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How Does Travel Insurance Define a Pre-existing Condition?

Becky Hart | Jul 8, 2022

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In both trip insurance and travel medical insurance, you'll see the term "pre-existing condition." Most of the time, pre-existing conditions are included in the exclusions in the plan document. The term can be both intimidating and confusing.

Let us help clear some things up with the definition of a pre-existing condition and other important information to help you understand what it means and ensure that you get the right coverage.

What Is Considered a Pre-existing Condition?

In simple terms, if an issue started before your plan did, it’s a pre-existing condition. The fuller definition of a pre-existing condition varies by plan, as we’ll explain in the sections below.

Generally, an example of a pre-existing condition is something you may have had for much of your life, such as diabetes or asthma. Or it may be a more recently diagnosed condition, such as your knee that started hurting a few days before your trip.

You may be receiving treatment for a pre-existing condition, or you may have never received medical treatment for it.

Pre-existing conditions in Seven Corners RoundTrip Trip Protection

With Seven Corners RoundTrip Trip Protection and Get Away USA, a pre-existing condition is an illness, disease, or condition you or your travel companion, business partner, or family member booked to travel with you has during the 60 days immediately before your plan starts.

During those 60 days before you purchased a plan, one of two things happens.

  • A test, exam, or treatment was received or recommended for a condition that first manifested, worsened, or became acute, or exhibited symptoms that would have prompted a reasonable person to seek treatment, or
  • Prescription medication was received or taken for the condition. However, if you took prescription medication, and your condition was controlled solely by that medication, and it remained controlled for 60 days before your plan began, your condition is not considered a pre-existing condition.

Our RoundTrip Choice plan provides coverage for pre-existing conditions if:

  • You buy the plan within 20 days of the date your initial trip payment or deposit is received; and
  • You or your traveling companion are medically able and not disabled from travel when you pay for the plan or upgrade your plan; and
  • You update your coverage to include the additional cost of subsequent travel arrangements within 15 days of paying your travel supplier for them.

Remember, there are some conditions and situations specifically excluded by travel insurance. You can find these by reading the exclusions in the plan document.

Waiver for pre-existing conditions

Some trip insurance offers a "waiver of pre-existing conditions" that can apply to your coverage. It is referred to as a waiver because it comes into play by waiving the exclusion for pre-existing conditions. The exclusion can be waived if you meet the requirements stated in the plan document.

Seven Corners’ Roundtrip Elite and RoundTrip Choice plans offer a waiver of pre-existing conditions, which eliminates the exclusion for pre-existing conditions. Watch our video on how trip protection defines pre-existing conditions to learn more.

Pre-existing conditions in Seven Corners Travel Medical Insurance

With Seven Corners Travel Medical Insurance, a pre-existing condition is defined as any medical condition, sickness, injury, illness, disease, mental illness or mental or nervous disorder or resulting consequence, regardless of the cause, that existed with reasonable medical certainty during the 36* months prior to the start date of coverage. Additional terms apply, so please read your plan document carefully for a full explanation.

Seven Corners Travel Medical Insurance provides coverage for pre-existing conditions that is different from what you’ll find in our RoundTrip product just described. Below you’ll find some important information to note. As always, though, we recommend you review your plan document to understand your coverage and exclusions.

*If your trip does not involve travel to the USA, it is 12 months instead of 36.

Acute onset of pre-existing conditions

Travel medical plans often have coverage for an acute onset of pre-existing conditions up to a stated dollar amount that typically varies by the age of the traveler, with reduced coverage for older ages. An acute onset can be described as a sudden flare-up, like an asthma attack. In order to be eligible for coverage of these types of conditions, you must receive immediate emergency care, within 24 hours of the onset of symptoms.

Coverage for Acute Onset varies by plan.

  • Seven Corners Travel Medical Insurance for trips excluding the USA covers up to $50,000 for travelers ages 64 and younger and up to $10,000 for travelers ages 65 to 79 years old. There is no coverage for those 80 years and older.
  • Seven Corners Travel Medical Insurance for trips including the USA covers up to $50,000 for travelers 69 years and younger and up to $5,000 for travelers ages 70 to 79. Acute Onset coverage is not available to travelers aged 80 and older.

Additionally, a chronic, congenital, or other type of condition that gradually becomes worse over time would not be covered by the Acute Onset benefit. And, if you had a change in prescription or treatment during the days before you sought treatment for an acute onset, it would not be covered.
 
It’s best to review the plan document to see how a pre-existing condition is defined, because this varies by plan.

Pre-existing condition exclusion period

Some plans provide this coverage only if the acute onset occurs after a specified waiting period, which can vary from 72 hours to seven days, before coverage begins.

Emergency benefits and non-insurance assistance services

The Emergency Medical Evacuation and Repatriation benefit applies regardless of whether your transportation is related to a pre-existing condition. Likewise, the Emergency Medical Reunion and Return of Children benefits apply regardless of whether your hospitalization is related to a pre-existing condition, and the Return of Mortal Remains and Local Burial/Cremation benefits provide coverage regardless of whether your death is due to a pre-existing condition.

Again, we encourage you to review your plan document for details.

Questions?

Contact the licensed travel insurance agents at Seven Corners. We can explain how coverage for pre-existing conditions works for your plan and help you find the right insurance to fit your needs.

Email sales@sevencorners.com

Toll free 1-800-335-0611

Worldwide 1-317-575-2652

Collect 1-317-818-2809

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