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Understanding Pre-Existing Conditions

Dec 19, 2016 (0) comment

Understanding Pre-Existing Conditions

To understand how your coverage would respond to a claim, it is important to understand what a pre-existing condition is and how it relates to your medical history. The following discussion outlines what a pre-existing condition is, how it relates to a travel insurance policy, common misconceptions, and why a licensed broker is your best resource when purchasing a travel insurance policy.

 

What is a Pre-Existing Condition?

A Pre-Existing Condition* is a medical condition for which treatment has been received or taken or which exhibited symptoms, before the policy start date and within the period specified, and includes a medically recognized complication or recurrence of a medical condition.

    • For example, if a policy has a stability period of 90 days and during those 90 days the insured is diagnosed and treated for high blood pressure, this condition would be excluded during the upcoming trip, as it was not stable and controlled for the 90 days prior to the departure date. In short, if you’ve visited the doctor during the stability period, be sure to tell your insurance broker and provide details about the visit.

Stable and Controlled* means the medical condition is not worsening and there has been no alteration in any medication for the condition or its usage or dosage, nor any treatment, prescribed or recommended by a physician or received within the period specified in the policy, before the policy start date.

    • In other words, if the insured has had a change in medication (new prescription, increase/decrease or discontinuation), experienced a new medical condition, had an existing condition recur, or has any pending test or treatments, the associated condition would be not be considered stable and controlled under the policy and therefore not covered under the given policy.

*These are typical definitions for Travelance policies and in this blog post are used for illustrative purposes only. Definitions and coverages vary by provider. Please read policy wordings carefully for details.

 

Why is it important to understand the definition of pre-existing condition as it relates to your policy?

Policies that provide coverage for pre-existing conditions may require a condition to be stable and controlled for a specified period before the insured’s departure date for the coverage to be available. Check with a licensed insurance broker for the stability periods outlined in your policy.

If you have any pre-existing conditions, be sure to mention them to your broker so they can help you find a policy that meets your needs.


What are some common misconceptions about travel insurance and pre-existing conditions?

Physician’s Approval

It is a common misconception that if a doctor approves a patient’s travel plans the patient will be covered under a travel insurance policy. Unfortunately, a physician’s approval to travel does not necessarily mean coverage for a medical condition will be provided under the terms and conditions of a given travel insurance policy.

Adjustment to Medication

Another common misconception is that when a person’s health improves, they will be covered under a travel insurance policy. This may not be the case. For example, if a physician changes the dosage of a prescribed medication during the stability period, the condition associated with that medication is no longer stable and controlled. Therefore, coverage for that condition will not be available. Changes in dosage include an increase, a decrease, the prescription of a new medication, and even discontinuation of a medication.

Have a thorough and honest discussion with your licensed insurance broker regarding your medical history before you purchase emergency medical travel insurance. Be sure to disclose all of your medical conditions, read the policy wording, and ask your broker questions.

Please note, your broker is not a medical professional. If you are not sure about your medical history or medical condition(s), speak to your doctor.


Don’t be Afraid to Ask Your Broker Questions

Your broker is your best resource when it comes to understanding policy benefits, definitions, exclusions, limitations, terms, and conditions. They have the experience and knowledge to guide you through your travel insurance policy. If there is something in your policy you don’t understand, don’t hesitate to ask your broker or contact the insurance company.

Having the right insurance plan will help you to travel with better peace of mind. For more information on travel insurance in Canada or to find a licensed broker in your area, contact Travelance online or call 1-855-566-8555.

Last updated: June 30, 2017

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