Travel insurance for pre-existing medical conditions

A pre-existing medical condition is a condition that you had prior to your insurance purchase. There are many ways in which insurers may classify a health issue as a pre-existing medical condition. Some common descriptions from insurers on pre-existing medical conditions include:

• Conditions that have resulted in you being hospitalised or having surgery in the previous 24 months (this period of time will vary between insurers)
• Conditions that have required you to seek professional medical advice
• Conditions that have resulted in you taking medication
• Conditions where you have displayed symptoms but not yet received professional medical advice or been treated, are still under investigation or where you are waiting for a specialist opinion
• Conditions that are described as chronic or ongoing medical or dental conditions (including mental illnesses)
• Conditions that affect you with any other ongoing issues or chronic illnesses that have been diagnosed

Taking out travel insurance with coverage for your pre-existing medical conditions can be beneficial for many reasons. In particular, you don’t want to ruin your holiday or worse, impact your long-term financial well-being because of your condition, and have your medical claims rejected because you weren’t covered.

In 2021-22, more than three quarters of Australians had at least one long-term medical condition,¹ and many may need cover for these conditions if travelling overseas. Before your trip, consider getting a medical check-up, so that not only would you know if you’re fit to travel, but you also know what you need to disclose to your travel insurer. Failure to disclose information on any condition could invalidate future claims related to that condition.

Cover for many conditions may also depend on whether you have needed medical treatment within a certain period (e.g. 12 months) before a relevant date. This date can vary between policies and insurers; for example, for a single trip policy, it’s counted from the start date listed on your certificate of insurance, and the issue date of your travel insurance for an annual multi-trip policy.

Knowing that you’re covered for unexpected events can help you feel more at ease when travelling. Go through the PDS from insurers to find out exactly what you may or may not be covered for.

There are various levels of travel insurance coverage available in Australia, ranging from basic products that only cover limited medical expenses to comprehensive policies that cover a wide range of other benefits.

Depending on your level of cover, there may be conditions or limits that outline what you can and can’t claim with your specific policy. As well as cover for your pre-existing medical conditions, you may have general travel insurance benefits such as:

• Emergency assistance and medical transport or repatriation
• Overseas hospital fees and medical treatment
• Trip cancellations and travel delays
• Lost deposits
• Curtailment cover (for accommodation and booked services if you need to cut your trip short)
• Stolen, lost and damaged luggage and property
• Personal liability.

Adding cover for pre-existing health conditions means you may be covered for the expenses and costs of overseas emergency medical and hospital services that may arise because of your pre-existing medical condition. This can be especially helpful if you’re in a country with expensive healthcare.

It’s always best to disclose any conditions you have to your insurer so you can be given relevant and accurate advice and recommendations.

Many travel insurance policies nowadays automatically cover a certain number of pre-existing medical conditions. Most other conditions are assessed on a case-by-case basis.

These health conditions are included on the provision that the condition has been stable and hasn’t needed medical attention or hospital treatment for the past 12 months (or up to three years with some insurers), and there is no planned surgery or treatment for it in the immediate future. Certain age limits for senior travellers may also apply to travel insurance for pre-existing conditions.

The included conditions vary depending on your insurer and policy, but may include:

• Acne
• Allergies
• Asthma (as long as you don’t have a lung disease and are under 60)
• Cataracts
• Coeliac disease
• Congenital blindness
• Congenital deafness
• Epilepsy (as long as you haven’t had a seizure within a certain timeframe)
• Gastric reflux
• Hiatus hernia
• High cholesterol/hypercholesterolaemia
• Hypertension and high blood pressure (as long as you don’t have other heart conditions)
• Menopause (provided you don’t have osteoporosis).

This is not a complete list, so you should be sure to read your policy’s PDS for the complete list of automatic inclusions and full details on your insurer’s eligibility criteria.

Some pre-existing medical conditions may incur higher or additional premiums to your travel insurance, or stricter eligibility and limitations. Some conditions that can often be covered for an additional premium include (but aren’t limited to):

• Heart conditions (coronary angiography, using pacemaker)
• Stroke
• Deep vein thrombosis
• Lung disease
• Diabetes
• Mental health conditions
• Conditions where you’ve had surgery in the past 12 months or 24 months, depending on the insurer.

Note: A medical assessment and disclosure of your condition does not require your insurer to give you cover. Pre-existing conditions are individually assessed, and cover can depend on what your medical condition is, its severity and your insurer’s policy.

There are certain situations in which your condition may not be covered at all; for example, most travel insurance providers won’t provide cover for certain chronic conditions. People with these conditions may still take out general travel insurance, however, but any claims arising from or connected to these medical issues will not be paid.

Though this may vary depending on the insurer, travel insurance usually doesn’t cover the following pre-existing medical conditions:

• Conditions that are a result of alcohol or drug dependency
• Conditions for which you’re awaiting any type of treatment or medical procedures
• Conditions where you’ve received treatment from a medical practitioner, had surgery or required hospitalisations within a specific time frame of buying your policy (this varies between conditions and insurers)
• Terminal illnesses
• Conditions or illnesses requiring continual oxygen supply
• Certain diseases such as chronic lung disease or cardiovascular disease
• Types of cancer
• Congestive heart failure
• Conditions where you are experiencing recurring pain.

Regardless of whether your medical condition is included in your insurance, you may not be covered if you’re travelling against medical advice. Keep in mind also that different insurers may have different exclusions, so always read the PDS of any policy you’re considering for further information.

You should always get travel insurance if you’re planning a trip overseas. Even if your pre-existing condition can’t be covered, a travel insurance policy can still give you important protection overseas in case of things like theft or damaged luggage, as well as illnesses, injuries or cancellations (that are unrelated to your pre-existing conditions).

Typically, you can’t apply for travel insurance cover for a medical condition while you’re overseas or after you’ve departed. However, if you’ve forgotten to take out travel insurance before departing for your trip, certain insurance providers may be able to help you out – although this might come with conditions and at a higher price.

In addition, if you do purchase cover after departing Australia, you may need to wait 48 to 72 hours before your coverage begins. See our page on getting travel insurance when you’re already overseas for more information.

It’s highly recommended you take out travel insurance in the early planning stages of your trip to make sure you have all the bases covered, especially if you have a pre-existing medical condition which may affect your travel insurance policy.

Pregnancy is often automatically covered through travel insurance, but only under certain circumstances. For example, you may be covered up to a certain number of weeks (usually 23) for a single uncomplicated pregnancy.

Although pregnancy costs from unexpected medical complications will be covered, most policies will come with specific terms, conditions and exclusions and do not cover childbirth and expenses related to the healthcare of a newborn.

You should generally be covered for:

• Changing your travel plans, which may include flight and accommodation cancellation costs or additional travel (if your doctor advises that you aren’t able to fly).
• Unexpected pregnancy complications for a limited period (e.g. up to 23 weeks for many policies, but this cover varies between insurers).
• Overseas medical care and medical treatment some illnesses or injuries related to your pregnancy.

Read the PDS of your policy for more details on getting travel insurance for pregnancy.

There are lots of insurers who will provide travel insurance for seniors with pre-existing medical conditions. However, most insurers have age limits. These age limits can vary between different insurers – some may be as low as 65 and others may be up to 80 years of age.

While there aren’t many exclusions specific to seniors, you may want to check the medical condition exclusion list in your policy’s PDS; you might find that some common, age-related conditions, such as dementia, may not be covered.

Credit card travel insurance is not always as comprehensive as other travel insurance policies and, as such, often automatically excludes pre-existing conditions. Some insurers may offer cover for some conditions for an additional premium; however, you may have to directly contact your insurer to ask for this cover.