How To Get Pre-Existing Conditions Covered By Travel Insurance

The federal Affordable Care Act, commonly called Obamacare, prohibits health insurance companies in the U.S. from refusing coverage or bumping up insurance premiums because you have a pre-existing condition. Travel insurance policies don’t fall under this law.

However, a feature of a travel insurance policy known as a “pre-existing medical condition exclusion waiver” could let you, for instance, cancel a trip due to a flare up of an existing condition and then be reimbursed for nonrefundable travel costs.

How Do Travel Insurers Define A Pre-Existing Condition?

Travel insurance companies normally exclude pre-existing conditions from coverage. These conditions rank among the most frequent reasons for denial of travel insurance claims.

In the world of travel insurance, a pre-existing condition refers to an injury, illness or medical condition that prompted someone to seek treatment, experience symptoms or take medication before buying the travel insurance policy, according to travel insurance provider Allianz Travel.

To determine what qualifies as a pre-existing condition, an insurer looks back 60 to 180 days before the day the policy was purchased, says Squaremouth, a travel insurance provider. If a traveler had any changes in their medical status during that period, such as a new diagnosis, a decline in health or the addition of new prescription medication, the condition will be considered pre-existing.

Allianz Travel notes that you don’t need an official diagnosis from a health care professional to have something designated a pre-existing condition for travel insurance purposes.

How Can You Get a Waiver for a Pre-Existing Condition?

You can generally get a pre-existing medical condition exclusion waiver only within 14 to 21 days of making an initial deposit for a trip and after insuring the full nonrefundable costs of a trip. So it’s really best to buy your travel insurance immediately after booking your trip, making sure the policy includes the exclusion waiver.

A pre-existing condition waiver might even take effect if a non-traveling member falls ill or dies and the insured traveler must cancel or cut short a trip.

If you meet various eligibility requirements, such as being “medically stable” to travel when your policy is purchased, the insurance company won’t charge extra for a waiver. Most travel insurance policies don’t impose an age limit.

Common claims tied to a pre-existing condition include emergency medical care, emergency medical evacuation, trip cancellation, trip interruption and travel delay.

Here are three possible scenarios where a pre-existing condition exclusion waiver could be used:

  1. Pre-existing arthritis that brings a halt to your plans for Antarctic excursion
  2. Mild heart attack suffered while exploring China after being diagnosed with coronary artery disease
  3. Flare-up of pre-existing lupus while you’re on a Caribbean cruise

Without a waiver, a travel insurer won’t pay for medical bills or claims related to your recent medical history, such as high blood pressure or asthma. With a waiver, a travel insurance company can’t examine your recent medical records when it’s reviewing a medical claim.

Pre-Existing Conditions Not Eligible for a Waiver

Even with a waiver, some medical scenarios still likely won’t be covered by travel insurance. These include:

  • Alzheimer’s disease
  • Dementia
  • Anxiety
  • Depression
  • Pandemic
  • Illness or injury related to alcohol or drug abuse
  • Complication-free pregnancy or childbirth

Some high-dollar trips (perhaps $50,000 or more) also may be ineligible for pre-existing condition waivers.

Be sure to carefully read your travel insurance policy to see what’s covered and what’s not when it comes to pre-existing conditions. Also, be aware of the policy’s limits for travel medical insurance and medical evacuation coverage, to avoid any surprises.

More from Forbes Advisor