Travel insurance with pre-existing conditions

What counts as pre-existing?

There's no single definition. It's whatever your policy says, so read that section carefully. It often covers any condition for which, during a set period before your policy begins, you've had:

• A diagnosis, treatment or a checkup that flagged a problem
• Symptoms, even if you never saw a doctor about them
• A new medication or a change in medication
• Tests or investigations, including ones still pending

Common examples include diabetes, high blood pressure, heart conditions, asthma and recent surgery. The UK government specifically warns that pending treatment and tests should be declared. Something minor, such as a resolved injury, may still count if it falls within the window.

How look-back periods work

Many policies check a look-back period, often from 60 to 180 days before cover begins. If your condition has been stable and unchanged throughout that period, a policy may treat it as covered.

The word "stable" can have a very specific meaning. A dose change could break stability even if your doctor considered it routine, so check this before relying on it.

Two ways policies handle conditions

Different markets take different approaches. It's worth knowing which one you're looking at.

The waiver approach, common in the US

Many US comprehensive plans exclude pre-existing conditions unless you qualify for a waiver. Typical conditions include:

• Buying within a set time after your first trip payment. Commonly quoted windows are 14 or 21 days
• Insuring your full non-refundable trip cost
• Being fit to travel when you buy cover

The declaration approach, common in the UK, Australia and elsewhere

Here you answer medical questions when you buy, and the insurer accepts, charges more for or refuses each condition. Specialist insurers exist for conditions that mainstream ones won't cover. Once accepted, you should have written confirmation, so keep it with your policy.

How to declare properly

1. Gather your medical facts before you start. Your medications, doses, recent appointments and any planned tests.
2. Answer exactly what's asked. Don't guess, and don't round down. "Mild" can still count.
3. Declare for everyone covered. Each traveler needs to be included.
4. Save the screening record or email. If it was over the phone, note the date, the name and a reference number.
5. Update your insurer if something changes. Your health might change between buying and traveling. Check what your policy requires.

If you're unsure about something, disclose it. A slightly higher premium is far better than a refused claim during an emergency.

Family members can affect your claim

This surprises many people. A cancellation claim could relate to a relative who isn't traveling at all. If your mother has a long-term condition and you cancel because it suddenly worsens, the insurer might still treat that as a pre-existing condition. Check how your policy deals with this, particularly if you have a family member who's unwell.

If a mainstream insurer turns you down

• Try a specialist. Some insurers focus on people with serious medical conditions.
• Consider a broker. A specialist broker can compare policies you wouldn't easily find yourself.
• Compare partial cover. Some insurers will cover everything except the named condition. That could be useful, but be clear about what's excluded.
• Talk to your doctor. Ask about fitness to travel, and ask for a letter you can take with you.

Practical steps before you go

• Bring enough medication for your trip and some extra in case of delays.
• Keep it in the original packaging, in your hand luggage, with a copy of your prescription.
• Check the rules at your destination, since some common medicines are restricted in other countries.
• Carry a summary of your conditions, in the local language if you can.

Most insurers won't pay for your regular prescriptions, as Smartraveller points out. Medicines you take routinely are your own responsibility, so plan ahead.

Don't assume a condition doesn't count because it feels well controlled. Insurers rely on the policy's definition, not on how you feel. When you're unsure, declare it and keep the written reply.