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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.
