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mafig

What exactly is pre-existing condition?

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I went on 25 cruises without buying insurance.

We did purchase it last time through the TA, but it was a cheap cruise.

This time, the cruise we're considering is more expensive, and I want to be a more careful consumer.

 

What is pre existing condition? I take High blood pressure medication (a very low dose), do I have a pre existing condition?

My dh was very sick three years ago and still takes some medication associated with that illness (neurosarcoidosis). The meds keep it under control. He's fine. Is that a pre existing condition?

 

I hope I don't sound too stupid. But we live in Florida, so we don't need/want our plane trip covered, probably don't need to worry about our luggage being lost. Our cruise is more than we usually spend and 8% or more of $4000 sounds like a lot to me.

 

Help me out if you can.:)

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Basically any medical condition you have had in the past or are currently taking needs for..... So yes you have. If you fail to declare it will invalidate any claim you may have to make

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Both conditions are pre-existing, meaning you already suffered from them before taking out the insurance.

 

If pre-existing conditions are not declared and you had a medical situation which was completely unrelated to anything you'd ever had before, the insurance company could deny payment if they discovered you had a pre-existing condition you hadn't declared.

 

It is absolutely essential to declare anything you are already aware of, including such things as asthma, high blood pressure, high cholesterol etc.

 

It's just not worth the risk of trying to hide anything.

 

What normally happens is the insurance company will then decide whether or not these conditions warrant an extra payment, on top of the insurance premium, in order to cover them.

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Oh, no, I wasn't going to hide them, I just wasn't sure what was considered a pre-existing condition. After a certain age, I'm sure most people have something that's considered pre-existing.

 

For instance, I wondered if you take meds for something and it's under control if that would be pre-existing. Like high cholesteral, that is normal with meds.

 

Thank you. You've answered my questions.:)

Edited by mafig

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A pre-existing condition is whatever the insurance policy you purchase says it is. There will be a section, usually near the front, that has definitions of lots of words you think you know the meaning of, like: "Family", "Hospital", etc. Pre-existing condition will also be defined in that section. I just grabbed the definition from a Nationwide policy that someone posted a few threads down, and it says:

 

Pre-Existing Condition means an illness, disease, or other condition during the sixty (60) day period immediately prior to

the Effective Date for which the Insured, Traveling Companion or Family Member booked to travel with the Insured: 1)

exhibited symptoms which would have caused one to seek care or treatment; or 2) received or received a

recommendation for a test, examination, or medical treatment or 3) took or received a prescription for drugs or medicine.

Item (3) 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 sixty (60) day period before the Effective Date.

The Pre-Existing Conditions exclusion is waived for You if the Insured (a) enrolls in this Policy within at the time he/she

pays the deposit required for his/her Trip (or within twenty-one (21) days of the initial deposit); (b) purchases this Policy for

the full cost of his or her Trip; and © is medically able to travel at the time the premium is paid.

 

So for this specific insurer, if the medications for your high blood pressure and your husband's neurosarcoidosis have been the same dosage for more than 60 days; and if you have not visited a physician who recommended any tests or treatments for these conditions during that time, then they do not count against you. If you have changed medications or had additional tests, then you can still get insurance coverage via this policy as long as you purchase it within 21 days of booking and are currently able to travel.

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So for this specific insurer, if the medications for your high blood pressure and your husband's neurosarcoidosis have been the same dosage for more than 60 days; and if you have not visited a physician who recommended any tests or treatments for these conditions during that time, then they do not count against you. If you have changed medications or had additional tests, then you can still get insurance coverage via this policy as long as you purchase it within 21 days of booking and are currently able to travel.

 

See? Color me confused. The last time I was researching this, I came away with your definition of pre-existing relating to purchasing insurance. However, other posters see it differently. So I guess other insurers do too.:o

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See? Color me confused. The last time I was researching this, I came away with your definition of pre-existing relating to purchasing insurance. However, other posters see it differently. So I guess other insurers do too.:o

 

I'd suggest that you contact Steve at

 

http://www.TripInsuranceStore.com

 

(Call, don't just read the online policy summaries. The fine print matters!)

 

Discuss this with him, and he can describe the definitions used by several different insurers/policy types.

 

What "matters" is what is stated in the actual policy you purchase.

 

Usually, to get coverage that waives the exclusion of pre-existing conditions (that's a good thing: the double negative-type wording means that pre-existing conditions are NOT excluded) one needs to start the insurance within 14 or 21 days of making the *first* payment.

But there is at least one other insurer that allows this waiver if one purchases the policy within 24 hours of final payment (defined very specifically).

 

If you have a policy that waives the exclusion, then it just doesn't matter whether/what previous medical conditions/treatments one has had.

It also means that for a claim, the insurer does *not* need to request earlier medical records, because it just doesn't matter.

That can also make the claim process easier.

 

Also, policies do not necessarily ask one to "declare" medical conditions, treatments, medications.

Keep in mind that most policies do not result in claims.

 

However, IF one does need to make a claim, THAT is when one needs to deal with this - or not, if one has a policy with the waiver.

Without that waiver, then the insurer IS very likely going to start checking through previous medical records, to see if it is possible that the claim is related to some pre-existing condition.

They'll ask for signed statements from physicians/etc., too.

 

We've had two claims, both related to medical emergencies, and because we had those waivers, the claims process was limited to documenting all costs, which were reimbursed promptly.

No need for any medical histories.

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Basically any medical condition you have had in the past or are currently taking needs for..... So yes you have. If you fail to declare it will invalidate any claim you may have to make

 

No travel insurer I'm aware of (based in the US) requires any type of "declaring" of medical conditions/history prior to purchase of the policy by US residents.

 

However, many Canada or UK-based insurers do require that all medical conditions must be declared to the insurer prior to purchase. The insurer can then refuse to sell the policy or can increase the rates. If something isn't disclosed prior to purchase and it's the reason for a claim the claim can be denied. I think any Canadians considering buying a travel insurance policy are better off finding an insurer that offers the US-style of coverage of pre-existing conditions. Some, like TravelSafe do.

Edited by cruiseco

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When we buy insurance the insurer asks a whole lot of questions on a form

if you have heart problems, diabetes etc..

If you are stable then they decide if & how much they will sell you insurance for

If you do not disclose these problems & you should have a heart attack while away & they check your records you may not be covered

It also depends on the look back period

 

Mind you we buy trip cancellation/interruption so this may be different than just medical

 

I would talk to an trip insurance broker & tell them what you are looking for in the way of coverage

 

Canadians are usually not covered by US insurance policies so do your due diligence

 

JMO

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so we don't need/want our plane trip covered, probably don't need to worry about our luggage being lost. Our cruise is more than we usually spend and 8% or more of $4000 sounds like a lot to me.

 

Help me out if you can.:)

so you are not planning on buying trip cancellation insurance just medical is that correct?

 

playing devils advocate here

What happens should you fall ill the day before the cruise (it happens)

you have an accident on the way to the airport or the cruise port & are in hospital & miss the ship

are you prepared to lose the $4000. for the cruise or are you willing to pay the 8% for insurance that would probably get you the $4000 back in your bank account

something to consider when looking into insurance

 

if you can afford to eat the cost of the cruise then it is not an issue

 

JMO

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They sound like pre existing to me.

 

But to what degree they impact on coverage is another question.

 

Always read the Ts&Cs.

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Oh, no, I wasn't going to hide them, I just wasn't sure what was considered a pre-existing condition. After a certain age, I'm sure most people have something that's considered pre-existing.

 

For instance, I wondered if you take meds for something and it's under control if that would be pre-existing. Like high cholesteral, that is normal with meds.

 

Thank you. You've answered my questions.:)

 

Yes that is pre existing, but if under control and no related condition, such as blood pressure, may well make no difference to coverage.

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When we buy insurance the insurer asks a whole lot of questions on a form

if you have heart problems, diabetes etc..

If you are stable then they decide if & how much they will sell you insurance for

If you do not disclose these problems & you should have a heart attack while away & they check your records you may not be covered

It also depends on the look back period

 

Mind you we buy trip cancellation/interruption so this may be different than just medical

 

I would talk to an trip insurance broker & tell them what you are looking for in the way of coverage

 

Canadians are usually not covered by US insurance policies so do your due diligence

 

JMO

 

TravelSafe is one that does. Here's this is from their Classic and Classic Plus plans' fine print for Canada residents (except Quebec):

 

"Waiver of the Pre-Existing Condition Exclusion

The exclusion for Pre-Existing Conditions will be waived

if this plan is purchased within 21 days of the date Your

initial Trip deposit is paid."

 

It's the same wording as their plans for US residents. No pre-disclosure, no pre-qualifying. Buy your plan within 21 days of making the first payment on your trip and you're good to go. Those Canadian insurers just leave themselves too many loopholes to get out of paying a claim by calling it a pre-existing condition. With TravelSafe there's only one condition you have to meet -- buy the policy inside that 21-day period. Easy.

 

http://www.travelproservices.com/ca.htm

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TravelSafe is one that does. Here's this is from their Classic and Classic Plus plans' fine print for Canada residents (except Quebec):

 

 

I am sure there are a few that sell to Canadians that is why people need to do their homework before buying a policy

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I am sure there are a few that sell to Canadians that is why people need to do their homework before buying a policy

 

What's a little different is this is not jan American company that just happens to also sell to Canadians. It's underwritten by a Canadian insurer that's been in business over 100+ years and the plan is approved and regulated by the various provincial departments of insurance if there's ever a problem. It's more a Canadian company only servicing Canadian citizens (they don't sell to US residents) than a US-based company that just happens to sell to Canadians (without the oversight of Canadian authorities).

 

Here's one place in the wording where this makes a difference:

 

"Notice: Notwithstanding any other provisions herein

contained, this contract is subject to the Statutory Conditions

in the Insurance Act respecting contracts of Accident and

Sickness Insurance. For Québec residents, notwithstanding

any other provisions herein contained, this contract is subject

to the mandatory provisions of the Civil Code of Québec

respecting contracts of Accident and Sickness Insurance."

 

You're protected under Canadian law, not US laws. I don't know if these laws are more consumer-friendly than US laws but at lease Canadian policy holders have full access to the Canadian regulatory and dispute resolution procedures.

Edited by cruiseco

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thanks for the link I will have a look at the product

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We always use Steve from Tripinsurancestore.

 

We have CSA which we purchased prior to final payment and waives pre-existing conditions.

It's a little more expensive, but I didn't want to take chances with a couple medical problems that have made us see the doctor recently.

 

Steve is fantastic!

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See? Color me confused. The last time I was researching this, I came away with your definition of pre-existing relating to purchasing insurance. However, other posters see it differently. So I guess other insurers do too.:o

 

I'm a bit confused too. You said you live in Florida, but lots of people are describing Canadian insurance requirements in answer to your question. Are you actually a Canadian who just lives in the U.S. part-time? If not, just ignore all the posts about Canada and UK requirements. They are very different from how insurance works in the U.S.

 

The advice to call and speak to a real person who is familiar with the policies sold in your state is good. That will help cut through the confusion.

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I live in Florida. You know how threads take on their own life, like this one did with advice for Canadian residents.

 

I have just ignored the Canadian responses. I'm sure they're helpful to someone else though.

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A pre-existing condition is whatever the insurance policy you purchase says it is. There will be a section, usually near the front, that has definitions of lots of words you think you know the meaning of, like: "Family", "Hospital", etc. Pre-existing condition will also be defined in that section. I just grabbed the definition from a Nationwide policy that someone posted a few threads down, and it says:

 

 

 

So for this specific insurer, if the medications for your high blood pressure and your husband's neurosarcoidosis have been the same dosage for more than 60 days; and if you have not visited a physician who recommended any tests or treatments for these conditions during that time, then they do not count against you. If you have changed medications or had additional tests, then you can still get insurance coverage via this policy as long as you purchase it within 21 days of booking and are currently able to travel.

 

Riding on this thought - so my husband's doctor wants him to have a routine blood test to monitor his current cholesterol levels. That means as long as I purchase with XX number of days of my initial payment he's good?

 

And only those policies that have that "must purchase within XX number of days of initial payment" statement will have that coverage?

 

I don't understand the policies that say "no coverage. Pre-existing look-back period 60 days". If they are not offering coverage for pre-existing conditions, why even have a look-back period?

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And that is why you need to talk to Steve at the trip insurance store. Follow Geezer Couple's advice. Steve and his staff will ask you a lot of questions and answer your questions and then find the best policy for you. Everyone is different so there is no one policy that fits all. I am a type 2 diabetic, that is a pre-existing condtion, I have coranery artery disease, that is a pre-exsisting condition. That means I have to buy my insurance with in 10 to 21 days of making my initial deposit on a trip. The look back period and conditions vary from policy to policy, company to company so you really need to talk to an expert or three, not just the people here. Insurance is a lot of legalize and sometimes I think they make it that way to make harder for us to collect.

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A pre-existing condition is whatever the insurance policy you purchase says it is. There will be a section, usually near the front, that has definitions of lots of words you think you know the meaning of, like: "Family", "Hospital", etc. Pre-existing condition will also be defined in that section. I just grabbed the definition from a Nationwide policy that someone posted a few threads down, and it says:

.

 

Exactly right. it doesn't matter what you think a pre-existing condition is or what a doctor tells you it is, or what ramdon folks on the internet think it is, or what some other insurer says it is. All that counts is what the policy you're looking at says it is. All else ir irrelevent

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So most are saying that their pre existing condition is covered because their treatment has not changed and it's stable. But say it's not stable, then you can't get coverage for that condition?

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So most are saying that their pre existing condition is covered because their treatment has not changed and it's stable. But say it's not stable, then you can't get coverage for that condition?

 

There are insurance policies that will waive the pre-existing conditions exclusion if you purchase them within x days of making the initial deposit (x varies by insurer, but is usually 3 weeks or less). If you have an unstable condition, then you need to buy insurance shortly after paying the deposit on your cruise.

 

Also, policies require the insured to be capable of traveling on the date that the policy is purchased, so do not purchase trip insurance for someone who would be too ill to go if the cruise left today, even though you expect them to be well by the actual sailing date.

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"so you are not planning on buying trip cancellation insurance just medical is that correct?

playing devils advocate here

What happens should you fall ill the day before the cruise (it happens)

you have an accident on the way to the airport or the cruise port & are in hospital & miss the ship

are you prepared to lose the $4000. for the cruise or are you willing to pay the 8% for insurance that would probably get you the $4000 back in your bank account

something to consider when looking into insurance

if you can afford to eat the cost of the cruise then it is not an issue "

 

This is my issue also. The answer to the above quote for me is YES I am willing to lose the prepaid money if I have to cancel early. So, Can I put 0$ in the prepaid amount, buy the insurance whenever I want before the trip, and still be covered for PEC for medical/evac while on vacation? I realize the cost s will not be paid if I cancel pre trip.

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