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In general, pre-existing medical conditions aren't covered under travel medical insurance for foreign nationals visiting the United States. Pre-existing conditions are ongoing medical conditions you are being treated for under a physicians care. So it is important to know how to determine which international travel medical insurance policies will meet your specific needs. We also have plans that offer more options to those with prior injuries or medical conditions. .
What Qualifies as a Pre-Existing Condition in Travel Medical Insurance?
A pre-existing condition in travel medical insurance is any health issue that existed before your policy's effective date. Insurance providers typically examine your medical history within a specific "look-back period" (usually 60-180 days) to determine what conditions are pre-existing.
Common examples include:
- Cardiovascular conditions (heart disease, high blood pressure)
- Diabetes
- Cancer (current or in remission)
- Respiratory conditions (asthma, COPD)
- Autoimmune disorders
- Recent surgeries
Even well-controlled conditions with minimal symptoms may still qualify as pre-existing conditions from an insurance perspective if they required medical attention, medication changes, or treatment during the look-back period.
How Do You Determine Which Conditions are Pre-Existing Medical Conditions for Travel Insurance?
In simple terms, any medical condition that existed before you secured your international travel insurance is a pre-existing condition.
There are three general ways a condition can be classified as a pre-existing condition:
1. Health history form
All new patients are required to fill out this form before seeing any doctor in the United States. The form seeks information about the general health history of the patient and makes it binding on the doctor to properly diagnose and treat the patient.
2. Attending physician's opinion
During the consultation, the doctor or physician may ask the patient specific questions about their health history for proper diagnosis and treatment. The information will be used by the doctor to form an opinion about the health history of the patient, including whether there was any pre-existing condition, and share the same with the travel insurance company.
3. Diagnosis & lab results
The doctor will send official Doctor Notes that include the diagnosis results for the patient to the travel insurance company if there's any relevant information with regard to a pre-existing condition.
What Travel Insurance for the US Actually Covers Pre-Existing Conditions?
Despite general exclusions, several travel medical insurance options provide some level of coverage for travelers with health concerns:
What Are the Best Plans for Visitors with Pre-Existing Conditions?
Traditionally, travel insurers have been reluctant to cover travelers with pre-existing conditions, as they are deemed too high a risk. But luckily there are some really strong specialized plans that cover pre-existing conditions:
The top choice plan for most is the INF Elite X plan. This is a comprehensive plan that has some of the strongest pre-existing condition coverage available.
If INF Elite X's coverage is too much for you, its sister plan, INF Premier X, is an excellent option for those alright with more limited coverage for their travel medical insurance.
Another good choice is ChoiceAmerica. Though the standard plan doesn't cover visitors with pre-existing conditions, you can purchase an add-on benefit rider.
Finally, a really strong option that many of our customers looking for pre-existing condition coverage for the US have leaned towards, is Visitors Protect.
How Do I Determine If My Specific Condition Is Covered?
To assess whether your particular health condition qualifies for coverage:
- Study the Policy's Definition: Examine exactly how the plan defines pre-existing conditions (definitions vary significantly between policies).
- Understand Acute Onset Parameters: If your plan includes acute onset coverage, know the specific requirements, exclusions, and benefit maximums.
- Check Age-Based Limitations: Many plans reduce or eliminate pre-existing condition coverage after certain age thresholds (sometime 70 and beyond).
- Review Condition-Specific Exclusions: Some plans explicitly exclude certain conditions regardless of stability (often cardiac conditions, cancer, or stroke).
- Consider the Look-Back Period: A shorter look-back period (60 days vs. 180 days) may mean fewer conditions qualify as pre-existing.
What To Do When Your Claim Is Denied Based on Pre-Existing Conditions?
You have the right to make an appeal on the matter by providing supporting evidence to contest the denial of the claim based on a pre-existing condition. The evidence can include a recent physical (general health checkup) report or written statement from your family doctor, stating that this condition was under control or not existing before the start date of the current insurance.
Claim
A claim form can be obtained from the insurance company. File the claim within the specified period/date, generally within 90 days from the day the service was obtained. Follow up the process from time to time with the insurance company.
Claim tips
- Provide all the documents and/or information on time when requested by the travel insurance company to avoid delay and additional frustration.
- Some of the information and supporting documents might be requested from the doctor/hospital. The claim process can be delayed if the hospital or doctor doesn't send the requested information on time.
- It's a good idea to get a health checkup done prior to traveling to the United States. Those reports can be vital to support your claim.
The claim process might take time and effort on your part, but if it's a genuine case, you can be rest assured that your claims will be paid.
What Should You Do Before Getting Travel Medical Insurance for Pre-Existing Conditions?
Living with pre-existing medical conditions doesn't mean you can't travel internationally, but it does require careful planning and realistic expectations about insurance coverage.
Understanding the nuances of pre-existing condition coverage in travel medical insurance is essential for protecting yourself financially and ensuring access to necessary medical care abroad.
- Most travel medical insurance plans exclude routine care for pre-existing conditions but there are some specialized travel medical insurance plansavailable with strong pre-existing condition coverage.
- Thoroughly research insurance options designed specifically for travelers with pre-existing conditions, like INF Elite X, INF Premier X, ChoiceAmerica, and Visitors Protect.
- Document your medical stability before traveling to strengthen potential claims.
- Understand exactly how your chosen policy defines and handles pre-existing conditions, including any benefit limitations, age restrictions, and exclusions.
- Prepare for your trip by carrying adequate medication, medical documentation, and emergency contact information.
- If you need to file a claim, make sure to provide all the information requested to make the process go as smoothly as possible
By taking these steps and selecting appropriate coverage, you can travel with greater confidence knowing you've taken responsible measures to manage your health concerns while abroad.
However, if at any point you have any questions, don't hesitate to reach out to our Customer Success Team. Our team of licensed insurance specialists are here to walk you through whatever questions or concerns you have.
Frequently Asked Questions About Pre-Existing Conditions in Travel Medical Insurance
Can I purchase travel insurance if I've recently been hospitalized?
No, you should not. If you purchase travel insurance after hospitalization, your recent condition will be considered pre-existing and on-going. Therefore, you will not receive coverage for it, even if you purchased a pre-existing coverage plan. Travel insurance plans will not cover a medical condition or emergency contracted before the policy's start date. Even a pre-existing condition plan will only cover the unexpected and sudden worsening of a previous condition that you have been treated for and you have not received treatment for within the past 3-6 months.
If I have a pre-existing condition, should I just avoid declaring it?
No, failing to disclose pre-existing conditions is considered insurance fraud. Insurance companies investigate claims thoroughly, reviewing medical records that reveal your history. Non-disclosure can result in claim denials, policy cancellation, and being blacklisted by insurance providers.
If my pre-existing condition worsens due to an accident while traveling, will it be covered?
This situation falls into a gray area. If an accident causes your pre-existing condition to worsen, coverage depends on whether the insurance company determines the accident was the primary cause of your medical emergency or if your pre-existing condition contributed significantly. Documentation from treating physicians will be crucial in these cases.
Will my travel medical insurance cover me if I have a heart condition?
Most standard travel medical insurance plans exclude coverage for pre-existing heart conditions. However, plans with acute onset coverage might cover a sudden cardiac event if it meets the criteria for acute onset (sudden, unexpected, and requiring immediate treatment). Benefit limits are typically lower for cardiac conditions.
Can I get coverage for my diabetes while traveling?
Diabetes is generally considered a pre-existing condition. Routine care, insulin, and regular check-ups aren't covered. However, if you experience a sudden diabetes-related emergency that meets acute onset criteria, some plans will provide coverage up to the specified benefit limits.
How do I prove my condition was stable before traveling?
To demonstrate stability, gather medical records showing consistent treatment without changes, statements from your physician confirming stability, prescription records showing consistent medication, and results from recent check-ups indicating the condition was under control.
How can I find the best travel insurance for my specific pre-existing condition?
Look for insurance plans specializing in travel coverage for people with a health history, here are some of the best plans we recommend. Compare multiple policies, focusing on how each plan handles your specific condition. Consider consulting with an insurance broker experienced in helping travelers with medical concerns.
Will Medicare cover my pre-existing conditions while traveling internationally?
Original Medicare generally doesn't provide coverage outside the United States, regardless of whether conditions are pre-existing or new. Some Medicare Supplement (Medigap) plans offer limited foreign travel emergency coverage, but this is typically insufficient for comprehensive protection abroad. And, if you are a visitor to the US, you will not be qualified for Medicare coverage, regardless of your age or your family's residency status.
What is the difference between travel medical insurance and trip cancellation insurance for pre-existing conditions?
Travel medical insurance provides coverage for emergency medical expenses while traveling, with some coverage for pre-existing conditions (if you selected a specialized plan). Trip cancellation insurance may include a "pre-existing condition waiver" that allows you to cancel your trip for medical reasons related to pre-existing conditions. These are distinct types of coverage serving different purposes.
