Pre-Existing Condition Question

[sail7seas]

I have been reading lots of policy descriptions and when evaluating pre-existing most say the insured cannot have had tests, treatment, doctor's visits, change in Rx etc for a stated look back period and I understand that.

 

What I am confused about is if the insured had a test and the results were good. No treatment needed, no Rx, no problems found..... Would just having the test disqualify them for pre-existing coverage?

 

Thank you if you can help.

[sirwired]

If you saw a doctor for a routine checkup, and nothing was found, you have nothing to worry about.

 

But if you saw a doctor for sharp stomach pains, he/she didn't find anything at the time, but it later turns out that it was probably due to a bleeding ulcer that you discover the hard way a week before departure, that's going to trigger a pre-ex. Most of the policies talk about having "symptoms that would cause a prudent person to seek medical treatment." (As in, no buying insurance, and then heading to the ER at 12:01 the next morning...) It doesn't matter when you actually see a doctor about them (or when the doctor chooses to do anything); rather it matters when the symptoms started.

[sail7seas]

Perfect. Thank you.

 

It was routine check up and common, usual tests which showed no problems.

[KyleClark]

But if he has the waiver and something was found during his exam he is covered right?

[sail7seas]

But if he has the waiver and something was found during his exam he is covered right?

 

 

 

The insured has to be fit to travel on the date they write the insurance.. Would that person have been deemed healthy to travel?

Edited July 4, 2014 by sail7seas

[KyleClark]

The insured has to be fit to travel on the date they write the insurance.. Would that person have been deemed healthy to travel?

 

Lets say he was deemed healthy to travel. Lets change the scenario. Say he went to the doctor for pain in his knee. He already purchased the trip insurance with a pre-existing conditon waiver. He goes on the cruise and he further injures his knee due to the extensive walking. He goes to the ship doctor. Would the insurance cover this visit and any other subsequent visits once he is back on land? I am trying to get my head wrapped around how this waiver works. I am trying determine if I should buy it right away with the waiver.

[cherylandtk]

<snip>I am trying determine if I should buy it right away with the waiver.

You are almost always better off to buy a policy with the waiver than without. The price is the same, it is just a matter of timing, and unless you end up canceling the trip and not needing the coverage after all, you haven't lost anything by purchasing early but have gained coverage for the entire time from purchase to the trip, including any new or worsening medical conditions or accidents that may occur. Even if you cancel the trip without a loss you can often transfer the coverage to a later trip (some providers are easier about this than others).

 

Your specific scenario has many variables; is this a primary or secondary policy, is the scenario ongoing care substantially different than what is currently ongoing for the PEC knee condition, when did the knee pain originally start, what treatment was needed for the worsened pain due to excess walking, was there an actual knee injury, when did it happen and when was it diagnosed? Some of those questions are eliminated if you have a waiver, some are not.

Edited July 6, 2014 by cherylandtk