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When Does Travel Insurance Cover Existing Medical Conditions?

pre-existing medical conditions

A travel insurance plan can save your travel investment if you must cancel your trip for a covered health-related reason caused by an existing medical condition. It also can cover the costs of medical care for a covered illness or injury while you’re traveling, even if that medical emergency is caused by a pre-existing condition.

But in order for this to happen, you’ll need to select a plan that offers a Pre-Existing Medical Condition Exclusion Waiver, and also meet the requirements for that waiver. We’ll explain how this works, so you can make sure your existing medical condition is covered.

What is an existing medical condition?

Quite simply, an existing medical condition is an injury, illness, or medical condition that, within the 120 days prior to and including the date you purchased your policy:

  1. Caused a person to seek medical examination, diagnosis, care, or treatment by a doctor;
  2. Presented symptoms; or
  3. Required a person to take medication prescribed by a doctor (unless the condition or symptoms are controlled by that prescription, and the prescription has not changed).

Note that you don’t need an official medical diagnosis from a physician for something to be considered an existing condition.

How to meet conditions for a Pre-Existing Condition Exclusion Waiver

We know that the term is a mouthful. But the conditions needed to qualify for a Pre-Existing Condition Exclusion Waiver are fairly straightforward. You must be a U.S. resident and:

  • Purchase your policy within 14 days (or the time period specified in your plan) of the date of the first non-refundable trip payment or deposit;
  • Be medically able to travel when the policy was purchased; and
  • Insure your full nonrefundable trip costs on the policy purchase date.

We’re going to cover each of these requirements in more depth below.

1. Travel insurance only covers existing medical conditions if you buy your plan within 14 days (or the time period specified in your plan) of making your first trip payment or deposit.

Example: You and your husband are both nature lovers, and to celebrate your 25th anniversary you're planning a two-week stay at a luxury eco-resort in Costa Rica. You buy travel insurance to protect your trip investment, but not until three weeks after the trip purchase. Because you waited, existing medical conditions aren't covered. No problem, you think. You're both fit and healthy. Except your husband has had some urinary problems over the past few months, so you make him go to the urologist before the trip. Bad news: he has a prostate condition that will keep him grounded. It's treatable, but you'll have to cancel the trip. Is this trip cancellation covered?

For Allianz Travel Insurance plans, an existing medical condition is defined as an illness or injury that exhibited symptoms or was treated any time 120 days prior to purchasing your plan. In this instance, your trip cancellation due to an existing medical condition would have been covered if you had bought travel insurance within 14 days of paying your first trip deposit.

2. For travel insurance to cover your existing condition, you must be medically able to travel on the day you purchase your plan.

Example: After suffering debilitating pain in your left knee for three years, you've finally scheduled a total knee replacement. You get the procedure done and find that your recovery goes more swiftly than expected. After two weeks of physical therapy, your doctor says she's amazed at your progress. So you book a cycling trip through the French Alps for the fall, and you purchase travel insurance to protect it. If you suffer knee problems and you have to cancel the trip, are you covered?

With an existing medical condition, the safest course of action is to get your physician's certification that you're fine to travel before you book your trip. Allianz Global Assistance requires you to be medically able to travel on the day you buy your plan. It doesn't matter if you expect to be able to travel in the future, or if your doctor says you should be able to travel by the time you're scheduled to leave.

Let's say you book that cycling trip and buy your travel insurance 12 weeks after your surgery, when you're feeling pretty good and you can take long walks around the neighborhood. Don't assume you're medically able to travel. If you end up making a travel insurance claim related to your knee, Allianz Global Assistance may review your medical records and talk to your physician to determine your condition at the time you bought insurance.

One more important thing to understand: the "medically able to travel" only applies to the people named in the insurance plan. If your mother has uncontrolled diabetes, for instance, you need existing medical condition coverage in case you need to cancel your trip because she's in the hospital. But your mother does not need to be medically able to travel in order for you to be covered.

3. For an existing medical condition to be covered, you must insure your full nonrefundable trip costs on the day you purchase your plan. Additional trip costs must be insured within 14 days of purchase.

Example: You just booked the trip of a lifetime, a two-week European river cruise with your sister. You hold out on buying your plane ticket, however, because you're hoping airfares to Paris will drop. A few weeks later, you grab that cheap ticket. Whew! You update your travel insurance plan by adding the airfare cost to your coverage. Then, a week before departure, you’re hospitalized with diverticulitis—a recurring condition you’ve had in the past. Will travel insurance cover your trip cancellation that was caused by an existing medical condition?

In this case, yes. While you didn’t insure the full trip costs on the plan purchase date, you did add them to your plan as soon as you were able.

If you incur additional non-refundable trip costs after buying your travel insurance plan, you must insure them within 14 days of their purchase. The same applies if any trip expenses that were refundable become non-refundable or subject to cancellation penalties. If that’s the case, you must insure those additional expenses with us within 14 days of the change.

Three more things you need to know about travel insurance and existing medical conditions

  • General exclusions still apply. Read the exclusions listed in your specific plan, so you understand what kinds of medical conditions and other situations aren’t covered.
  • Your trip cancellation and trip interruption benefits have specific coverage limits for losses due to pre-existing conditions. For example, OneTrip Prime has a maximum limit of $100,000 (per person) for trip cancellation. However, the plan can only reimburse up to $50,000 (per person) for a loss caused by an existing medical condition.
  • You must be a U.S. resident to buy travel insurance with existing medical condition coverage.

We encourage customers to contact our insurance advisers at 1-866-884-3556. They'll answer your questions and help you find the travel insurance plan that's best for your needs. Safe travels!

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