What constitutes an existing condition?

[Deenkid]

The more I read about the pre-existing condition clauses the more confused I become. I've been taking medication for High Blood Pressure (HBP) for over 30 years and have been cruising that long as well. I usually get trip insurance but never have mentioned that I take medication for this. Is HBP considered a pre-existing condition if it is monitored and under control? Does it need to be considered when getting insurance?

 

Hope this isn't a silly question or one that has been answered numerous times, but I wanted to stop wondering and get an answer.

 

Thanks for your help.

[cruiseco]

The more I read about the pre-existing condition clauses the more confused I become. I've been taking medication for High Blood Pressure (HBP) for over 30 years and have been cruising that long as well. I usually get trip insurance but never have mentioned that I take medication for this. Is HBP considered a pre-existing condition if it is monitored and under control? Does it need to be considered when getting insurance?

 

Hope this isn't a silly question or one that has been answered numerous times, but I wanted to stop wondering and get an answer.

 

Thanks for your help.

 

There's no universal answer to your question. Every insurer has its own definition which may vary from plan to plan. And then each plan may have some variation depending on your state of residence. There's just no way around it -- you have to read and understand that plans definition and then if you look at another plan you have to start over -- never assume that what's true for one insurer/plan will also be true for another.

 

In the fine print for every plan you'll find a definition such as the following:

 

“Pre-Existing Condition” means any injury, sickness or condition of You, a Traveling Companion, or Your or Your Traveling Companion’s Family Member booked to travel with You for which medical advice, diagnosis, care or treatment was recommended or received within the 60 day period ending on the Effective Date. Sicknesses or conditions are not considered pre-existing if the sickness or condition for which prescribed drugs or medicine is taken remains controlled without any change in the required prescription."

 

Still can't figure it out? Call the insurer. And even if you do think you have it figured out be sure to check for any state-based exceptions found elsewhere in the document. For example, a New York resident buying this exact same plan would find this in the state-specific exemptions section:

 

"The definition of “Pre-Existing Condition” is deleted in its entirety and replaced by the following:

 

“Pre-Existing Condition” means any Injury, Sickness or condition of You, Your Traveling Companion, or Your Family Member booked to travel with You for which medical advice, diagnosis, care or treatment was recommended or received within the six (6) month period ending on the Effective Date. Sicknesses or conditions are not considered pre-existing if the Sickness or condition for which prescribed drugs or medicine is taken remains controlled without any change in the required prescription.

 

Such an Injury or Sickness will continue to be a Pre-Existing Condition until the expiration of 12 consecutive months, beginning with the effective date of coverage for which You have not received any medical care, consultation, diagnosis, or treatment or has not taken any prescribed drug or medicine on account of such condition."

 

Same insurer, same plan, completely different definitions.

[Deenkid]

Thanks so much for your reply. This helps immensely, but I most likely will call the insurance company to double check.

[FlightMedic555]

Hypertension would be a pre existing condition. More importantly since hypertension increases ones risk for heart attacks and strokes an insurance company MIGHT be able to deny a claim for a heart attack or stroke if you did not disclose that you have the history of hypertension.

 

Again, pure speculation on my part.

[cruiseco]

Hypertension would be a pre existing condition.

 

Maybe yes, maybe no depending on the plan's definition of a pre-existing medical condition. From the plan wording posted above:

 

"care or treatment was recommended or received within the 60 day period ending on the Effective Date. Sicknesses or conditions are not considered pre-existing if the sickness or condition for which prescribed drugs or medicine is taken remains controlled without any change in the required prescription"

 

Say the blood pressure meds were changed 90 days ago. By the above definition the condition has been stable for the last 60 days and is NOT considered to be "pre-existing" by the plan's own definition.

 

However, if this person lives in New York it WOULD BE defined as "pre-existing" because the meds were changed and are therefore not stable within the 180 day period called for.

 

All that matters is what the plan's definition says.

[Deenkid]

I don't ever recall being asked whether I had any pre-existing conditions. When my travel agent asked whether I wanted insurance, I would agree and then he would send me the pamphlet. It usually was Access America, but more recently I used Travel Guard. Thankfully, (and touch wood) I have never had to use it.

 

Thinking about it further, I doubt I would have even considered my HBP being a pre-existing condition since I have been on the same prescription for over 20 years and have never had a high reading while on it. I usually never give it a thought but reading this thread set me to thinking about it.

 

This keeps getting more confusing and I'm going to have to draft DH for some input. We have two cruises coming up and need to investigate this further.

[GoofyGraham]

I don't ever recall being asked whether I had any pre-existing conditions. When my travel agent asked whether I wanted insurance, I would agree and then he would send me the pamphlet. It usually was Access America, but more recently I used Travel Guard. Thankfully, (and touch wood) I have never had to use it.

 

Thinking about it further, I doubt I would have even considered my HBP being a pre-existing condition since I have been on the same prescription for over 20 years and have never had a high reading while on it. I usually never give it a thought but reading this thread set me to thinking about it.

 

This keeps getting more confusing and I'm going to have to draft DH for some input. We have two cruises coming up and need to investigate this further.

 

Any insurer that fails to ask about pre-existing conditions is, without a doubt (in my mind), looking for a means by which they can refuse to pay the simplest of claims. It will be in the small print somewhere.

 

Most insurers will happily quote extra for pre-existing medical conditions... some advertise the fact... they are almost as bad as those not asking as they prey on peoples fears of not being covered and make you pay loads for the cover. Last year I was well and truly ripped off, I went to one of the (well known) insurers who quoted me silly numbers for cancer cover, and when you read the small print (weeks later) it says they don't cover claims arising from the cancer anyway!!

 

Any insurer should tell you what pre-existing conditions do not attract higher premiums, I have just obtained mine online through my bank (Santander) where the online process is clear and concise, they list conditions that do not require them to be notified, anything that falls outside that list would attract the higher premium... but they will still insure you for the basic cover, they clearly state that should you make a claim directly or indirectly through the pre-existing condition, you won't be covered.

 

As a cancer survivor, I'm happy with that deal, a lot of insurers load the premiums for anyone within 5 years of a cancer diagnosis, even if it's all gone: a few are now pointing out that they will still cover you for everything else without having to pay huge sums on top. With the one I've just got, I clicked 'Yes' to the declaration of the pre-existing condition (which isn't the cancer as they have a 2 year limit not 5) and it simply asks if you're happy to continue the purchase but not be covered for the pre-existing condition (whilst still offering the opportunity to pay the extra if you want it covered)

 

I hope that all makes sense :confused:

 

As has been said... check with your insurer, but most importantly, don't worry about it to the detriment of your cruise.

[cherylandtk]

In my experience one is not asked to disclose PEC at policy purchase; it is when you file a claim that the determination is made as to whether the exclusion applies or not.

[cruiseco]

In my experience one is not asked to disclose PEC at policy purchase; it is when you file a claim that the determination is made as to whether the exclusion applies or not.

 

The poster is from Great Britain and their policies are WAY different from what we have here in the US.

[sweetpea1714]

I just purchased a policy and it didn't give a chance to state anything like that.

 

Is the pre existing period from the 60 prior to purchase or 60 days prior to my cruise?

[sirwired]

The pre-ex "lookback" period is keyed to the day of policy purchase.

 

They do not ask about pre-existing conditions during policy purchase, because they do not perform medical underwriting. The details on the exclusion will be present in the policy text itself.

[cherylandtk]

---see below

Edited March 12, 2014 by cherylandtk

[cherylandtk]

The poster is from Great Britain and their policies are WAY different from what we have here in the US.

Ah, I thought it says Pennsylvania??:confused:

 

Eta- oK, now I see what you mean; it looks like I was responding to the prior post....which perhaps did influence the wording. Let me modify: Deenkid, your HBP will be evaluated as to whether or not it is/was a PEC only after you file a claim. If you don't file, there is no determination. Many people assume their conditions will be excluded as stable, but any minor change, routine visit to the Dr., etc. can be used to exclude it after a claim is filed. Because of that, many people prefer to obtian their waiver by purchasing within the waiver period, rather than fight the stable claim later.

 

Is that better? :)

Edited March 12, 2014 by cherylandtk