When I think of pre-existing medical conditions and travel insurance, Richard Cutler’s case comes to mind. After a flare-up of his arthritic condition, “which made my hands, wrists and feet swell,” he says he had to cancel a recent American Airlines flight.
Cutler asked American for his money back. But it refused, citing its strict refund policies.
Would travel insurance have helped him? Maybe, maybe not.
That’s because many travel insurance policies exclude pre-existing medical conditions like the one Cutler had. Some insurance companies offer a waiver of the pre-existing condition exclusion, but only if you buy your trip insurance plan within a specified number of days from the date you pay your initial trip deposit.
But there’s a new development in the travel insurance space that could mean good news for people like Cutler. Some insurance companies, including those that cater to visitors to the United States, are relaxing their pre-existing conditions exclusions.
As a result, travel insurance might now cover you in ways you don’t expect. But you still have to be careful to read the fine print in your insurance policy, because yes, things are also getting more complicated.
“When it comes to travel insurance, it is really important to read your contract so you know what it covers,” says Chris Abrams, owner of Abrams Insurance Solutions. “There are big differences in how each travel insurance company will treat pre-existing conditions. Some insurance companies limit or deny coverage for these conditions. And some companies consider any health history a pre-existing condition, no matter how long ago it occurred.”
How to get a full refund, despite a pre-existing medical condition
Cutler, an attorney from Sacramento, Calif., had spent about $1,500 on airline tickets for his two daughters and himself. When his arthritis flared up, he says he contacted American and received only a generic reply thanking him “for taking the time to inform us of your concerns.”
“We apologize that your request was not resolved to your satisfaction,” the airline continued. “However, the matter was given every consideration and we are unable to provide the resolution requested.”
Cutler appealed to one of the American Airlines executives listed on my consumer advocacy site.
“I’ve followed the chain but have not heard anything back,” he told me.
Cutler’s case was difficult because any insurance he purchased through the airline wouldn’t have covered him.
In the end, the executive contacts proved useful. A customer service manager overturned the airline’s decision and offered him a full refund — a happy ending for Cutler.
What’s changing, when it comes to pre-existing conditions and travel insurance?
Travel insurance is changing, but slowly. It’s true that for many years, the travel insurance industry has offered a waiver of the pre-existing condition exclusion if you buy your trip insurance plan before you travel. Other restrictions apply, too.
“Most people are not aware that they can get travel insurance coverage for pre-existing conditions,” says Stan Sandberg, co-founder of TravelInsurance.com, a travel insurance site. “In general, travel insurance plans that offer a pre-existing condition exclusion waiver — meaning pre-existing conditions will be covered — require that you purchase the plan within a set amount of days from your initial trip payment or deposit date, usually 14 to 21 days, that you insure 100% of your prepaid and nonrefundable trip costs and you are medically fit to travel at the time of purchasing the plan.”
But there’s now a new twist, say experts.
“Recently, we’ve seen a couple of plans that now allow consumers to buy a trip insurance plan within 24 hours of the date you make final payment for the trip,” says Justin Tysdal, CEO of Seven Corners, a travel insurance site.
Some companies that offer visitors insurance are also loosening their restrictions on pre-existing medical conditions. INF Health Care, for example, broadened its policies to cover more than what’s known as acute onset of pre-existing conditions, which has a narrow definition and only cover an emergency.
“Our plans are liberal in the sense we cover all pre-existing conditions,” says PK Rao, INF Health Care’s president. “This is beneficial for those who may need to seek outpatient care, like urgent care, a doctor’s visit or specialist care, during their stay.”
A survey of more than 8,000 INF members who purchased Rao’s plans in the last six months found that 82% said that preventing a sizable medical bill because of pre-existing conditions was their top reason for buying travel insurance.
When pre-existing medical coverage works
Nikki Mantri knows the feeling. Her parents were visiting her in Boston, and as a precaution, they bought a policy through INF Health Care.
“My mom is hypertensive and my dad has a history of diabetes and heart issues,” says Mantri, an automation engineer from Boston. “I never really considered visitor’s insurance until one of my colleagues recommended I get some due to his own experience.”
Good thing, too.
“While my parents were here, my dad started complaining about shortness of breath and ankle pain,” she says. “I took him to the ER, where he was diagnosed with diabetic nephropathy. Doctors said that he has small nodules in his kidney and that have to be removed. ”
INF paid around $13,000 in claims for the hospital charges, blood tests, medications, and appointments with the urologist, leaving the family with about $4,000 in expenses.
“You never know when one of these pre-existing conditions can worsen and cost you a lot of money,” says Mantri.
Why insurance companies are changing
Why the change? Consumers want it more inclusive coverage for moderate to severe pre-existing conditions, according to Zeshan Jeewanjee, CEO of Go One Global, a company that specializes in visitor’s insurance.
“There are plans currently available that cover the acute onset of pre-existing conditions, which is a sudden and unexpected recurrence of a pre-existing condition that happens without warning,” he says. “Almost all plans still exclude chronic and congenial pre-existing conditions.”
Insurance companies can cover these conditions because of big data, he says. The insurance industry can predict the likelihood of treatment costs and claims percentages, so underwriters now offer plans that will cover more types of pre-existing conditions, such as types of cancer.
“This would never be covered in previous years, but we are seeing this type of well-rounded coverage occur more frequently as travel becomes easier and more accessible for all, and demand for international coverage grows,” says Jeewanjee.
Pre-existing conditions can get a little complicated
What exactly does travel insurance cover, when it comes to pre-existing conditions? Abrams, the owner of Abrams Insurance Solutions, says it’s complicated.
“There are big differences in how each travel insurance company will treat pre-existing conditions,” he says. “It’s really important to read your contract so you know what it covers.”
For example, one company might define pre-existing as any illness or condition that existed at the time of application or at any time before the effective date, whether or not previously manifested, symptomatic or known, diagnosed, treated, or disclosed to the company before the effective date. Another might define it as a condition that was treated or diagnosed by a legally qualified physician occurring within six months before the coverage date for the insured.
“Read the fine print in your policy,” he advises.
Some pre-existing conditions still aren’t covered
No matter how much insurance companies loosen their policies, some conditions will never be covered, say experts. “Pregnancy and mental health are almost always excluded,” says Sheryl Hill, executive director of Depart Smart, an educational nonprofit organization.
All the more reason study insurance policies before you buy one. Yes, the small changes happening in the pre-existing conditions clause could save your next vacation, but they won’t if you don’t know about them.
Tullia Marcolongo, the executive director of the International Association for Medical Assistance to Travellers (IAMAT), echoes Abrams’ advice.
“Always read the fine print of your insurance policy to ensure that the plan adequately covers your health status, including any pre-existing conditions, and the activities you will be doing at your destination,” she says. “You may discover that the plan you want to buy or your existing coverage — provided by your credit card, for example — is not the right one if you have a pre-existing condition.”
For travelers, this is mostly good news. I’ve lost count of the number of travelers who weren’t covered because of a pre-existing conditions clause and lost a trip. I probably have hundreds of stories on my consumer advocacy site.
Maybe insurance companies are finally starting to understand that their customers want everything — including their medical conditions — covered when they travel.