Hep with pre-existing exclusion

[Luvmyrotti]

My DH and I are in the process of finalizing our TA cruise from FLL to the Med for May 2011. My DH has cancer, and while it is considered advanced-stage, he is considered stable and is in bi-weekly maintanance treatment at present (and has been in the same treatment regimen for the last 16 months. I'm trying to decipher how the pre-existing condition exclusion works. I think it is like this: We purchase the policy now, at time of booking; we elect a 60-day lookback period (during which time his condition has been stable, bit consistent treatment); if we have to cancel in say, April due to a worsening of his cancer, since the condition had been stable during the lookback period, we would be covered for cancelation. Am I correct in this? Has anyone had a similar circumstances? TIA for any assistance.

[cherylandtk]

1. Purchase the policy while he is deemed by his doctor as able to travel. Not "should be OK in a few months although not right now"; he must be able to travel on the date of purchase.

2. Purchase a policy which waives the pre-existing exclusion; most do if it is purchased within ~14 days of putting down the cruise deposit. (Two companies also waive it if purchased before final payment).

 

IMO it is too difficult with cancer to get around the lookback period because of the frequency of treatments; even blood tests with different results could be used to say that the condition was not stable. Better to get complete inclusion of pre-existing conditions and not have to worry about meeting the stability test.

[Luvmyrotti]

Hi Cherylandtk - Thanks for your response. What does it mean if I waive the pre-ex exclusion? Wouldn't that just guarantee that the condition would not be covered? How can I ensure complete inclusion of the condition?

[sirwired]

If you "waive" the pre-ex exclusion, it means you have purchased a policy that removes the exclusion from the policy, as long as you meet certain conditions.

 

For instance, with TravelGuard, if you purchase the policy within 15 days of making your very first deposit, insure the entire trip amount, and are able to travel at the time you purchase the policy, they will completely ignore any pre-existing conditions if you file a claim.

 

Many 3rd-party trip insurance providers provide such a policy feature. But act quickly! Most (if not all) require that the insurance be purchased soon after you book the trip. If you buy the insurance later, your policy choices go way down (and once you hit final payment, there are zero pre-ex waivers available.)

[Host Caroline]

IMHO you need to contact the insurance company directly (all have 800 numbers or via email) and be very very sure what you are getting.. get the name of the person you talked to, write it all down... before you purchase anything. Not that people here aren't knowledgeable but you need to find out what is covered from the company in your specific situation... all the better if you can get them to send you something via email confirming it.

[cherylandtk]

What does it mean if I waive the pre-ex exclusion? Wouldn't that just guarantee that the condition would not be covered? How can I ensure complete inclusion of the condition?

The pre-existing condition exclusion waiver is a double-negative. Normally the PEC is excluded from policies, and if you get a waiver of that exclusion, it means you are including it.

 

A good explanation of it can be found here:

http://tripinsurancestore.com/3/pre-existing.shtml

 

If you have specific questions relating to your husband's current diagnosis and status, please discuss them before purchasing any policy. Some policies are better than others for certain stages of cancer; it all comes down to what is a 'foreseeable condition' and what is not, per each policy's definitions. The folks at Trip Insurance Store are very helpful and knowledgable in this area.

[cruiseco]

My DH and I are in the process of finalizing our TA cruise from FLL to the Med for May 2011. My DH has cancer, and while it is considered advanced-stage, he is considered stable and is in bi-weekly maintanance treatment at present (and has been in the same treatment regimen for the last 16 months. I'm trying to decipher how the pre-existing condition exclusion works. I think it is like this: We purchase the policy now, at time of booking; we elect a 60-day lookback period (during which time his condition has been stable, bit consistent treatment); if we have to cancel in say, April due to a worsening of his cancer, since the condition had been stable during the lookback period, we would be covered for cancelation. Am I correct in this? Has anyone had a similar circumstances? TIA for any assistance.

 

With most policies your husband's condition would not be considered stable just because the treatment regimen has not changed in the "look back period."

 

For example this is from CSA:

 

"PRE-EXISTING CONDITION means an illness, disease, or other condition during the 180-day period immediately prior to your effective date for which you or your Traveling Companion or Family Member is scheduled or booked to travel with you:

 

1. received, or received a recommendation for, a diagnostic test, examination, or medical treatment; or

 

2. took or received a prescription for drugs or medicine.

 

Item 2 of this definition does not apply to a condition which is treated or controlled solely through the taking of prescription drugs or medicine and remains treated or controlled without any adjustment or change in the required prescription throughout the 180-day period before coverage is effective under this Policy. "

 

Under (1), the cancer is established as a pre-existing condition -- your husband is receiving medical treatment.

 

The "stable or controlled" exemption is described in the highlighted section. Is your husband's condition being treated solely with the taking of prescription medication? No, it sounds like the treatment requires office visits. Even though the visits happen on a regular basis and maybe the treatment received during those visits never changes, the condition is not stable as it requires treatment way over and above taking a couple of pills every day.

 

You'll find most plans are this way -- Taking blood pressure meds every day with no changes during the "look back period" = controlled/stable. Once the condition requires treatment above and beyond the meds you're no longer stable, even if the treatment hasn't changed.

 

I wouldn't buy any plan, even if you are in the time frame to get the pre-existing condition waiver, without calling/emailing the insurer directly to find out exactly where you stand.