It’s the most important clause, and the least read, in a travel insurance policy. Depending on the contract, a pre-existing medical condition can be covered provided it has been stable for a set period before departure. Understanding this concept prevents many unpleasant surprises at claim time.
What counts as a pre-existing condition?
Any medical condition that existed before your coverage took effect: high blood pressure, diabetes, asthma, arrhythmia, a history of cancer, but also symptoms you’ve consulted about that have no diagnosis yet. Having a pre-existing condition does not necessarily prevent you from getting insured; what matters is its stability.
The definition of “stable”, in practice
Exact wording varies from policy to policy, but a condition is generally considered stable if, during the required period (90 to 365 days depending on the contract and age), there has been none of the following:
- New diagnosis or recurrence
- New symptom, or a symptom that became more frequent or more severe
- Medication change: new drug, stopped drug, or dosage change
- New treatment or hospitalization
- Test in progress with results not yet known
- Consultation or procedure recommended by a doctor and not yet done
Two frequent traps: a dosage adjustment, even downward, even because things are going better, generally counts as a change; and a test awaiting results makes the condition unstable even if you feel perfectly fine.
Why it matters so much
If an emergency related to a condition deemed unstable happens during the trip, the insurer can deny the claim related to that condition. A misstatement on the medical questionnaire can even void the whole policy. On an American hospital bill, the difference runs into the tens of thousands of dollars.
How to get it right
- Answer the medical questionnaire precisely. If a question is unclear, ask. Our advisors do this every day.
- Reassess stability as of the departure date, not the purchase date: a medication change in between must be reported to the insurer.
- Ask what stability period applies to your age and policy: it varies, and some policies offer an option covering some unstable conditions.
- Keep a written record of your exchanges with the insurer if your situation changes before departure.
The reflex to remember
Any medical change between purchase and departure deserves a call to your insurer or advisor. Five minutes on the phone beats a denied claim. To explore coverage suited to pre-existing conditions, see our travel insurance page or the one for visitors to Canada.