What is a pre-existing condition exclusion on your travel insurance policy?

If you have ever bought a travel insurance policy, you have likely heard about a pre-existing condition exclusion. It is a key exclusion on almost all travel insurance policies and some health insurance policies.

If you are not used to reading insurance contracts, this exclusion can be confusing. This exclusion is especially important for older travelers, snowbirds, and those seeking super visa insurance, as it can significantly limit coverage if not properly understood.

What is a pre-existing medical condition?

It is any medical condition (major or minor) that existed before the insured bought their policy and requires treatment or monitoring. This includes conditions for which the insured is:

• Receiving treatment or therapy
• Prescribed medication (regardless of whether they are currently taking the medication)
• Undergoing diagnostic tests or investigations (blood tests, X-rays etc.)
• Awaiting surgery or specialist appointments

Most plans will only cover pre-existing medical conditions that they consider to be ‘stable’.

A condition is typically considered stable if:

• It does not require a change in treatment
• There have been no changes in medication (including dosage)
• No new symptoms, treatments, or investigations have occurred
• No pending or recommended surgeries or specialist referrals exist

If there are any changes—such as starting, stopping, reducing or adjusting medication, or new symptoms—during the stability period, that condition will be excluded from coverage

Insurers ask to confirm the stability of a pre-existing condition for a specified period, sometimes called the ‘stability period’ prior to effective date of the policy. The stability period can range from 60 to 365 days, depending on the insured’s age, condition, and insurer. More severe conditions or advanced ages have a longer stability period required by the contract.

Let’s review coverage for Neil whose policy stipulates a stability period of 180 days

Neil, age 67, plans to visit his son in Canada. He has high blood pressure, controlled by medication, with no changes in the last 180 days—so his condition is considered stable and is covered. However, he was also recently diagnosed with asthma and started a new medication within the last 180 days. His asthma is not considered stable and would not be covered by his policy.

While Neil’s high blood pressure is covered because it is stable, it is still a pre-existing condition. Neil needs to disclose it on his application. Not disclosing it on his application could give reason to the insurer to void his contract.

Key Takeaways

• Always disclose all pre-existing conditions when applying for insurance. Failure to do so can void your policy
• Carefully review the definitions of any medical conditions that impact you and the stability clause in your policy documents.
• For older travelers or those with chronic conditions, ensuring your medical history meets the stability requirements is crucial for peace of mind

If you are buying a travel or supervise insurance policy for your parents or elderly relatives, make sure you read and understand the pre-existing conditions exclusion and stability clause in their policy. Having the right policy will ensure that they are covered in case of an emergency and enjoy their stay worry-free.

Contact me if you have questions or need help finding the right travel insurance policy.