Medical Travel Insurance

Posted December 9th, 2013 and last modified July 3rd, 2014

Steps to get adequate travel medical insurance cover

If you are thinking of going on holiday – whether on a cruise, backpacking, or a family trip abroad – one of the trip essentials you need to consider is travel insurance. However, if you have a pre-existing medical condition, you might have already found out how difficult and expensive it is to get insurance cover. Each insurer will have their own set of criteria for assessing people with pre-existing medical conditions, so whether or not you are accepted for cover the price that you will pay can vary greatly between providers. This makes comparing quotes from a range of insurers essential for anyone that has pre-existing conditions and is interested in taking out cover. This guide will discuss how travel insurers assess different medical conditions.


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Treatment of travel insurance for pre existing medical conditions from Australian insurers

In the past, it was not uncommon for people with pre-existing medical conditions to be denied from taking out travel insurance as they were considered too great a risk to the insurer. With more and more travel insurance providers arriving on the market, intense competition among insurers now means people that may have been denied cover in the past or forced to pay exuberant amounts, can now find a policy at a reasonable rate. That said, if you do have a pre-existing medical condition that is not automatically covered under your policy, you will need to notify your insurer of the condition and may be required to pay a premium loading.


What exactly is a pre-existing medical condition in travel insurance?

Definitions around what a pre-existing medical condition is can vary between insurers so it is always worth checking prior to application how you will be assessed. Generally however, a pre-existing condition is:

  • An ongoing medical or dental condition that you are aware of/have been aware of
  • A medical or dental condition that is currently being investigated by an approved medical practitioner
  • A condition for which you take prescribed medication for
  • A condition that you have undertaken surgery for
  • A condition that you receive ongoing treatment for from a medical practitioner
  • Pregnancy

This definition is not only relevant to you as the policyholder but any other people that are listed under your contract of insurance such as spouse or dependent children.


How will my pre-existing medical condition be assessed?

Depending on the condition you have, an insurer will take one of four steps during the application process:

  1. Automatically accept you for cover
  2. Refuse your application
  3. Exclude claims related to the condition from cover under the policy
  4. Apply a premium loading to account for the additional risk

Medical conditions that are automatically covered under travel insurance policies

As stated previously, the conditions that will automatically be covered under a policy can vary greatly between insurers. As an example, below is a list of the type of conditions that may not require further assessment or result in a premium loading. It is worth noting that most insurers will require the applicant to have not been hospitalised for the condition for at least 24 months:

  • Acne
  • Common allergies
  • Asthma
  • Bell’s Palsy
  • Benign Positional Vertigo
  • Bunion
  • Carpal Tunnel Syndrome
  • Cataracts
  • Coeliac Disease
  • Congenital Blindness
  • Congenital Deafness
  • Diabetes Mellitus*
  • Dry eye syndrome
  • Epilepsy*
  • Folate Deficiency
  • Gastric Reflux
  • Glaucoma
  • Goitre
  • Graves Disease
  • Hiatus Hernia*
  • High Cholesterol*
  • High Blood Lupids*
  • High Blood Pressure*
  • Hypothyroidism
  • Impaired Glucose Intolerance
  • Incontinence
  • Insulin Resistance
  • Iron Deficiency Anaemia
  • Macular Degeneration
  • Meniere’s Disease
  • Migraine
  • Nocturnal Cramps
  • Osteopaenia
  • Osteoporosis
  • Pernicious Anaemia
  • Plantar Fasciitis
  • Pregnancy: Generally only covered for unexpected complications within 26 weeks of pregnancy cycle
  • Raynaud’s Disease
  • Sleep Apnoea
  • Solar Keratosis
  • Trigeminal Neuralgia
  • Trigger Finger
  • Vitamin B12 Deficiency

Conditions for automatic cover for the list above may vary greatly between providers. Always read through the conditions of the policy you are considering closely before purchasing.


Pre-existing medical conditions that are generally not covered

Travel Insurance Providers will generally not provide cover for claims arising from or that are attributable to the following conditions:

  • Any condition for which you have been given a terminal prognosis of with life expectancy less than 24 months
  • HIV or AIDs
  • Condition that has resulted in you being hospitalised or attend the emergency department of a medical facility in the past 24 months
  • Any condition that arises from symptoms that you are aware of but have not sought medical attention for, have sought medical attention for and are currently under investigation to define diagnosis or that you are awaiting a specialist opinion for
  • Conditions related to surgery that the policyholder has recently undergone
  • Have been diagnosed with cardiovascular disease or have received treatment for related conditions
  • If you suffer from cardiovascular disease or diabetes in combination with;
    • High Blood Pressure
    • High Blood Lipids
    • High Cholesterol
  • DVT and Pulmonary Embolism
  • Diabetes*
  • Epilepsy*
  • Conditions that have resulted in seizures in the past 12 months
  • If you require oxygen at your home or while you are travelling
  • Conditions that have required brain or spinal surgery
  • Chronic or recurring pain
  • Forms of cancer
  • Condition where surgery treatment is planned
  • Chronic renal failure
  • Have previously had or plan to undergo organ transplant
  • Sexually transmitted diseases
  • Different types of mental illness including dementia, anxiety, drug or alcohol addiction, eating disorders
  • Pregnancy
    • For fertility treatment
    • If you have experienced complications prior to cover being taken out
    • Childbirth
    • Care of newborn child
    • Regular antenatal care
    • Generally most policies will not cover unexpected complications that arise under a single policy after 26 weeks and 19 weeks for a multiple pregnancy

As mentioned previously, the list of medical conditions that will not be automatically covered and the different conditions that will apply for each may vary greatly between providers. The list above is just to give a general overview of conditions that are unlikely to be automatically covered.


Is it still possible to take out travel insurance if I have a pre-existing medical condition that is not covered?

Yes. It is still possible to take out cover for other losses but you will not be covered for any medical expenses that may be incurred that are related to or attributable to your pre-existing conditions. This will include expenses incurred for hospitalisation, emergency evacuation, emergency medical assistance etc.


What if my condition is not listed?

If your condition is not listed under the automatically covered or not automatically covered groups, you may be able to receive cover for the condition by paying an additional premium. If you do not pay the additional premium for the cover, you will not be covered for any claims arising from or that can be attributed to your condition.

It is generally not possible to purchase additional medical cover for domestic or annual-multi trip policies.


Are other people on my travel insurance policy covered for pre-existing medical conditions?

Generally, the insurance company will not provide a benefit payment for claims arising from pre-existing medical conditions that are automatically covered other than for those that are named on the insurance policy. Cover for pre-existing conditions can be provided to your spouse and/or dependent children/grandchildren.


Group travel insurance with cover for pre existing medical conditions

It is not uncommon for people to take out group travel insurance policies to provide cover for up to 10 or more friends, co-workers, teammates etc. While there is only one certificate of insurance for group policies, cover is still provided to each member of the group as if they were to have their own policy.

When taking out cover, the applicant that is applying for the cover for the group will be asked if any member of the group has any pre-existing medical conditions. In the event that one member does have a pre-existing condition that is not automatically covered under the policy, they may be required to take out their own separate policy. It may be possible to still purchase group cover if the condition is not listed though an additional premium may be incurred.


Learn more about group travel insurance policies

Can I get medical only travel insurance?

If you are only interested in taking out cover for medical related losses, many insurers will offer basic policies with a reduced range of benefits for a lower premium rate. This can be a good option for those that may have other forms of cover in place and just need to make sure they are looked after for medical events overseas. As an example, One Cover’s Basic Overseas Travel Insurance Policy will only provide cover for the following events:

  • Overseas emergency medical assistance: Cover for emergency medical treatment while you are travelling overseas. This may include:
    • 24 hour emergency medical assistance
    • Ambulance fees
    • Medical evacuations
    • Funeral arrangements
    • Messages to loved ones
  • Overseas medical and hospital expenses: Cover for treatment overseas including medical, surgical, dental and nursing
  • Personal liability: Provides cover for legal expenses incurred following injury to another person or damage to another persons property

It is never worth neglecting taking out cover you actually require just to save on your policy. Anyone considering a basic level of cover must make the right assessments of their own situation to ensure that they are comfortable with the amount of cover they will actually receive.


Is it possible to take out medical travel insurance for seniors?

Each insurer will have a different set of criteria for how they will assess senior applicants, particularly when it comes to pre-existing medical conditions that they might have. Generally, if the applicant is below 75 years of age they will be automatically covered and excluded for the same conditions as younger applicants. Applicants that are above the age of 75 will generally not be covered for those conditions that other applicants are automatically covered for, regardless of whether or not they meet the necessary criteria. They may also be required to complete a medical questionnaire to allow the insurer to assess whether or not they can actually provide them with cover.


Find travel cover for seniors

Find travel insurance policies with cover for medical related losses

It is critical that anyone considering taking out travel insurance takes the time to actually read through the product disclosure statement so that they are aware of any particular exclusions that may be relevant to their situation. This is especially important when it comes to pre-existing medical conditions as the terms can vary quite significantly between different providers on how they will cover certain conditions. If you are ever unsure whether a condition you have or have previously had will be covered under the policy, it is always best to contact your insurer to clarify prior to purchasing your cover.


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4 Responses to Medical Travel Insurance

  1. Default Gravatar
    JD | August 11, 2014

    My mother has been diagnosed with pancreatic cancer however no time frames have been given and she is quite well at the moment. I am travelling to the US for 2 weeks in October. will anyone cover my costs to return home if she is hospitalised or passes away?

    • Staff
      Richard | August 12, 2014

      Hi JD,

      Thanks for your question. There are insurers that will cover you for reasonable expenses due to a family emergency. However, many insurers do have a clause tucked away in the general exclusions section its product disclosure statements (PDS), which excludes cover for pre-existing conditions. It is worthwhile reviewing various cover options, and checking their PDS for this kind of exclusion. Once you have found a few policies that you think may cover you for this type of situation, double check that they do indeed cover pre-existing conditions by contacting the insurer directly.

      I hope this was helpful,

      Richard

  2. Default Gravatar
    Robyn | June 23, 2014

    My sister-in-law has pulmonary hypertension and is on multiple drugs and warfarin. Are there any travel insurance companies that would cover this?

    Thank you.

    • Staff
      Shirley | June 24, 2014

      Hi Robyn,

      Thanks for your question.

      Unfortunately you’ll need to do some research on the policies available to determine whether hypertension is covered. Some insurers do cover high blood pressure under certain medical conditions.

      Cheers,
      Shirley

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