A standard emergency medical travel insurance policy will include coverage for pre-existing medical conditions — provided you meet the insurer’s stability requirements. What does that mean?
That means it is important to let your broker or insurer know of any health-related changes when applying for insurance and prior to the start of each trip.
If you travel as planned without notifying your insurer, you risk paying a medical bill if your symptoms recur while you are away.
Here’s the hurdle you may be facing: to meet an insurer’s stability requirements there must be no change in your medical treatment or health condition in a specified time frame– and the rules around this differ between insurers.
Does that mean your health changes will prevent you from getting the coverage you need? The good news is you do have options. Here’s what you need to know.
Understand how your travel insurance policy defines ‘stable’ for health-related developments
Here are typical ways that an insurer will define the stability of your condition:
- There are no symptoms or signs of illness, whether new, more frequent, or severe
- There have been no new diagnoses or tests pointing to a deterioration in health
- You have had no new treatments, medical care, medications, dosages, or admissions to hospital
- There has been no recent referral to a specialist, or a new recommendation for treatments or tests
- You have not failed to act on a necessary recommendation or referral, and you have not refused to wait for test results before travelling.
The insurer will require that you (the insured) will NOT have had any of these developments during a specified period stated in the policy, usually between 90 days and one year.
If you have had one of these developments, your coverage for a pre-existing condition could be void when you are travelling.
So, what is a ‘treatment’ or a new ‘medication’? The rules are not straightforward.
All travel policies include a section of definitions but a common word like treatment may not be defined and may not be clear.
Here are health-related developments that can impact your travel insurance
Remember, “stability” in a travel insurance policy means no change whatsoever to your medical condition. These health-related developments are changes and will be considered ‘unstable:
An Improvement in Your Condition
If your medication decreases or is stopped…that is a change! It may be good news, but for the purposes of travel insurance your health may not be considered stable.
An Adjustment to Your Medication or Treatment
That’s an alteration! You may be taking the same medication, but your dosage has been increased. Or you’ve switched from a brand name medication to a generic. That is a change! However, some insurers will allow it as ‘no change’ if it is the same dosage — so you must understand your policy’s definition.
A Minor Ailment
How travel insurance policies define stability for a minor ailment differs. For example, one week of medication for a cold may be acceptable to some insurers, but not others.
Awaiting Diagnosis
Referrals to a specialist, planned surgeries, recommended or upcoming treatments and tests will all mean that you are no longer ‘stable’ according to your travel insurance policy.
Avoidance does not help you avoid triggering the stability clause. If you suspect you have a health problem, it counts too! The insurance company will likely deny any related claim as the symptom or medical issue, although not diagnosed, arose during the stability period.
What happens if your medical condition does not meet the stability requirements in the stability period stated in the policy? Your condition is considered unstable. It may be excluded from the policy and not covered.
SBIS has Travel Insurance coverage options if your health has changed
SBIS offers policies that may meet your needs if your health is changing. You may be eligible for the following travel medical insurance plans with Reduced stability period riders or an Individual Medical Underwriting plan:
TuGo Quest Travel Insurance (for ages 55-89)
If your pre-existing condition does NOT meet traditional stability requirements, you may be eligible for TuGo Quest Travel Insurance that provides limited coverage (up to $150,000) for unstable pre-existing medical conditions. However, conditions for which symptoms arose or for which medical consultation was required or took place on the date of departure or at any time within the 7 days prior to the date of departure, other than a minor ailment, will not be covered.
You can also consider the TuGo Future Stability Option, which is important for multi-trip plans. Future Stability Option provides coverage for a pre-existing condition which is stable at the time of application but become unstable between the effective date of your plan and the departure date of each trip.
Destination Health Travel Plans (for ages up to 89)
The Reduced Stability Period option is available with Destination Travel Health Plans. You may qualify for 30-day, 90-day or 180-day reduced stability period for your pre-existing medical condition, depending on the plan you are eligible for based on your answers to medical questions on the application. Coverage for a pre-existing medical condition that has been stable within a reduced stability period is up limited to $150,000.
Individual Medical Underwriting Plan underwritten by Manulife (no age limit)
If you have unstable pre-existing medical issues or you have been denied coverage, you may be eligible for Manulife’s individual medical underwriting plan. It is emergency medical insurance that covers fully disclosed pre-existing conditions without stability requirements. The cost of your insurance is based on your own specific health situation. You must declare ALL medical conditions including any that have been diagnosed in the last 5 years, you have received treatment for or taken medication for. If you meet the eligibility requirements all your declared conditions will be covered during the trip.
Read our blog here for tips on how to complete a Travel Insurance Medical Questionnaire.
Don’t worry. Call us today.
Everybody knows that Canadians enjoy insurance coverage that is paid for by the government. However, that coverage does not follow you out of the country. When you are heading out on a well-deserved vacation, adequate travel insurance is the most valuable thing you can pack – even if you’ve experienced changes to your health.
You and your loved ones can rest at ease knowing that you can call us at 1-800-667-0429 during our regular business hours or email us at general@sbis.ca for guidance and assistance in getting the coverage you need.
