Pre-Existing Health Conditions: Frequently Asked Questions

Pre-Existing Health Conditions: Frequently Asked Questions

When purchasing travel medical insurance with a pre-existing medical condition, it can be difficult to understand what care may be covered and what definitely won't be covered. Most visitor and travel insurance policies do not cover pre-existing conditions.

Here is a video that explains why pre-existing medical conditions are not covered by most travel insurance plans, and what visitors can do about it.

Travel Insurance Explained: Pre-Existing Conditions from VisitorsCoverage on Vimeo.

Q:

What are pre-existing conditions? How do insurance companies determine these conditions?

Generally, pre-existing conditions include all such medical or physical conditions that do not occur overnight, including high blood pressure, diabetes, AIDS, pregnancy, and any such condition, whether known or unknown. However, each visitor insurance plan has its own definition of what is considered a pre-existing condition, hence you are advised to read the policy documents carefully. Any injury, illness, or medical condition that meets any of the following criteria will be considered a pre-existing condition: 1) condition that requires you to seek medical advice, diagnosis, care, or treatment before the Effective Date of coverage under the policy, 2) condition for which manifestation, medical advice, diagnosis, care or treatment was recommended, received, or noticed prior to the Effective Date of coverage under the policy.

Q:

Who determines if it is a pre-existing condition?

The insurance company evaluates the attending physician's (doctor's and hospital's) statement, past and present medical records, history, and nature of treatment to determine if the condition is pre-existing. Learn more about the process and if/when you should contest a denial.

Q:

Why are pre-existing conditions not covered by most visitor insurance plans?

Travel or visitor insurance plans are short terms plans. The polices are meant to cover an insured person for any new conditions that may occur after the policy Effective Date. The insurance company will not cover for conditions the traveler knowing will have to undergo while traveling outside of their home country such as check-ups, dialysis and any other known and scheduled treatments and services.

Q:

Are there any travel insurance plans that do cover pre-existing conditions?

Yes. VisitorsCoverage offers USVisit-Pro or Visitors Protect travel medical insurance plans offer visitors to the U.S. coverage for certain pre-existing conditions and also provides benefits such as emergency evacuation. Should your condition worsen or you need to seek medical attention, these may be options that can help in those situations.

Q:

What is a Pre-existing Medical Conditions Waiver?

If you have a pre-existing medical condition, don't worry. When purchasing a travel medical policy, you'll want to look for a policy that includes a pre-existing medical conditions waiver. With this waver, you can cancel or interrupt your trip, or receive medical treatment. As long as the incident or sickness is tied to a pre-existing condition, you'll be covered.

Q:

Is it possible to get a regular check up or cover planned surgeries?

No, preventative care services like check-ups are not are not covered under the plans. Also, any known or preplanned treatment and services prior to the Effective Date such as surgeries will not be covered in the polices.

Q:

I want to have a vision/eye test and get new pair of eyeglasses. Is this covered in the insurance?

Depending on the plan purchased, you may be covered for emergency eye exams and covered for eyeglasses. Please read your policy terms and conditions carefully.

Q:

Is pregnancy and prenatal care covered?

Pregnancy and maternity related care are not covered in most travel insurance plans.

Q:

What is Acute Onset of a Pre-existing Condition?

An acute onset of a pre-existing condition is classified as a sudden and unexpected medical episode related to a pre-existing condition (either confirmed by a physician or by the obvious presence of symptoms).

Q:

What does Acute Onset of Pre-existing Coverage include?

Acute onset of pre-existing conditions benefits covers necessary emergency care for any medical emergency that's life-threatening or requires immediate medical treatment. It may also cover you for emergency medical transportation, emergency room costs, surgery, medications, etc. depending on the plan benefits you choose.