What qualifies as a "preexisting condition" for insurance?

[markwfpb]

Hi, 

I've searched through past posts but they're mostly about very specific conditions/situations.

I'm wanting to know if I need to purchase travel insurance now or can wait till closer to final payment?

It seems like the only negative to not purchasing with 2 weeks of first payment is that preexisting conditions aren't covered.

But even talking with a travel insurance agent, I still don't understand what that means.

It seems like everyone has some chronic condition or another (diabetic, heart problems, cancer, etc.) and wouldn't be covered.

Or does preexisting condition mean something that is actively an issue - uncontrolled diabetes, recent heart attack, just finishing chemo, etc.?

Thanks for any clarity you can provide!

 

 

 

 

[GeezerCouple]

37 minutes ago, markwfpb said:

Hi, 

I've searched through past posts but they're mostly about very specific conditions/situations.

I'm wanting to know if I need to purchase travel insurance now or can wait till closer to final payment?

It seems like the only negative to not purchasing with 2 weeks of first payment is that preexisting conditions aren't covered.

But even talking with a travel insurance agent, I still don't understand what that means.

It seems like everyone has some chronic condition or another (diabetic, heart problems, cancer, etc.) and wouldn't be covered.

Or does preexisting condition mean something that is actively an issue - uncontrolled diabetes, recent heart attack, just finishing chemo, etc.?

Thanks for any clarity you can provide!

Speak with the travel insurer, or better yet, a broker working with several travel insurers.  (Many of us here use Steve at www.TripInsuranceStore.com - he may chime in here!)

 

"Pre-existing conditions" are defined very specifically in the travel insurance terms and conditions, and they are usually NOT the same as what we think of in "regular life".  And the specifics may vary from policy to policy, so please don't rely upon examples provided by other travelers.  Their "terms" may not be the same as in a policy that *you* purchase.

 

And not having pre-existing conditions covered, if that's relevant, can be a huge problem for some.  But again, it depends upon your specifics and the policy specifics.

 

GC

[klfrodo]

I would link it to you but I’m on my phone. If you go to www.TripInsuranceStore.com and look under the FAQ tab, you find a definition or explanation as to pre-existing condition.

 

Also know that the pre-existing condition clause can protect your trip if non-traveling family members get ill or worse and you have to cancel your trip or fly home early due to their pre-existing condition.

[klfrodo]

Here's the link. And remember, it also applies to non-traveling family members. So, if mom, dad, grandma, grandpa, aunty, uncle, brother, sister etc, get hospitalized or pass away and require you to cancel or terminate your travel, any of their pre-existing conditions may count towards whether the claim might be denied. The insurance company might/will review their medical records. You have the right to deny them access to the medical records, but they also have the right to deny the claim. (This is for US. Other countries may have differing laws/regulations.)

 

How Travel Insurance Pre-Existing Medical Condition Coverage Works « Get the Best Trip Insurance Details, Advice (tripinsurancestore.com)

[markwfpb]

Thanks to you both - this helps clarify it for me. And I think we're good - neither of us nor family members have had a major change in years. 

[CDNPolar]

Just think this way.

 

Any medical condition that you have, controlled or not, can be considered a pre-existing condition.

 

What is key is understanding the stability period that is required for your medical or cancellation insurance to be valid with a pre-existing condition.

 

You may have a heart condition that you take a beta blocker for and you have been taking the same dose and same medication for 3 years and you are perfectly stable in that condition.  This is nothing to worry about - you go - you travel - and all is good.

 

This heart condition can become an unstable pre-existing condition in the eyes of the insurance company if:

 

1) There are new symptoms and you have talked to your doctor about this

2) There are tests ordered or scheduled, or results are pending from tests

3) Medication is increased, decreased, or stopped

4) New medication is prescribed that you have not taken before

 

There are so many elements to pre-existing conditions including some very vague language such as:  "at the time of booking it was not reasonable to believe that something would happen medically" and many other statements like that.

 

Consider that you buy insurance both medical and cancellation.  Before you are set to go, something happens to you medically and you cancel, the insurance company is going to get your medical records, and if they can prove that you bought the trip with an "unstable" condition and it could have been reasonably expected that something could or would go wrong, they won't pay out.

 

Just buying insurance at the point of making your first payment does not always cover all pre-existing conditions under every circumstance.  Every insurance company policy is going to be different.

[Coral]

20 hours ago, markwfpb said:

Thanks to you both - this helps clarify it for me. And I think we're good - neither of us nor family members have had a major change in years. 

Though what happens if next week, someone is diagnosed with something. Just because they don't have anything now doesn't mean that next week they may not get diagnosed. It can simply be blood pressure. 

 

Once it is diagnosed, you would wish you would have bought it before that diagnosis.

Edited June 29 by Coral

[CDNPolar]

On 6/29/2024 at 9:22 AM, Coral said:

Though what happens if next week, someone is diagnosed with something. Just because they don't have anything now doesn't mean that next week they may not get diagnosed. It can simply be blood pressure. 

 

Once it is diagnosed, you would wish you would have bought it before that diagnosis.

 

This is where "Pre-existing" comes down to definition.

 

What was "pre-existing" when you bought the policy.

 

If you buy the policy today, and lets assume that everything that you have pre-existing or not is stable.

 

If in two weeks you have symptoms, go to the doctor, and a new condition is diagnosed then you are 100% covered for cancelation before the trip leaves.

 

Anything can happen after buying, it is what is in your medical records before buying.  If that condition that was just diagnosed was found as noted in your medical file 6 months prior, then you would be in trouble.  If brand new, you would be covered at least for cancellation.

[Coral]

6 minutes ago, CDNPolar said:

 

This is where "Pre-existing" comes down to definition.

 

What was "pre-existing" when you bought the policy.

 

If you buy the policy today, and lets assume that everything that you have pre-existing or not is stable.

 

If in two weeks you have symptoms, go to the doctor, and a new condition is diagnosed then you are 100% covered for cancelation before the trip leaves.

 

Anything can happen after buying, it is what is in your medical records before buying.  If that condition that was just diagnosed was found as noted in your medical file 6 months prior, then you would be in trouble.  If brand new, you would be covered at least for cancellation.

Correct. I was simply saying if you don't have pre-existing conditions now and decide to wait until final payment to buy insurance at final payment, it may be too late. No one knows what will happen tomorrow.

 

We were saying the same thing.

Edited June 30 by Coral

[CDNPolar]

Just now, Coral said:

Correct. I was simply saying if you don't have pre-existing conditions now and decide to wait until final payment to buy insurance at final payment, it may be too late. No one knows what will happen tomorrow.

 

We were saying the same thing.

 

Gotcha.... obviously mis-read.... sorry.

[emdia43]

Is there an affordable way to buy coverage for pre existing conditions? 

[CDNPolar]

On 8/13/2024 at 12:09 PM, emdia43 said:

Is there an affordable way to buy coverage for pre existing conditions? 

 

Sorry - no quick and easy answer to that.

 

Depends on:

1) Age

2) Type of condition

3) Stability of condition which includes new meds, change in meds, stoping meds, tests recommended, test results outstanding, and other things.

4) Whether you have to go through underwriting and do a medical questionnaire. 

 

Most pre-existing (most) have requirements that the condition be stable for 3 months prior to departure for cancellation, and 6 months prior to departure if you are going to potentially rely on the medical portion while travelling.

 

Manulife has a plan called the "Premium Protection Plan" that basically covers everything and anything, but you MUST purchase within 72 hours of booking and paying any deposit.  Even if you only paid $50 bucks in deposit but that was more than 72 hours ago, then you cannot buy this policy.

 

Manulife have other packages that cover pre-existing but you will have to call them and go through the process to find out what it will cost.

 

The pre-existing condition policies are not cheap, but in the grand scheme of things, if there is possibility of something happening, you don't want to be caught without proper coverage OR find out that it is not covered.

 

Also, note that not every policy will pay every hospital/doctor/clinic directly.  You may have to pay out of pocket and be reimbursed.

[GeezerCouple]

45 minutes ago, CDNPolar said:

 

Sorry - no quick and easy answer to that.

 

Depends on:

1) Age

2) Type of condition

3) Stability of condition which includes new meds, change in meds, stoping meds, tests recommended, test results outstanding, and other things.

4) Whether you have to go through underwriting and do a medical questionnaire. 

 

Most pre-existing (most) have requirements that the condition be stable for 3 months prior to departure for cancellation, and 6 months prior to departure if you are going to potentially rely on the medical portion while travelling.

 

Manulife has a plan called the "Premium Protection Plan" that basically covers everything and anything, but you MUST purchase within 72 hours of booking and paying any deposit.  Even if you only paid $50 bucks in deposit but that was more than 72 hours ago, then you cannot buy this policy.

 

Manulife have other packages that cover pre-existing but you will have to call them and go through the process to find out what it will cost.

 

The pre-existing condition policies are not cheap, but in the grand scheme of things, if there is possibility of something happening, you don't want to be caught without proper coverage OR find out that it is not covered.

 

Also, note that not every policy will pay every hospital/doctor/clinic directly.  You may have to pay out of pocket and be reimbursed.

 

On 8/13/2024 at 12:09 PM, emdia43 said:

Is there an affordable way to buy coverage for pre existing conditions? 

 

emdia43 is in the USA (Indiana), and the travel insurance policy terms seem to be quite different for USA vs. Canadian policies.

 

We (in the USA) usually don't have to pay extra for pre-existing condition coverage, IF one starts the policy within the required time period (which can vary from policy to policy, sometimes a lot).  Otherwise, that coverage just isn't available, or not from many major insurers.

[We've never encountered a plan that had a surcharge for pre-existing conditions, but we haven't tried to find any policies like that.  We get ours within a "window" to include pre-existing conditions.]

 

And you left out another criterion:

5. "How much" is considered "affordable".

The cost of the coverage can vary a lot, and might vary with the cost of the trip (some policies do, others less so), and each of us probably have our own thresholds of what is "affordable".

 

But emdia43 would probably benefit from calling a travel insurance agent or broker to ask about types of coverages and costs, rather than an open-ended question here.

 

GC

[Hlitner]

Those who work in the insurance industry will tell you "read the policy!"  Different policies (even issued by the same company) can have different rules and definitions.   And policies can (and do change) so it is important to review the policy language (including the definitions) before you purchase.  In fact, the same policy might have different language for residents of various States.

 

For those who do not want to take the time to read a policy, or who fear they might not be able to understand what they read, then the advice to seek out a decent broker is a good idea.  And that broker should be someone who specializes or truly understands travel/medical insurance.

 

Hank