Find travel insurance for medical related expenses and pre-existing conditions
If you have a pre-existing medical condition, you're probably all too aware of the expense and difficulty involved with getting medical travel insurance. Each insurer has its own criteria for assessing pre-existing medical conditions, so whether or not you're accepted can vary between providers. This makes comparing quotes from a range of insurers essential for anyone with a pre-existing condition. This guide will discuss how travel insurers assess different medical conditions.
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Travel insurance and pre-existing conditions in Australia
In the past, it was common for people with pre-existing medical conditions to be denied medical travel insurance, as they were too great a risk for the insurer. However, with such intense competition in the insurance industry today, people that may have been denied cover can now find a cover for a reasonable price.
What exactly is a pre-existing medical condition in travel insurance?
Definitions of what is a pre-existing medical condition vary between insurers, so it is always worth checking prior to application. However, a pre-existing condition is generally defined as:
- An ongoing medical or dental condition you knew about prior to applying for cover
- A medical or dental condition that is currently being investigated by an approved medical practitioner
- A condition for which you take prescribed medication
- A condition which has required surgery
- A condition that you receive ongoing treatment for from a medical practitioner
This definition is not only relevant to you as the policyholder but any other people that are listed on your medical travel insurance such as your spouse or dependent children.
How will my pre-existing medical condition be assessed?
Depending on your condition, an insurer will take one of four steps during the application process:
- Automatically accept you for cover
- Refuse your application
- Exclude claims related to the condition from cover under the policy
- Apply a premium loading to account for the additional risk
Medical conditions automatically covered by travel insurance
Conditions that are automatically covered under a policy vary greatly between insurers. As an example, below is a list of conditions that often cover automatically without the need for further assessment or premium loading:
- Common allergies
- Bell’s Palsy
- Benign Positional Vertigo
- Carpal Tunnel Syndrome
- Coeliac Disease
- Congenital Blindness
- Congenital Deafness
- Diabetes Mellitus
- Dry eye syndrome
- Folate Deficiency
- Gastric Reflux
- Graves Disease
- Hiatus Hernia
- High Cholesterol
- High Blood Lupids
- High Blood Pressure
- Impaired Glucose Intolerance
- Insulin Resistance
- Iron Deficiency Anaemia
- Macular Degeneration
- Meniere’s Disease
- Nocturnal Cramps
- Pernicious Anaemia
- Pernicious Anaemia
- Plantar Fasciitis
- Pregnancy: Generally 26 weeks max
- Raynaud’s Disease
- Sleep Apnoea
- Solar Keratosis
- Trigeminal Neuralgia
- Trigger Finger
- Vitamin B12 Deficiency
Dengue fever in downtown Bali
Pre-existing medical conditions that are generally not covered
Travel insurers generally not provide cover for claims arising from 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 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
- 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 including:
- For fertility treatment
- If you have experienced complications prior to cover being taken out
- Care of newborn child
- Regular antenatal care
- Complications that arise under a single policy after 26 weeks and 19 weeks for a multiple pregnancy
The list above is a general overview of and differs depending on the insurer.
If my pre-existing condition is not covered can I still get cover?
Yes. It is still possible to take out cover for other losses but you will not be covered for any medical expenses incurred that are related or attributed to your pre-existing condition. This includes expenses incurred for hospitalisation, emergency evacuation and emergency medical assistance.
What if my condition is not listed?
If your condition is not listed under the automatically covered or automatically excluded 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.
Yes, some insurers do provide cover for those who have suffered from cancer. However, the ways that insurers treat cancer varies. Below is an example of how some Australian travel insurers treat cancer:
- Covermore, Travel Insuranz, Virgin, WoolworthsYouGo and Medibank Private. You can get cancer cover through these insurers if your diagnosis took place at least six months ago, and you have not gone through radiation or chemotherapy in the preceding six months. In addition, you will receive cover for no more than a six months trip period. Both offer cover for skin, breast, colon, bowel, kidney, and prostate cancer, provided your Prostate Specific Antigen (PSA) is 10 or less.
- AAMI, Citibank. You can get medical travel insurance if you have prostate or breast cancer as long as your diagnosis took place at least 12 months ago. It covers prostate cancer only if your PSA is 3.0 or less, and it does not cover secondary cancers.
- Priceline. Priceline offers travel over for prostate cancer patients in cases when PSA. is 3.0 or less.
- Budget Direct, EasyTravelInsurance, InsureandGo, Tick Travel Insurance, travelinsurancesaver. Will provide cover. However no cover claims if you had treatment or hospital tests for cancer in the last five years.
Tavel insurers consider all heart conditions as high risk factors, and many conditions related to the heart tend to find automatic exclusions from medical travel insurance policies. The good news is it is possible to get cover even with a pre-existing heart condition through different insurance providers, but they would expect the following.
- A medical assessment
- No instances of heart trouble in the last five years as per your medical history
- Lower cover limits and higher premiums
Getting medical travel insurance in the early stages of pregnancy is relatively simple. While there are some exclusions for things such as previous complications, multiple pregnancies and medically assisted pregnancies, most insurers offer cover up until around the 26th week of pregnancy.
There are insurers that offer cover for those between 26 and 32 weeks, those having multiple pregnancies and those who have undergone IVF treatment.
To find out how the insurers in our panel treat travel insurance for pregnant women, you can follow the link below.
To get travel insurance while suffering from Type I or Type II diabetes, you will, in all likelihood, have to meet the following conditions:
- You are less than 50 years of age
- Your diagnosis took place at least 12 months ago
- You don’t have eye, nerve, vascular, and kidney complications
- You don’t suffer from hypercholesterolaemia, hypertension, or a known cardiovascular disease
Australians heading to countries like India, Thailand, and Singapore for elective surgeries is common. However, most medical travel insurance policies do not provide cover for complications arising from elective procedures.
While there are insurers out there who offer cover to those heading abroad for surgery, the list is sparse. You're more likely to find a provider that will give you a policy that covers things like cancellation and delays but excludes any complications arising from your surgery.
Travelling overseas to avail of cheap medical treatment is gaining popularity in many developed countries, Australia included. While the cosmetic enhancement business is now around a billion dollars a year business in Australia, data suggests that around 15,000 Australians head overseas each year and spend around $300 million on cosmetic surgery tourism alone.
Globally, the medical tourism industry is worth more than $100 billion, and it’s growing at a rate of around 20% to 30% in Australia. Insurance providers in Australia seem to have finally woken up to this fact, and you can now find an option or two. NIB, for instance, offers patients a 12 months guarantee on foreign surgery as long as they stick to approved Thai hospitals and doctors. GoInsurance now offers Dental Tourism Insurance that provides cover to deal with different circumstances that may arise owing to the treatment.
The price of elective dental treatment in Australia can be prohibitive to many, and this is probably why the promise of getting cheaper and equally good treatment gets a number of Australians to look overseas. Getting medical travel insurance that covers complications that are the result of dental treatment is not particularly easy, and as of now only Go Insurance provides a suitable cover.
Go Insurance’s Dental Tourism Insurance policy, underwritten by Lloyd’s of London, provides cover in the following scenarios.
- Trip cancellation. You can look forward to cover if your procedure does not proceed as per plan, and you have to reschedule or cancel.
- Emergency overseas dental treatment. If the original procedure results in complications and you need emergency post procedure treatment, this insurance policy provides suitable cover.
- Additional transport and accommodation. Complications might require you to extend your stay, and in such a scenario you can get cover for additional costs incurred in accommodation and travel.
- Return travel and accommodation for remedial dental treatment.You’ll get cover if you have to return overseas for remedial treatment.
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Group travel insurance for pre-existing medical conditions
It's quite common for people to take out group travel insurance policies to provide cover for up to 10 or more friends, co-workers or teammates. 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.
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.
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.
- Have you spoken with a medical advisor? If you are sick or injured, don't leave anything, and seek medical assistance immediately.
- Have you called your travel insurer? This should be your first point of contact after the relevant local authorities if you have suffered a medical event. Not only will they be able to put you in touch with local medical providers, this will also ensure you don't have to pay out-of-pocket.
- Have you called your family and friends? Make sure you keep your family and friends appraised of your situation. They may be able to deal with your doctors or the insurer should you be unable to.
- Have you contacted your consular services? In some cases you may want to get in touch with the consular services if you have exhausted other avenues of assistance.
If you receive medical treatment when overseas and wish to file a claim, while claim processes can vary from one insurer to the next, the basics remains the same. When filing your medical travel insurance claim, you'll need to provide the following:
- A medical certificate that states your receiving treatment for a given illness or injury
- Receipts proving you’ve paid for treatment
Contacting your insurance provider upon hospitalisation is a good idea, as it can then communicate with the medical facility and authorise payment.
In case of hospitalisation, contacting your insurance provider can be necessary if you wish to claim for expenses towards airfare or evacuation. It’s important to note that your medical travel insurance might not cover medical and hospital costs that you incur in Australia.
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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