Traveller's Insurance: Understanding Pre-Loss Condition Auto Coverage

Travel insurance is a valuable asset when planning a trip, especially for those with pre-existing medical conditions. While most travel insurance policies exclude pre-existing conditions from medical coverage, obtaining a pre-existing conditions waiver can extend your travel medical insurance to include these conditions. This type of coverage provides peace of mind when travelling, ensuring that any medical emergencies related to pre-existing conditions are covered.

What is a pre-existing condition?

A pre-existing condition is a health problem that a person has before the date that new health coverage starts. This could be a medical illness or injury that has already been diagnosed or treated before enrolling in a new health plan. Pre-existing conditions tend to be chronic or long-term, such as asthma, diabetes, cancer, chronic obstructive pulmonary disease (COPD), lupus, epilepsy, depression, and sleep apnea. Other less severe conditions like acne, anxiety, and pregnancy are also considered pre-existing conditions.

Before 2010, insurance companies could deny coverage or charge higher rates to individuals with pre-existing conditions. However, the Affordable Care Act (ACA), passed in 2010, made it illegal for health insurance providers to discriminate against individuals with pre-existing conditions. Now, insurance companies cannot refuse to provide coverage or charge higher premiums based on a person's health status or medical history. This applies to both individual and employer-sponsored health plans.

It is important to note that there are still some types of health coverage, such as short-term medical plans and fixed indemnity plans, that are not regulated by the ACA and may require applicants to disclose their medical history. These plans may still deny coverage or charge higher rates for individuals with pre-existing conditions.

In summary, a pre-existing condition is a health issue that existed prior to enrolling in a health insurance plan, and thanks to the ACA, individuals with pre-existing conditions now have better access to affordable health coverage without facing discrimination or higher costs.

How to qualify for a pre-existing medical conditions waiver

To qualify for a pre-existing medical conditions waiver, you must meet certain criteria. Here are the requirements you need to fulfil to be eligible for the waiver:

• Be medically fit to travel: You must be medically fit to travel on the day the travel insurance plan is purchased to meet the health qualifications for a pre-existing medical conditions waiver. This requirement also extends to others listed on the policy, so they must also be medically fit to travel. If your doctor or insurance company believes you should avoid travelling for any medical reason, you will likely be disqualified for coverage.
• Buy the policy within a specific timeframe: The pre-existing condition waiver is a time-sensitive benefit, and you must purchase the travel insurance plan within a certain timeframe to be eligible for the waiver. This is typically within 10-21 days of making your initial trip deposit.
• Insure the full non-refundable cost of your trip: The amount of your coverage must be equivalent to the total pre-paid, non-refundable cost of your trip. This includes any pre-paid, non-refundable travel arrangements.

It is important to note that the requirements may vary slightly between different insurance providers, so it is always a good idea to carefully review the eligibility requirements of the specific policy you are considering.

Where to find coverage for pre-existing conditions

Finding the right travel insurance plan can be challenging when dealing with pre-existing medical conditions. Luckily, there are many providers that offer coverage for pre-existing conditions.

Travel Insurance Companies

You can turn to travel insurance companies such as:

• Allianz
• Travel Guard by AIG
• RoamRight

Comparison Sites

Instead of getting quotes from every travel insurance company, you can use a free comparison site such as InsureMyTrip, which allows you to get quotes from multiple providers at once.

Policybazaar.com

If you suffer from more than one pre-existing condition, you can buy a policy with no restrictions or capping on Policybazaar.com.

EHealth

EHealth is another option to help you find effective health coverage at an affordable price, regardless of your current health condition.

Medicaid and CHIP

The ACA has made it impossible for Medicaid and CHIP programs to deny coverage to individuals with pre-existing conditions.

Catastrophic Health Plans

Available to people under 30 and to some low-income people, these plans cover essential health benefits but have a high deductible.

Community Health Centers

For uninsured individuals, these centers provide health services on a sliding fee scale based on income, offering an alternative for primary care and other medical services.

How to file a pre-existing medical condition travel insurance claim

To file a pre-existing medical condition travel insurance claim, you will need to follow the steps below:

• File your claims form: You will need to provide your name, policy number, the reason for the claim, and other important details.
• Submit your claims form with all necessary documentation: This includes a doctor's note, flight delay or baggage notices, police reports, and any other related documents.
• Your travel insurance company reviews your claim: The insurance company may request more details or documents supporting your claim.
• If your claim is approved, you will receive reimbursement, up to your policy limits: Make sure to keep all your documents in order and provide as much detail as possible to increase your chances of a successful claim.

• Get a pre-existing conditions waiver: This is important as it prevents the travel insurance company from denying your claim based on your pre-existing condition. Most companies require you to purchase the waiver within 10 to 21 days of your initial trip deposit.
• Review your policy for covered pre-existing conditions: Not all pre-existing conditions are covered by travel insurance. Common conditions that may be covered include high blood pressure, high cholesterol, and thyroid issues. Chronic conditions like cancer, cardiovascular disease, and heart-related conditions may require an additional premium for coverage.
• Provide detailed documentation: When filing a claim, make sure to include all relevant medical records, bills, and a letter from your doctor confirming your condition and fitness to travel.
• Contact your insurance company as soon as possible: If you need to see a doctor or require medical attention while on your trip, reach out to your insurance company right away. They can guide you through the claims process and let you know what documentation you will need to provide.

What is a waiver of lookback?

A lookback period is a specific amount of time set by a state to determine whether gifts made during this time will be counted as divestments that incur a penalty period for Medicaid eligibility. The lookback period is usually a few years, and any gifts made during this period can be counted as divestments. For example, the lookback period for Medicaid in Florida is 60 months (5 years).

In the context of payroll, a lookback period is used by employers to determine their deposit schedule for withheld FICA tax (Social Security and Medicare) and federal income tax. Employers with a tax liability of $50,000 or less during the lookback period are considered monthly depositors, while those with a tax liability of more than $50,000 are considered semiweekly depositors.

A waiver of lookback, therefore, refers to the waiving of the consequences of divestments made during the lookback period, which would otherwise result in a penalty period for Medicaid eligibility or a change in deposit schedule for payroll taxes.

In the context of travel insurance, a pre-existing medical condition waiver can be selected for plans that cover pre-existing medical conditions. This means that the insurance company will not review the traveller's medical records from the past 60 to 180 days (the look-back period) to determine whether a claim is related to a pre-existing condition and thus whether it will be covered.

Frequently asked questions