Pre-existing Condition Look back Period

[Jade13]

For those who do not purchase insurance that has a pre-existng condition waiver, is the look back period from the date the vacation/cruise starts, or from when payment of the policy is made in full - or different for each policy? I am asking about the Effective Date.

 

I know we have purchased the Celebrity (Berkeley) policy a few times for short Caribbean cruises, 2, 3, 4, 5 nights and we do have medical insurance that covers us out of network. At least twice I was insuring a minor child and their friend and at the time for their inside cabin the cost was $29.00 per person (now starting rates are about $39.00 per person). I wanted the policy in case the friend backed out. Celebrity assured me (although I never believed them 100%) that I could get the 75% cruise credit in my name since I had paid if someone else's minor backed out, as I sure wouldn't be inviting them again. The other major reason for the policy was for the 25K medical evac around the Caribbean.

 

In any event I am now wondering about these look back periods and when they start. Celebrity has a different date for cancelation and interruption. I know the Celebrity Cruise Protection Look Back Period for pre-existing conditions is 60 days, but from when?

[SuzanneSLO]

The policy includes the following language: "Celebrity Cruises will not waive their cancellation penalty and provide a cash refund, should you cancel or interrupt your cruise vacation for any of the following reasons:

a condition that first presents, worsens, becomes acute or has symptoms causing a person to seek diagnosis, care or treatment, or prompts a change in medication, during the 60 days before you purchased this waiver...." [emphasis added]

 

I think that answers your question. -- Suzanne

[Jade13]

The policy includes the following language: "Celebrity Cruises will not waive their cancellation penalty and provide a cash refund, should you cancel or interrupt your cruise vacation for any of the following reasons:

a condition that first presents, worsens, becomes acute or has symptoms causing a person to seek diagnosis, care or treatment, or prompts a change in medication, during the 60 days before you purchased this waiver...." [emphasis added]

 

I think that answers your question. -- Suzanne

 

Actually I wanted to know the look back period if you have an injury/illness while on the ship. It says 60 days, but from when? Thanks.

[cruiseco]

For those who do not purchase insurance that has a pre-existng condition waiver, is the look back period from the date the vacation/cruise starts, or from when payment of the policy is made in full - or different for each policy? I am asking about the Effective Date.

 

I know we have purchased the Celebrity (Berkeley) policy a few times for short Caribbean cruises, 2, 3, 4, 5 nights and we do have medical insurance that covers us out of network. At least twice I was insuring a minor child and their friend and at the time for their inside cabin the cost was $29.00 per person (now starting rates are about $39.00 per person). I wanted the policy in case the friend backed out. Celebrity assured me (although I never believed them 100%) that I could get the 75% cruise credit in my name since I had paid if someone else's minor backed out, as I sure wouldn't be inviting them again. The other major reason for the policy was for the 25K medical evac around the Caribbean.

 

In any event I am now wondering about these look back periods and when they start. Celebrity has a different date for cancellation and interruption. I know the Celebrity Cruise Protection Look Back Period for pre-existing conditions is 60 days, but from when?

 

 

 

Start with the plan's definition of "pre-existing condition":

 

“Pre-Existing Condition” means an illness, disease, or other condition during the 60-day period

immediately prior to your effective date for which you or your Traveling Companion, Business Partner or

Immediate Family Member who is scheduled or booked to travel with you:

1) received or received a recommendation for a diagnostic test, examination, or medical treatment; or

2) took or received a prescription for drugs or medicine.

Item 2) of this definition does not apply to a condition which is treated or controlled solely through the

taking of prescription drugs or medicine and remains treated or controlled without any adjustment or

change in the required prescription throughout the 60-day period before coverage is effective under this

Policy."

 

So now you know the "look back period" (by the way, you'll probably never see that exact term in any plan's wording) is the 60 days prior to the coverage's "effective date".

 

So now look up the term "effective date" Again, even though the plan wording uses the term "effective date" earlier in the plan document, the info you need won't be found under that exact term. With this plan what you're looking for is under the section labeled "Term of Coverage"

 

"TERM OF COVERAGE

When Coverage Begins

All coverages (except Pre-Departure Trip Cancellation and Post-Departure Trip Interruption) will take

effect on the later of: 1) the date the plan payment has been received by Celebrity Cruises; 2) the date

and time you start your Covered Cruise Vacation; or 3) 12:01 A.M. Standard Time on the Scheduled

Departure Date of your Covered Cruise Vacation.

 

Pre-Departure Trip Cancellation coverage will take effect on the day your plan payment is received byCelebrity Cruises. Coverage begins at 12:01A.M. Standard Time of the effective date of the certificate if

the required plan payment is received. Post-Departure Trip Interruption coverage will take effect on the

Scheduled Departure Date of your Covered Cruise Vacation if the required plan payment is received."

 

As you noted, there are separate "effective dates" for trip cancellation/interruption and for all other coverages (medical, evacuation, etc).

 

For the trip cancellation coverage it's the 60-day period prior to the date that Celebrity receives your payment for the policy.

 

For the trip interruption coverage you'll find that it's the 60-day period prior to your departure date.

 

For all other coverages it's the LATER of one of the following:

 

1) the date the plan payment has been received by Celebrity Cruises;

2) the date and time you start your Covered Cruise Vacation; or

3) 12:01 A.M. Standard Time on the Scheduled Departure Date of your Covered Cruise Vacation.

 

So if you file a medical claim for what may or may not be a pre-ex condition they would look at your medical history ONLY in the 60 day period prior to whatever date is the later of one of the three options above (most likely #2) to determine if you fall under the plan's definition of a "pre-existing condition."

 

Here's more general information that should apply to just about any plan:

 

http://www.travelinsurancebasics.com/effective.php

[Jade13]

Start with the plan's definition of "pre-existing condition":

 

“Pre-Existing Condition” means an illness, disease, or other condition during the 60-day period

immediately prior to your effective date for which you or your Traveling Companion, Business Partner or

Immediate Family Member who is scheduled or booked to travel with you:

1) received or received a recommendation for a diagnostic test, examination, or medical treatment; or

2) took or received a prescription for drugs or medicine.

Item 2) of this definition does not apply to a condition which is treated or controlled solely through the

taking of prescription drugs or medicine and remains treated or controlled without any adjustment or

change in the required prescription throughout the 60-day period before coverage is effective under this

Policy."

 

So now you know the "look back period" (by the way, you'll probably never see that exact term in any plan's wording) is the 60 days prior to the coverage's "effective date".

 

So now look up the term "effective date" Again, even though the plan wording uses the term "effective date" earlier in the plan document, the info you need won't be found under that exact term. With this plan what you're looking for is under the section labeled "Term of Coverage"

 

"TERM OF COVERAGE

When Coverage Begins

All coverages (except Pre-Departure Trip Cancellation and Post-Departure Trip Interruption) will take

effect on the later of: 1) the date the plan payment has been received by Celebrity Cruises; 2) the date

and time you start your Covered Cruise Vacation; or 3) 12:01 A.M. Standard Time on the Scheduled

Departure Date of your Covered Cruise Vacation.

 

Pre-Departure Trip Cancellation coverage will take effect on the day your plan payment is received byCelebrity Cruises. Coverage begins at 12:01A.M. Standard Time of the effective date of the certificate if

the required plan payment is received. Post-Departure Trip Interruption coverage will take effect on the

Scheduled Departure Date of your Covered Cruise Vacation if the required plan payment is received."

 

As you noted, there are separate "effective dates" for trip cancellation/interruption and for all other coverages (medical, evacuation, etc).

 

For the trip cancellation coverage it's the 60-day period prior to the date that Celebrity receives your payment for the policy.

 

For the trip interruption coverage you'll find that it's the 60-day period prior to your departure date.

 

For all other coverages it's the LATER of one of the following:

 

1) the date the plan payment has been received by Celebrity Cruises;

2) the date and time you start your Covered Cruise Vacation; or

3) 12:01 A.M. Standard Time on the Scheduled Departure Date of your Covered Cruise Vacation.

 

So if you file a medical claim for what may or may not be a pre-ex condition they would look at your medical history ONLY in the 60 day period prior to whatever date is the later of one of the three options above (most likely #2) to determine if you fall under the plan's definition of a "pre-existing condition."

 

Here's more general information that should apply to just about any plan:

 

http://www.travelinsurancebasics.com/effective.php

 

That is what I thought I read regarding the Celebrity plan. The Look back for a medical condition being paid sounds like 60 days from the vacation/cruise (not the purchase date).

 

I bet there are a lot of people who would be excluded.

 

Btw, I did see another one of your posts and I believe the HAL plan is very differant than this one (also administered by Berkely), but it does cover pre-existing conditions.

 

This link is excellent. Thank you.

[patseacruiser]

If you don't purchase AND pay for at time of booking with the cruise line's insurance then the look back period would be 60 days from the day you paid for the insurance. If you pay at deposit then the pre-existing condition is usually waived.

[cruiseco]

If you don't purchase AND pay for at time of booking with the cruise line's insurance then the look back period would be 60 days from the day you paid for the insurance. If you pay at deposit then the pre-existing condition is usually waived.

 

The pre-existing condition exclusion in the Celebrity Cruise Care plan is NEVER waived.

 

For trip cancellation, if you cancel for a medical reason that IS NOT a pre-existing condition you get 100% of your loss back in cash.

 

Again, for trip cancellation, if you cancel because of a medical reason that IS a pre-existing condition you're covered under the "cancel for any reason" benefit and you get a portion of your loss back in the form of a voucher that can be used for a future cruise, the same as if your pet goat is sick and you won't leave it at home. But there is no "waiver" of the pre-ex exclusion that will turn this into a cancellation due to a covered reason and thus get you a reimbursement of 100% cash instead of a 70% voucher.

 

For trip cancellation, when you purchase your policy will change the time frame used to determine if a medical condition is pre-existing or not (the "look back period" will always be the 60 days prior to the policy purchase -- changing the purchase date changes the "look back" dates) but it never waives the exclusion.

 

The same applies to the other plan benefits (medical, trip interruption, etc). There is no way to get the pre-ex exclusion waived -- if the loss is due to a pre-ex condition your claim will be denied.

[Jade13]

Start with the plan's definition of "pre-existing condition":

 

“Pre-Existing Condition” means an illness, disease, or other condition during the 60-day period

immediately prior to your effective date for which you or your Traveling Companion, Business Partner or

Immediate Family Member who is scheduled or booked to travel with you:

1) received or received a recommendation for a diagnostic test, examination, or medical treatment; or

2) took or received a prescription for drugs or medicine.

Item 2) of this definition does not apply to a condition which is treated or controlled solely through the

taking of prescription drugs or medicine and remains treated or controlled without any adjustment or

change in the required prescription throughout the 60-day period before coverage is effective under this

Policy."

 

So now you know the "look back period" (by the way, you'll probably never see that exact term in any plan's wording) is the 60 days prior to the coverage's "effective date".

 

So now look up the term "effective date" Again, even though the plan wording uses the term "effective date" earlier in the plan document, the info you need won't be found under that exact term. With this plan what you're looking for is under the section labeled "Term of Coverage"

 

"TERM OF COVERAGE

When Coverage Begins

All coverages (except Pre-Departure Trip Cancellation and Post-Departure Trip Interruption) will take

effect on the later of: 1) the date the plan payment has been received by Celebrity Cruises; 2) the date

and time you start your Covered Cruise Vacation; or 3) 12:01 A.M. Standard Time on the Scheduled

Departure Date of your Covered Cruise Vacation.

 

Pre-Departure Trip Cancellation coverage will take effect on the day your plan payment is received byCelebrity Cruises. Coverage begins at 12:01A.M. Standard Time of the effective date of the certificate if

the required plan payment is received. Post-Departure Trip Interruption coverage will take effect on the

Scheduled Departure Date of your Covered Cruise Vacation if the required plan payment is received."

 

As you noted, there are separate "effective dates" for trip cancellation/interruption and for all other coverages (medical, evacuation, etc).

 

For the trip cancellation coverage it's the 60-day period prior to the date that Celebrity receives your payment for the policy.

 

For the trip interruption coverage you'll find that it's the 60-day period prior to your departure date.

 

For all other coverages it's the LATER of one of the following:

 

1) the date the plan payment has been received by Celebrity Cruises;

2) the date and time you start your Covered Cruise Vacation; or

3) 12:01 A.M. Standard Time on the Scheduled Departure Date of your Covered Cruise Vacation.

 

So if you file a medical claim for what may or may not be a pre-ex condition they would look at your medical history ONLY in the 60 day period prior to whatever date is the later of one of the three options above (most likely #2) to determine if you fall under the plan's definition of a "pre-existing condition."

 

Here's more general information that should apply to just about any plan:

 

http://www.travelinsurancebasics.com/effective.php

 

Cruiseco - Per Michael R at Berkley, the 60 day look back period is not the date that the covered trip starts, it is from the date that you purchase the policy. For HAL, the pre-existing conditions exclusion is always waived.

 

We are not using these plans for our next trip, but never know what we will do in the future. And I agree the policy sounds different the way that it is written.

 

"Michael R", Senior Rep at Berkely said anyone is welcome to contact him, 1-800-382-6841, if they wish for clarification on the Celebrity policy or the HAL policy.

[willysgrandma]

That is correct. The day you pay in full for the plan is the date the policy begins.

If you are purchasing the cruise lines coverage, some lines allow you to pay for it at final payment. You should always pay at time of deposit to make sure your look back begins that date.

 

If you purchase insurance that has coverage for pre existing conditions you usually must buy at deposit or within 14 days of making you deposit (for most most third party insurance, some have different time limitations). If you buy within that time frame as long as your physician will state you were medically able to travel on the date you purchased the insurance you would be ok. Unless you have an emotional or mental issue as those care not covered by any insurance, you'd need to buy expensive cancel for any reason

coverage.

 

Cruiseco - Per Michael R at Berkley, the 60 day look back period is not the date that the covered trip starts, it is from the date that you purchase the policy. For HAL, the pre-existing conditions exclusion is always waived.

 

We are not using these plans for our next trip, but never know what we will do in the future. And I agree the policy sounds different the way that it is written.

 

"Michael R", Senior Rep at Berkely said anyone is welcome to contact him, 1-800-382-6841, if they wish for clarification on the Celebrity policy or the HAL policy.

[6rugrats]

Unless you have an emotional or mental issue as those care not covered by any insurance, you'd need to buy expensive cancel for any reason

coverage.

Just curious; what type of "emotional or mental issue" would "not be covered by any insurance"?

[klfrodo]

Just curious; what type of "emotional or mental issue" would "not be covered by any insurance"?

 

My wife has been researching this particular issue.

According to her research and her understanding (with the caveat that she could be mistaken) some mental health issues may not be covered under some/most/all travel insurance policies to include as a pre-existing condition.

 

For example Bipolor manic/depressive disorder. Under normal everyday life, this can be controlled with medications. Vacations, whether it be Vegas, Disney, or a cruise can cause problems due to the excitement of planning or just the new exciting environment. The person involved and their support people MUST consciously be aware of their environment and any personality changes that may take place. They must also be very aware of any medications they may take (ie. motion sickness meds) and how they may interact with regular meds.

A cruise could easily cause a bipolor person to go into a very high manic phase. The next phase is the worst because the higher manic they go, the farther into depression they go. Some people can be considered rapid cyclers which means they can cycle from manic to depression multiple times a day. If a person with this condition is not monitored by a friend or by themsleves for the signs of these changes, tragedy can strike.

[Colsen0924]

Thanks Cruiseco for the clear, concise and easy to understand insurance information you share with us. The link was very helpful as well :)

[Shelly&Jack]

The U.S. Affordable Care Act (referred to as Obamacare) prohibits insurance companies from denying coverage due to pre-exisitng conditions.

 

Since most of the trip insurance coverage is for cancellation due to illness, medical care and/or evacuation, it is essentially a medical insurance plan. (Pre-existing conditions have nothing to do with lost luggage or trip delay coverage.)

 

Does anyone know if the trip insurance companies can no longer deny either coverage or a claim due to pre-existing medical conditions?

 

This could have an impact on when it is necessary to purchase trip insurance, that is, at time of booking or at final payment. We sometimes book cruises 18 months out. Since most cruises can be canceled without penalty prior to final payment, the timing of the purchase of the trip insurance can be an issue.

 

We have usually purchased trip insurance at the time of final payment since we did not have any pre-existing conditions. However, that has changed and purchasing insurance so far in advance makes no sense since you can cancel a cruise at anytime up to final payment without penalty. So why purchase insurance so far in advance?

[sail7seas]

The U.S. Affordable Care Act (referred to as Obamacare) prohibits insurance companies from denying coverage due to pre-exisitng conditions.

 

Since most of the trip insurance coverage is for cancellation due to illness, medical care and/or evacuation, it is essentially a medical insurance plan. (Pre-existing conditions have nothing to do with lost luggage or trip delay coverage.)

 

Does anyone know if the trip insurance companies can no longer deny either coverage or a claim due to pre-existing medical conditions?

 

This could have an impact on when it is necessary to purchase trip insurance, that is, at time of booking or at final payment. We sometimes book cruises 18 months out. Since most cruises can be canceled without penalty prior to final payment, the timing of the purchase of the trip insurance can be an issue.

 

We have usually purchased trip insurance at the time of final payment since we did not have any pre-existing conditions. However, that has changed and purchasing insurance so far in advance makes no sense since you can cancel a cruise at anytime up to final payment without penalty. So why purchase insurance so far in advance?

 

 

What a good question.

I so hope we can get a definitive answer.

 

The insurance we buy for travel is substantially only medical and emergency evacuation/repatriation. Those policies include, incidentally, a small stipend for trip interruption and baggage delay but no coverage for cancellation of our cruise.

 

What we are buying is medical and I wonder if 'Obamacare' terms of prohibition of denial for coverage due to pre-existing would apply to our specific travel medical coverage.

 

It never occured to me to question that.

 

[CantanaLobo]

Obamacare governs health insurance. Health insurance is supposed to pay for medical expenses. Trip insurance pays for trip expenses. Missing a cruise due to medical reasons is not a medical expense.

 

Not sure about what to think if you e.g. have a preexisting heart condition, and have a heart attack of the ship. Do they have to pay the shipboard expenses? Medivac you back home?

 

Interesting question.

[dread_pirate]

What we are buying is medical and I wonder if 'Obamacare' terms of prohibition of denial for coverage due to pre-existing would apply to our specific travel medical coverage.

 

I would doubt it. I don't think Obamacare deals with extraterritorial medical coverage, which is what most travelers insure.