrip.com

[cruiseco]

I appreciate all the replies to my post. I think I will go ahead with the policy offering the preexisting waiver through HTH Worldwide. CSA is almost twice as high, with virtually the same coverage. Both are underwritten by the same insurance company. These are the only 2 companies available. If anyone knows why CSA would be twice as high, please post.

 

Squaremouth.com is much easier for me than insuremytrip.com

 

The CSA plans you're probably seeing at those online sites (definitely on insuremytrip) are the Custom and Custom Luxe plans.

 

This biggest reason why this usually comes in more expensive for those that are looking for the pre-existing condition coverage is that in order to get that coverage you have to step up to the Luxe plan -- you can't get it with the regular Custom plan.

 

For those that want to use CSA but not get over-charged you need to look for a site that offers the Freestyle and Freestyle Luxe plan. With these plans you can buy the less-expensive regular Freestyle plan and still get the pre-existing condition coverage. It can be found at:

 

http://www.travelinsurancecenter.com and

http://www.tripinsurancestore.com

 

Other than that, the biggest difference in coverage is that the regular HTH plan only has a trip interruption benefit equal to 100% of the trip cost insured. The CSA plan cover up to 150% of the amount insured. I would pay a little more for this better but not a huge amount more.

 

Those big sites like to give you the impression that they carry all of the options that are out there but, of course, they don't/

[parrotfeathers]

Thank you so much for your post!! I did go to tripinsurancestore.com and see both plans you mentioned and they look fine. You are such a big help to me in this endeavor.

[parrotfeathers]

Had a great conversation with Steve at the tripinsuranceStore. He explained several questions I had about coverage. I went with the CSA FreeStyle through him. Steve explained to me why he thought this would be suitable for my husband's trip to Israel. DH does already have some coverage for foreign travel through a supplemental medicare policy.

 

As cruiseco pointed out, the CSA FreeStyle is not available on the insuremytrip and squaremouth sites.

[Cuizer2]

This preexisting condition wording really confuses me. DH is going to Israel in December. He has a pacemaker and high blood pressure but is not clinically "ill"--his health is really very good. He did not get insurance within the required time frame after his deposit and there are only a couple of companies that will cover preexisting conditions. Money for the insurance is not an issue. He has not been to the doctor or changed medication other than his regular check ups. I think he had a chest x-ray that showed one spot of emphysema 2 years ago. Are his health issues considered preexisting?

 

After reading what I typed I guess my question becomes pretty foolish?

 

If he has a heart problem then it could be preexisting. If he breaks his leg, then no, it is not preexisting.