Waivers Of The Pre-Existing Medical Conditions Exclusion

As we've seen,every travel insurer excludes for losses that result from pre-existing medical conditions (although what is and what is not a pre-existing medical conditions can vary widely by plan and insurer). However, some -- but not all -- insurers are willing to waive this exclusion if the traveler meets certain requirements. These requirements vary from insurer to insurer and can also vary among plans offered by one insurer. Here's some examples:

"Waiver of the Pre-Existing Condition Exclusion (Only Available To Persons Under Age 80)   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. Note : This waiver does not apply for persons age 80 or older."

 

"The Pre-Existing Conditions exclusion is waived if You

(a) enroll in this policy at the time You pay the deposit required for Your Covered Trip (or within 21 days of the initial Covered Trip deposit);
(b) purchase this policy for the full cost of Your Covered Trip; and
(c) are medically able to travel at the time the premium is paid."

 

"Pre-Existing Medical Condition Exclusion Waiver
The Insurer will waive the pre-existing medical condition exclusion up to a maximum of the first $30,000 of Trip Cost per person if the following conditions are met:
1. This plan is purchased within 15 days of making the Initial Trip Payment;
2. The amount of coverage purchased equals all prepaid nonrefundable payments or deposits applicable to the Trip at the time of purchase, and the cost of any subsequent arrangement(s) added to the same Trip are insured within 15 days of the date of payment or deposit for any subsequent Trip arrangement(s);
3. All Insured's are medically able to travel when plan cost is paid."

 

"WAIVER OF THE PRE-EXISTING CONDITION EXCLUSION

The Pre-Existing Condition Exclusion is waived provided you meet all of the following requirements:

1. the payment for this plan is received prior to/or within 24 hours of your final payment for your Covered Trip; and
2. you are not disabled from travel at the time you make your plan payment.
" 

 

When trying to figure out which plan offers a waiver that best suits your needs the first thing to look at is if there are any age-related restrictions that might apply to you. For example, the first plan shown above restricts the waiver to those under age 80. It's not exactly clear from the plan wording but in this case it means under age 80 at the time the policy is purchased, not at the time of travel. We did what you should do if there's any question -- we called the insurer to find out. So if you're 79 or younger on the date you buy the policy you're eligible for the waiver if you buy the policy within 21 days of making the first payment on the trip EVEN IF you're 80 during the trip.  

OK, so you're 64 years old and all of the above examples are available to you. It looks like the next most important things to figure out are:

1) How is the date of your initial trip deposit determined

2) How is the 15 or 21 day period (other plans is 10, 14, 30, or 31 days) determined.

Hopefully, you have bought your coverage right away so there's no question that you have met these time requirements and have nothing to worry about. But the insurers do not budge on these dates and if you've missed the timeline by a day you do not have the coverage you thought you did.

If you have to cancel your trip because of a pre-existing medical condition the insurer will ask for proof of when that first payment was made. In general, if the first payment was by credit card they'll ask for a copy of your card statement and go by the date the payment was posted to your account. If that first payment was made by check, they'll ask for a copy of the cancelled check and use the date the check was written, not the date the checked was received by your travel agent and not the date the check hit your bank.

Let's say you're purchasing a policy from example #2 above. You made the initial payment on May 1st and are buying the policy on May 22nd -- 21 days later. Are you good? Maybe. Some insurers figure things just that way -- the 22nd is the last day for you to get your waiver. But others count the date of the initial payment as day #1 which means the 21st is the last day to get the waiver and you're out of luck.

If you are coming right down to the wire on any of these dates be sure to find out exactly where you stand before paying out money for a policy that might not do what you need it to do.

The next questions is what exactly is an "initial trip payment" or an "initial trip deposit." 99% of the time it will be obvious but there are circumstances where it's not.

Here's one very common example. Last year you cancelled a trip and the airline gave you a voucher for a future flight. You just booked a cruise and will be using that voucher to get to the departure port. You need the waiver of the pre-existing condition exclusion. If you buy the policy within the 21 day timeframe that example #2 above requires are you covered?

You take advantage of the cruise line's special deal that lets those currently on a cruise make a deposit on your next cruise and get a good discount -- you don't even have to pick a specific sailing yet. A few months later when you have chosen a cruise you have the cruise line apply that deposit to it then buy your insurance. Does the pre-existing condition waiver apply?

Any time there is any doubt about how applying an existing voucher or credit to your new booking will affect your eligibility for the pre-existing condition waiver be sure to call the insurer to find out where you stand. Again, don't pay out money unless you're sure you're getting the coverage you think you're getting.

Next, look at the following from example #3 above:
 

"2. The amount of coverage purchased equals all prepaid nonrefundable payments or deposits applicable to the Trip at the time of purchase, and the cost of any subsequent arrangement(s) added to the same Trip are insured within 15 days of the date of payment or deposit for any subsequent Trip arrangement(s);" 


With this insurer, not only do you have to meet the timeline requirements in order to get the pre-existing condition waiver, but you also have to make sure that 100% of your pre-paid, non-refundable trip costs are insured. The insurers in examples #1 and #4 don't care -- you can insure as little or as much of your trip arrangements as you'd like.

Your tour costs, your cruise fare and airline tickets are all pretty easy to figure out as far as their needing to be insured or not. But questions pop us most frequently with hotel reservations. You booked a night's pre-tour hotel in Paris. They charged your credit card immediately but if you give them at least 48 hours notice of a cancellation they'll issue you a refund. You hate to spend the money to insure it but the question is: do you have to? With examples #1 and #4 the answer is "no". But with the other two examples you'd better call them to find out. There are some insurers that definitely will require you to insure that hotel cost while others won't. And in all cases it's impossible to tell which is which from the plan wording. It is definitely worth a couple of minutes to find out for sure what you have to do rather than finding out later that you guessed wrong and your pre-existing condition waiver doesn't apply.

Example #4 above happens to be from the CSA Custom Luxe plan. CSA often pops up as a valuable option because of this section of the waiver definition:
 

"1. the payment for this plan is received prior to/or within 24 hours of your final payment for your Covered Trip; and" 


Whereas most insurers require that you buy your policy within a 10 to 30 day period following your initial deposit/payment, CSA offers their waiver as long as you buy the policy no later than 24 hours after making the FINAL payment on your trip. For those of you who have slipped past the point of being eligible for the waiver from other insurers be sure to keep CSA in the mix because of this.

One thing to keep in mind with CSA is what they consider to be the "final payment" of your trip. According to CSA that means the final payment made on the primary component of the trip. For example, say you've booked a three week tour through Central Europe. You made the final payment on that several weeks ago and have not purchased your policy. Now you add on a one-night pre-tour hotel room in Prague and the same day buy the CSA policy to get the pre-existing condition waiver. Sorry, but you're not eligible for the waiver. Since the primary reason for the trip is the tour, 24 hours after making the final payment for the tour is the last day to get the waiver. Anything else added on around the tour such as the hotel or a rental car doesn't count. Again, when in doubt call them to see where you stand.

Before you buy a CSA Custom Luxe policy be sure to read more here 

travel insurance basics