Travel insurance is essential in the case of illness or injury while travelling. Overseas medical costs can be extortionate, and if you have an existing medical condition, it increases the chance you may need medical attention on your trip – that’s why insurers charge you extra.
So if you can get cover for your pre-existing medical condition, it’ll take a bit of worry out of your trip. But even if you’re willing to pay extra, getting cover for an existing condition isn’t always easy.
What is a pre-existing medical condition?
A pre-existing medical condition is a medical condition that you had before you bought your travel insurance.
Different travel insurers will have their own specific definitions, but it’s usually a diagnosed medical condition that you’ve had or received any form of medical advice, treatment or medication for, in a specified time period before you bought your policy.
Most insurers would cover a condition if it hadn’t led to treatment in the one to two years before you booked your trip, but others may specify five years or longer
The ‘specified time period’ wording is worth paying attention to. If, for example, your condition last showed symptoms 18 months ago, but the time period specified by the insurer is 12 months, then you’ll be covered subject to the other conditions of the policy.
The insurance contract regulations set the time period as six months by default. Unfortunately, insurers can get around this six-month rule and exempt themselves simply by burying an exclusion or limitation in the product disclosure statement (PDS).
Insurers’ definitions vary as to what the specified time period is. Most insurers will cover a condition if it hadn’t led to treatment in the one to two years before you booked your trip, but others may specify five years or longer.
There are often a lot of hoops to jump through to get cover for pre-existing conditions.
Insurers can:
exclude pre-existing medical conditions altogether
include a list of accepted pre-existing medical conditions (specified in the PDS)
restrict cover for generally accepted conditions depending on other conditions you might have, or only cover some symptoms (for example, allergies may be covered, but not anaphylaxis)
subject you to an assessment for cover of your medical condition and charge a fee to complete this assessment (whether you get cover or not)
deny you cover for a medical condition on application.
Even if you survive that minefield, you may then have to fork out several thousand dollars for the privilege of getting cover for your condition.
Commonly covered pre-existing conditions
Below is a list of conditions that might usually be covered, with specific restrictions.
Acne
Allergies
Asthma
Blindness and low vision
Cataracts
Corneal graft
Coeliac disease
Deafness
Dermatitis
Ear grommets
Eczema
Gastric reflux
Gout
Hiatus hernia
High cholesterol/hypercholesterolaemia
High blood pressure/hypertension
Hip replacement
Knee replacement
Macular degeneration
Menopause
Underactive thyroid/overactive thyroid
Pre-existing medical conditions you usually have to pay an additional premium for
Chronic lung conditions
Cardiovascular disease
Reduced immunity
Cancer (some policies automatically cover skin cancer but not melanoma)
Anxiety
Depression
Heart-related medical conditions
Commonly excluded pre-existing conditions
Medical conditions you’re travelling to seek medical treatment or review for
Conditions involving drug or alcohol dependency
Conditions for which you’re awaiting surgery, treatment, investigation or procedures
Conditions with a terminal prognosis
This also includes any travel booked or undertaken against the advice of a medical practitioner.
Which policies cover pre-existing medical conditions?
A travel insurance policy’s PDS will list the pre-existing conditions that it automatically covers. If a condition is not listed as automatically covered, then you may be able to apply to the insurer to cover your condition.
The table below details which funds have a list of pre-existing conditions they automatically cover, and whether or not they give you the option to apply to have your condition covered (if it’s not on their automatically covered list).
For example, if you have asthma, you might like to choose a fund that has asthma listed in its covered conditions – or at the very least, one that lets you apply for asthma to be included in your coverage.
For the specified time period, the lower the number, the better. Read on below the table for more information.
Southern Cross Travel Insurance (SCTI) – Medical Only
36 months
No
Yes
Tick Travel Insurance – Basic
N/A
No
No
Tick Travel Insurance – Budget
N/A
No
No
Tick Travel Insurance – Standard
12 months
No
Yes
Tick Travel Insurance – Top
12 months
No
Yes
Travel Insurance Direct – Basics
6 months
Yes
No
Travel Insurance Direct – The Works
6 months
Yes
No
Virgin Australia – International Plan (bought with flight purchase)
12 months
Yes
No
Virgin Australia – Travel Safe International
12 months
Yes
Yes
Virgin Australia – Travel Safe Plus International
12 months
Yes
Yes
WAS Insurance – Covid Essentials
24 months
Yes
No
WAS Insurance – Discovery
12 months
Yes
No
Webjet – Travel Safe International
12 months
Yes
Yes
Webjet – Travel Safe Plus International
12 months
Yes
Yes
World Nomads – Explorer
6 months
Yes
No
World Nomads – Standard
6 months
Yes
No
World2Cover – Basics
12 months
Yes
Yes
World2Cover – Essentials
12 months
Yes
Yes
World2Cover – Top
12 months
Yes
Yes
Worldcare – Comprehensive
24 months
No
Yes
Worldcare – Essential
24 months
No
No
* The time period before booking your trip that a medical condition (that isn't specifically excluded) would be covered if it has not given rise to symptoms or required medication or treatment.
If your medical condition is on the insurer’s ‘Covered Conditions’ list, then the time period might be longer than what’s specified above.
For example, Go Insurance’s specified time period is 90 days (3 months), but if your condition is on their ‘Covered Conditions’ list, and you’ve been hospitalised for that condition within 24 months of booking the trip, then it may not be automatically covered. You’ll need to fill out a form to apply for cover.
#This indicates whether or not the insurer has a list of pre-existing conditions that they automatically cover. For some insurers, conditions on the ‘Covered conditions’ list might only be automatically covered if you don’t have other existing medical conditions beyond those on the list.
CHOICE tip: Filling out assessment forms for your medical condition can be time-consuming and frustrating, but try at least three different insurers because premiums and cover vary widely.
How you’re assessed for a pre-existing medical condition
Many Australian insurers use a ‘black box’ risk rating system to assess your condition, such as that provided by insurance technology firm Verisk.
The systems may contain a list of health conditions, each of which is assigned a risk factor. Depending on how high this risk factor is, the insurer can choose to rule out cover, or offer cover for an extra premium.
Credit card travel insurance and pre-existing medical conditions
Some credit cards come with travel insurance policies that may cover pre-existing medical conditions.
However, policies that come with credit cards vary just as much as standalone travel insurance policies, so you need to read the terms and conditions carefully to understand whether you’re automatically covered, whether you need to apply for cover, or if there’s no cover at all for pre-existing medical conditions.
Bear in mind that some credit card travel insurance policies require you to activate your insurance before you leave. Some people may find this a bit of a pain, but with pre-existing medical conditions it may actually be an advantage, since it will prompt you to check your cover.
What to do if you can’t get cover for a pre-existing medical condition
If you’re denied cover for your pre-existing medical condition, or if you can’t afford the extra premium, you may still be able to buy a travel insurance policy.
You’ll need to declare your condition to your insurer. They may then offer you travel insurance cover, but will issue a certificate that says you won’t be covered for any claim that arises because of your pre-existing medical condition.
Jodi Bird is the Managing Financial Content Editor at CHOICE. Previously at CHOICE, he worked as Travel project lead and as a Finance specialist.
Jodi has over 30 years experience in financial services, having worked with major banks such as CBA, Westpac and Credit Suisse. He enjoys breaking down complex consumer decisions into easy to understand steps and holding companies to account for failing their customers. He is regularly called upon for expert commentary by major broadcasters such as the ABC, SBS, and Channels 7, 9, and 10.
Jodi has a Bachelor of Commerce majoring in Economics from the University of Wollongong. He is RG146 compliance certified to provide general advice for General Insurance and is a Responsible Manager on CHOICE's Australian Financial Services License.
Find Jodi on LinkedIn.
Jodi Bird is the Managing Financial Content Editor at CHOICE. Previously at CHOICE, he worked as Travel project lead and as a Finance specialist.
Jodi has over 30 years experience in financial services, having worked with major banks such as CBA, Westpac and Credit Suisse. He enjoys breaking down complex consumer decisions into easy to understand steps and holding companies to account for failing their customers. He is regularly called upon for expert commentary by major broadcasters such as the ABC, SBS, and Channels 7, 9, and 10.
Jodi has a Bachelor of Commerce majoring in Economics from the University of Wollongong. He is RG146 compliance certified to provide general advice for General Insurance and is a Responsible Manager on CHOICE's Australian Financial Services License.
Find Jodi on LinkedIn.
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