What is a Pre-existing condition?

Photo By: Hui Quan Yang

Pre-existing condition

A chronic or long-term health condition that existed prior to your trip. Pre-existing conditions are generally excluded from coverage because they are not unforeseen or unexpected.

GOOD TO KNOW

Insurers generally define a pre-existing condition as:

  • A diagnosed illness, disease, disorder, injury, or other health issue for which you take prescription medication or are undergoing medical treatment at the time you purchased the plan.
  • A new medical condition or symptom, any new medical investigation, diagnosis, treatment, new medication, change in medication, or change in dosage prescribed between the day you purchase your policy and your date of departure.
  • A medical condition for which you have symptoms and require further investigation or a change in treatment as prescribed by your doctor, but a diagnosis has not yet been made.

IMPORTANT

You can get coverage for a pre-existing condition if it has been medically stable for a specific period of time (as determined by the insurer) before your departure date. All pre-existing conditions must be declared to the insurer.

If you file a claim for emergency treatment of your pre-existing condition, your insurer can access your medical file to determine if you were medically stable at the time of purchasing your plan. If there are inconsistencies or omissions on your application or medical questionnaire, your coverage will be voided.

ASK BEFORE YOU BUY

Do you have a plan that defines a pre-existing condition as one that has been diagnosed and that I am aware of?

Learn more in IAMAT’s Guide to Travel Health Insurance
  • Did you know?

    You are not covered if you need medical care or hospitalization as a result of drinking alcohol.

    The majority of travel health insurance plans exclude injuries resulting from alcohol consumption. Some plans do cover injuries related to alcohol use but you cannot exceed the maximum allowable blood alcohol levels.

  • Did you know?

    Your travel health insurance plan is a legal contract. When you purchase a policy, you have to adhere to the terms set out within that specific policy for the insurer to fulfill their obligation to provide coverage.

    Remember that insurance only covers you for unforeseen and unexpected events – an unstable pre-existing condition or participating in activities that can increase your risk for personal harm or injury put your coverage at risk.

  • Did you know?

    Medical questionnaires are required to be completed at the time of purchase if you are over a certain age (typically over 60) or have a pre-existing condition. These forms can be complex and include medical jargon. If you need help, ask the insurance provider for clarification. Many insurers also want your doctor to sign off on the medical questionnaire.

    If you file a claim, insurers will look closely at the answers on your medical questionnaire to see if they match your medical file before accepting your claim.

  • Did you know?

    Mental health coverage is excluded from most standard travel health plans.

    If you have a first time mental health event or need care for a pre-existing psychiatric condition, you will have to pay out-of-pocket for medical services and prescription medication you need abroad.

  • Did you know?

    If your existing insurance benefits plan or credit card (primary coverage) doesn’t fully or adequately cover you for your health condition, you will need to get supplemental or secondary coverage (also known as excess insurance).

    This additional plan pays for medical expenses after your existing or primary coverage has reached the payout limits. The secondary insurer pays the balance of your medical costs.

Photo By: Sharif Hossain Sourav