Travel insurance for a pre-existing medical condition

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.

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.

What’s covered, and what’s not

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.

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.

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

I manage CHOICE's Money and Travel team. We look after health, home, car, travel and pet insurance reviews plus all the travel content. I studied a Bachelor of Commerce Majoring in Economics and worked in finance for many years in Sydney, London, Amsterdam and Switzerland before I joined CHOICE in 2012. So I've done plenty of travel and I'm no stranger to playing with numbers. I like breaking down complex consumer decisions about financial services into easy to understand steps, and comparing all the products to find the best in the market. Especially when the best products are cheaper than those that aren't so good. We see that a lot. I also really like holding companies to account for failing their customers. Unfortunately we also see a lot of that. From timeshares to airlines, funeral insurance and poor financial advice. You can find me on Twitter and LinkedIn.

I manage CHOICE's Money and Travel team. We look after health, home, car, travel and pet insurance reviews plus all the travel content. I studied a Bachelor of Commerce Majoring in Economics and worked in finance for many years in Sydney, London, Amsterdam and Switzerland before I joined CHOICE in 2012. So I've done plenty of travel and I'm no stranger to playing with numbers. I like breaking down complex consumer decisions about financial services into easy to understand steps, and comparing all the products to find the best in the market. Especially when the best products are cheaper than those that aren't so good. We see that a lot. I also really like holding companies to account for failing their customers. Unfortunately we also see a lot of that. From timeshares to airlines, funeral insurance and poor financial advice. You can find me on Twitter and LinkedIn.

Related

Being prepared for a holiday includes sorting out the best value travel insurance. Don’t let a dud policy ruin your break.

Travel insurance policies to avoid

Helpful advice from CHOICE experts to ensure you don't get caught out

The dos and don’ts of buying travel insurance with a medical condition

How to secure cover for your next trip if you're dealing with existing medical conditions.

Travel insurance for a pre-existing medical condition

Our travel insurance comparison covers the majority of the travel insurance market in Australia. Here's how we rate policies.

How we compare travel insurance