Too Sick for Travel Insurance? Think Again

Think you’re too old or too sick to travel, even though there is nothing you would rather do? Think again.

Thanks to a proliferation of travel insurance plans in the United States, Canada, and across the globe, almost anyone with a pre-existing condition that has been stable and controlled for a certain period of time can find some protection from the potentially catastrophic costs of encountering a medical emergency abroad.

Your coverage may not be universal. It will involve some limitations and co-payments, and it will likely require complete and honest disclosure by you of your medical condition. So you need to do your homework. But that’s a small price to pay for the protection you need during that trip you have been hoping for, perhaps dreaming of.

I am often contacted by people diagnosed with heart conditions, cancer, or other illnesses who say their doctor has “cleared them for travel,” where can they find health insurance? I invariably tell them that their doctor’s “clearance” is not what matters. They need “clearance” from the insurer taking the risk of covering them, and they need to understand that when their insurer specifies their condition must be “stable and controlled”, they must know exactly how that is defined in the insurer’s policy contract—not how it is defined in some dictionary, or by their neighbour, or even by their doctor. And forget about your lawyer’s definition—that’s the most confusing of all.

“Stable and controlled” usually means that over a specified period of time the condition in question has not required treatment, hospitalization, or a change in medication; has not shown deterioration of any kind or a recurrence of symptoms; and has not required the intervention of a medical professional to “make things right.” The time period varies according to the seriousness of the condition and the terms the insurer sets. It could be 90 days, six months, a year, perhaps longer. If you’re looking at an insurance plan, you need to find out exactly what that period is, in writing.

There are also plans that will exclude certain pre-existing conditions from coverage, but will cover you for any other new, unexpected medical emergencies that may arise while you are travelling. Be careful with this clause, though. If you exclude your diabetes, but later have a heart attack, the insurer may easily be able to link the two if your past medical record shows you had some earlier signs of heart irregularities or high blood pressure, which many diabetics have. From a statistical point of view, diabetes and heart problems are very closely linked.

My advice, if you have any conditions or symptoms under treatment, surveillance, or investigation by medical professionals, is to seek out comprehensive, full-service travel health insurance that will clearly state what it covers and, more importantly, what it does not cover. Ask for a medically underwritten policy that requires you to complete a medical questionnaire, but that also gives you the assurance the insurance company acknowledges what it is underwriting. Stay away from any policy that does not ask medical questions. If you have any medical conditions, that can be a deep trap.

In the US, there are many travel insurance plans that concentrate more heavily on trip cancellation and baggage loss than health benefits, so you need to be more diligent in your search. I suggest you go online to www.ustia.org and look for the higher-end products offered by companies such as CSA, AIG TravelGuard, TravelSafe, Access America, Trip Mate, and others that offer a minimum of $1 million in coverage and repatriation home if medically necessary, along with direct payments to foreign hospitals. Anything less is just not good enough. Medical coverage of $25,000 or even $50,000 is totally inadequate.

In Canada, most travel insurance policies offered by the major insurers—for example, AIG Travelguard, Manulife, RBC, The Co-operators, ETFS/Royal & SunAlliance, Travel Underwriters, Mondial, Blue Cross, TourMed, and plans offered by most banks—will offer the options I have mentioned. And all will offer a minimum of $1 million in coverage, some $5 billion or more, with direct payments to hospitals and air ambulance repatriation if necessary. All of these will also coordinate with your provincial health insurance.

A good brokerage that specializes in travel health insurance will offer some or most of these plans.

Internationally, look up companies such as IMG, headquartered in the US, or AXA, Europ Assistance, Mondial, or Mapfre. They offer varieties of comprehensive plans with many options.

A word of caution: Credit card plans, employee benefit plans, or pension plans will usually not cover these situations. If you rely on them, you must get written assurance from the plan itself, and not just from a benefits clerk giving you their opinion, that your specific condition is covered.

Bon voyage. But verify.

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