Pre-existing condition....need help understanding!

Thank you all for your most enlightening advice. After calling the helpful woman at insuremytrip again, she managed to clarify some points and I bit the bullet and bought the one she suggested - RoamRight Preferred.

As both my husband and myself are healthy seniors with no pre-exsisting problems, I didn't think this option was needed but she thought it wise not to leave any loopholes. She also included the non-refundable airfares I purchased (almost as much as the cruise :( )

Thank you all again.

I think the person that said you need to disclose pre-existing conditions when you buy a policy is from England. Their rules are probably different than in the USA.

Thanks to you all! It is becoming a bit clearer to me now, but I still feel a bit confused. I will make some calls tomorrow to get some answers to the questions I still have.

One of those questions is........If I need to include all of the trip costs in the insurance amount in order to get the pre-existing waiver, how do I do that if I am unsure of the airfare at this point? We don't travel until next summer, and I won't book my air travel for another 6 months or so. Do I add on to the insurance at that time?

My next confusing decision is to decide which to purchase... PRIMARY or SECONDARY insurance. Any opinions on that one???

Thanks so much for your help with this!:D

I am somewhat shocked that this entire thread doesn't define a pre-existing condition.....because MOST people don't actually have a pre-existing condition as defined by their travel insurance policy.

 

I will paraphrase many policies here (read your specific policy): A preexisting condition is one that occurs within 60 (sometimes 90/120) days prior to your purchase of the policy.....or any other condition where your medical treatment or prescription has changed within the 60/90/120 days of purchasing the policy.

 

If you have high blood pressure and it is controlled and you have not had only routine visits to your doctor (pertaining to the high blood pressure) and your medication has not changed....you do NOT have a pre-existing condition.

 

Stop using what you think is a pre-existing condition and read the policy which clearly defines what THEY consider a pre-existing condition.

 

This is the most misunderstood part of travel insurance...and it is perpetuated by those who want everyone to buy a policy the day the book the trip because the money you pay for the insurance isn't refunded, even if you cancel the trip with no penalty. Don't fall for this...read the policy....it's actually very easy reading...and you can read it at insuremytrip, squaremouth or the other travel insurance sales sites.

 

I had high blood pressure...I've been on the same medication for years...I do NOT have a pre-existing condition as far as travel insurance policies.

 

Now that I've hopefully demystified this, there is a caveat....if something happens to a family member who is not on the trip, you may find that if they had a pre-existing condition, some insurance companies might try to avoid paying for trip interruption or cancellation. That's a stickier topic which I haven't explored thoroughly.

I do NOT recommend this approach for most people.

The danger in your scenario is if you have a change in your health before buy trip insurance.

Consider this scenario:

-Joe books a Mediterranean cruise that will sail in 6 months and buys airline tickets to Europe for his family of 4 (very expensive!)

- Joe and his family members are very healthy and are not on any medications, so Joe don't care about buying insurance right away (to waive pre-existing conditions)

- Joe decides that he'll wait and buy trip insurance when it is closer to his trip (and when it is too late to cover pre-existing conditions.)

- Before Joe buys trip insurance, he starts having blood pressure issues and his doctor prescribes blood pressure medicine. (Now Joe has a pre-existing condition.)

- Then Joe buys a trip insurance policy

- Joe has a heart attack a week before his cruise and his doctor says he cannot travel to Europe, so he needs to cancel the cruise and flights.

In this scenario, Joe was perfectly healthy when he booked the trip. But his health changed BEFORE he bought trip insurance. His policy will deny his claim if the blood pressure problems seem related to the heart attack.

However, if Joe had bought trip insurance when he first booked the cruise, his trip cancellation should be covered because his blood pressure problems started AFTER he bought trip insurance.

So your approach has significant risks that could have been avoided buy purchasing a policy right away. (That's fine for you as long as you are aware of those risks and don't complain if you later get burned by it.)

Thanks to you all! It is becoming a bit clearer to me now, but I still feel a bit confused. I will make some calls tomorrow to get some answers to the questions I still have.

 

One of those questions is........If I need to include all of the trip costs in the insurance amount in order to get the pre-existing waiver, how do I do that if I am unsure of the airfare at this point? We don't travel until next summer, and I won't book my air travel for another 6 months or so. Do I add on to the insurance at that time?

 

My next confusing decision is to decide which to purchase... PRIMARY or SECONDARY insurance. Any opinions on that one???

 

Thanks so much for your help with this!:D

I've been in that situation before. Most policies let you increase the amount of coverage later and keep the pre-existing waiver as long as you contact them and pay the additional premium within a specific number of days after you incur additional costs. Just don't forget to do that!

Also, every policy I've bought prices in increments of $500. So, if you need to insure $1,100 per person, round up and insure $1,500 per person. Your insurance cost won't increase, but you'll have a little buffer for additional non refundable prepaid costs such as tours and hotels.

I do NOT recommend this approach for most people.

 

The danger in your scenario is if you have a change in your health before buy trip insurance.

 

Consider this scenario:

-Joe books a Mediterranean cruise that will sail in 6 months and buys airline tickets to Europe for his family of 4 (very expensive!)

- Joe and his family members are very healthy and are not on any medications, so Joe don't care about buying insurance right away (to waive pre-existing conditions)

- Joe decides that he'll wait and buy trip insurance when it is closer to his trip (and when it is too late to cover pre-existing conditions.)

- Before Joe buys trip insurance, he starts having blood pressure issues and his doctor prescribes blood pressure medicine. (Now Joe has a pre-existing condition.)

- Then Joe buys a trip insurance policy

- Joe has a heart attack a week before his cruise and his doctor says he cannot travel to Europe, so he needs to cancel the cruise and flights.

 

In this scenario, Joe was perfectly healthy when he booked the trip. But his health changed BEFORE he bought trip insurance. His policy will deny his claim if the blood pressure problems seem related to the heart attack.

 

However, if Joe had bought trip insurance when he first booked the cruise, his trip cancellation should be covered because his blood pressure problems started AFTER he bought trip insurance.

 

So your approach has significant risks that could have been avoided buy purchasing a policy right away. (That's fine for you as long as you are aware of those risks and don't complain if you later get burned by it.)

D4, you've probably given one of the best descriptions of a general reason why waiting to purchase insurance and not selecting coverage that includes pre-existing conditions is very risky.

Worse, many people think they (or others) can "afford" the loss if a trip must be canceled and non-refundable payments go "poof".

Sure, by definition, if one could make those payments, one can "afford it", and thus the loss.

However, for many people - and especially for those "special trips" that are extra-expensive per one's general budget - IF that happened, they might not be able to afford to pay for it all a second time, having "missed" the first one.

But more important is if one needs the various medical coverages. That's *not* simply "losing what one has already paid", and the potential $$ limit is... really high if something serious occurs where one's own insurance won't cover costs.

This is "insurance" in it's basic form: Many people pooling premiums so that when there is the rare catastrophic loss (e.g., house burning down, car accident, etc.) none of the insured people would get hit with the full costs, and possibly go bankrupt (or worse, not be able to afford necessary care someplace).

The "trip cost" part of insurance is where it can make some sense to "self insure", as some call it. But it isn't really "insurance" against unknown and potentially catastrophic costs. That part is not much different from purchasing an expensive <something>, and realizing there is always a risk it will get lost or break, and doing one's best to avoid that. "Valuable item" insurance riders are like this. One knows what it would cost, approximately, to replace something, and one decides whether to risk needing to pay out of pocket, or to pay premiums so one has less to worry about.

There IS some value in "sleeping well at night", and this is a continuum that varies a lot among different people.

Medical costs without insurance is NOT the same.

GeezerCouple

Thanks to you all! It is becoming a bit clearer to me now, but I still feel a bit confused. I will make some calls tomorrow to get some answers to the questions I still have.

 

One of those questions is........If I need to include all of the trip costs in the insurance amount in order to get the pre-existing waiver, how do I do that if I am unsure of the airfare at this point? We don't travel until next summer, and I won't book my air travel for another 6 months or so. Do I add on to the insurance at that time?

 

My next confusing decision is to decide which to purchase... PRIMARY or SECONDARY insurance. Any opinions on that one???

 

Thanks so much for your help with this!:D

To answer your questions:

When you buy the policy, you include every penny you've laid out at that point. Once you make a further payment, you promptly call up the insurance company, and they tell you how much additional premium to send, if any.

As far as Primary vs. Secondary: For one-time policies, it doesn't make a whole lot of difference. For a secondary policy, you send your medical claim to your primary insurance (if you have any), they pay (or not), and the trip insurance picks up the rest. You do not need to appeal any claim denial with your primary insurance; for instance, if you have basic Medicare, they'll take one look at your claim, see it's for something outside the country, slap a "Denied!" stamp on it, and you are done; it'll add, at most, a week or two to your claim.

For annual policies: Many of them require to have primary medical coverage...

Purchased insurance today. Hopefully, I did my homework and purchased the correct plan for us. Feeling pretty good about the coverage and the cost.

Thanks, again, for your opinions and information!

I do NOT recommend this approach for most people.

 

The danger in your scenario is if you have a change in your health before buy trip insurance.

 

Consider this scenario:

-Joe books a Mediterranean cruise that will sail in 6 months and buys airline tickets to Europe for his family of 4 (very expensive!)

- Joe and his family members are very healthy and are not on any medications, so Joe don't care about buying insurance right away (to waive pre-existing conditions)

- Joe decides that he'll wait and buy trip insurance when it is closer to his trip (and when it is too late to cover pre-existing conditions.)

- Before Joe buys trip insurance, he starts having blood pressure issues and his doctor prescribes blood pressure medicine. (Now Joe has a pre-existing condition.)

- Then Joe buys a trip insurance policy

- Joe has a heart attack a week before his cruise and his doctor says he cannot travel to Europe, so he needs to cancel the cruise and flights.

 

In this scenario, Joe was perfectly healthy when he booked the trip. But his health changed BEFORE he bought trip insurance. His policy will deny his claim if the blood pressure problems seem related to the heart attack.

 

However, if Joe had bought trip insurance when he first booked the cruise, his trip cancellation should be covered because his blood pressure problems started AFTER he bought trip insurance.

 

So your approach has significant risks that could have been avoided buy purchasing a policy right away. (That's fine for you as long as you are aware of those risks and don't complain if you later get burned by it.)

All of our cruises are flexible since we're retired. We probably cancel or move over 1/3 of our cruise reservations due to conflicts or just change of plans. If a pre-existing condition appears prior to final payment, we have the option of scrapping the cruise. Our financial risk, if we cancel prior to final payment, is limited to either the airline change fee or cost to reinstate the miles into our airline points account. River cruises are different since the deposit is often non-refundable.

I agree that there is some risk in waiting, but given our history of changes, we save quite a bit by not buying the insurance up front. Having said that, I do need to further understand buying insurance at the time of booking for only the non-refundable part of the booking and then increasing it as the non-refundable part increases. However, I'm not sure how that works because at booking, there is zero non-refundable cost (other than a TA fee, if there is one)....so how do you buy a ta policy for zero dollar coverage???? I think most TA policies are written to cover the full cost of the cruise, even though if you cancel prior to the cruise, there is no cost....except, of course, the money you paid for that travel insurance policy that is now worthless.

I do, by the way, agree with all the risks pointed out about my "wait" approach...and of course some do have pre-existing conditions, as defined in the policy, so they need to take that into account...I'm only suggesting that one read the policy, undertstand what is and isn't covered, understand if you do or don't have a "pre-existing" condition and then make a measured decision.

All of our cruises are flexible since we're retired. We probably cancel or move over 1/3 of our cruise reservations due to conflicts or just change of plans. If a pre-existing condition appears prior to final payment, we have the option of scrapping the cruise. Our financial risk, if we cancel prior to final payment, is limited to either the airline change fee or cost to reinstate the miles into our airline points account. River cruises are different since the deposit is often non-refundable.

 

I agree that there is some risk in waiting, but given our history of changes, we save quite a bit by not buying the insurance up front. Having said that, I do need to further understand buying insurance at the time of booking for only the non-refundable part of the booking and then increasing it as the non-refundable part increases. However, I'm not sure how that works because at booking, there is zero non-refundable cost (other than a TA fee, if there is one)....so how do you buy a ta policy for zero dollar coverage???? I think most TA policies are written to cover the full cost of the cruise, even though if you cancel prior to the cruise, there is no cost....except, of course, the money you paid for that travel insurance policy that is now worthless.

 

I do, by the way, agree with all the risks pointed out about my "wait" approach...and of course some do have pre-existing conditions, as defined in the policy, so they need to take that into account...I'm only suggesting that one read the policy, undertstand what is and isn't covered, understand if you do or don't have a "pre-existing" condition and then make a measured decision.

As far as how to determine the amount of coverage to purchase, the policy we've used (same policy type for several trips now) only requires that you purchase insurance for ALL NON-REFUNDABLE payments made.

The one quirky feature to this is that you must purchase the insurance within 21 days of making the FIRST payment - and that's ANY payment. That means that the insurance must start within that window, so the *refundable* deposit must be insured, even if no "non-refundable" payments exist yet - IF that is the "first payment".

(It took us a while to figure this out so we didn't pay for more than necessary, OR overlook this first refundable payment!)

The down side of this coverage is that the first few dollars needing to be insured (e.g., the deposit) are charged a higher percentage.

That's because the policy may have less "trip costs" to cover, but the medical/etc., coverage is the same.

So it's a sliding scale in terms of percentage of covered trip costs, with the percentage highest with the smallest amount of covered costs.

[Hope that makes sense; let me know if it doesn't.]

GeezerCouple

As far as how to determine the amount of coverage to purchase, the policy we've used (same policy type for several trips now) only requires that you purchase insurance for ALL NON-REFUNDABLE payments made.

The one quirky feature to this is that you must purchase the insurance within 21 days of making the FIRST payment - and that's ANY payment. That means that the insurance must start within that window, so the *refundable* deposit must be insured, even if no "non-refundable" payments exist yet - IF that is the "first payment".

(It took us a while to figure this out so we didn't pay for more than necessary, OR overlook this first refundable payment!)

 

The down side of this coverage is that the first few dollars needing to be insured (e.g., the deposit) are charged a higher percentage.

That's because the policy may have less "trip costs" to cover, but the medical/etc., coverage is the same.

So it's a sliding scale in terms of percentage of covered trip costs, with the percentage highest with the smallest amount of covered costs.

[Hope that makes sense; let me know if it doesn't.]

 

GeezerCouple

I forgot to add one "plus" of this coverage (through TravelInsured, who paid promptly, by the way):

IF one cancels the trip while insurance is in place, before departure, a DIFFERENT TRIP can be substituted, so the insurance paid is not "lost".

This switch can be done once per individual policy.

Because we plan some trips, especially cruises, far, far in advance, this has "saved" that initial deposit more than once now.

That's especially good, because we always want coverage that does not exclude pre-existing conditions, meaning we must purchase at least the minimal coverage (for the deposit) within 2-3 weeks of making that first, early deposit.

I don't think this one little part of the coverage is particularly well known (?).

GeezerCouple

I've always wanted more clarification on this. So it sounds like if you purchase insurance at time of deposit should something happen before you travel, you will be covered?

I've always wanted more clarification on this. So it sounds like if you purchase insurance at time of deposit should something happen before you travel, you will be covered?

Yes if you purchase the proper insurance :)

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I've always wanted more clarification on this. So it sounds like if you purchase insurance at time of deposit should something happen before you travel, you will be covered?

Usually yes, but read the fine print. You usually must be able to travel on the day you buy the insurance (according to doctors, not your opinion) and there are usually exceptions about planned upcoming surgeries.

For clarification for anyone reading this thread - all this detail about pre-existing policies is in relation to USA insurance, not the rest of the world. UK insurance, for example, is entirely different.

Actually, UK insurance is so completely different that it would be helpful of Cruise Critic to split the forum into two - US insurance, and Rest of the World insurance. Anyone taking the advice above could be seriously misled if they were buying a British policy.

For clarification for anyone reading this thread - all this detail about pre-existing policies is in relation to USA insurance, not the rest of the world. UK insurance, for example, is entirely different.

 

Actually, UK insurance is so completely different that it would be helpful of Cruise Critic to split the forum into two - US insurance, and Rest of the World insurance. Anyone taking the advice above could be seriously misled if they were buying a British policy.

Good point, and also everything written above (and on other threads) is about specific policies and insurance companies. These can differ a lot in what they cover, how they define [benefits, restrictions, whatever], and assorted timing (when one must purchase the insurance, look back periods, etc.).

If anyone is considering purchasing a policy - anywhere - they should be sure they understand the specific policy they will purchase, including what it does cover, and what it does not, and any types of restrictions, even if "in the fine print".

We find TripInsuranceStore.com very helpful in pointing to specifics in different policies (and from different insurers) so we "get the best coverage at the best price" considering our specific needs and preferences.

For example: Just yesterday, we had to consider the trade-off between a policy that we'd have to purchase within 21 days of making the very first payment (the refundable deposit), vs. a policy where we did not need to pay anything until the full payment of the most expensive part (probably cruise or airfare).

Both policies covered pre-existing conditions if purchased at appropriate times.

The problem that Steve pointed out was that he asked if DH still wanted CFAR (Cancel For Any Reason) coverage. DH still did, due to unexpected and sometimes last-minute consulting requests. The second policy would have charged a HUGE extra premium for the CFAR.

That made the choice easy.

We may not have noticed that so quickly, and it allowed us to stop consideration of the other policy very quickly.

And when we do not need/want CFAR, then we'll check again about that other coverage.

GeezerCouple

For clarification for anyone reading this thread - all this detail about pre-existing policies is in relation to USA insurance, not the rest of the world. UK insurance, for example, is entirely different.

 

Actually, UK insurance is so completely different that it would be helpful of Cruise Critic to split the forum into two - US insurance, and Rest of the World insurance. Anyone taking the advice above could be seriously misled if they were buying a British policy.

Yes, very good idea.

Thankfully, our insurance is so much simpler. I think travel insurance in the US is still evolving:cool:

I have no pre existing medical conditions. Would it be best to wait to purchase insurance, I was thinking about how I don't have a complete total of our trip, I know what the cruise will cost, but I will be booking private excursions, renting a car, booking hotels. I would like to insure my entire trip. Is that even possible?

Start your coverage amt for what you have paid for update (deposit). Then increase your coverage as you spend "non refundable" dollars...so if you book excursions that must be paid for in advance increase your coverage. Remember not all your trip is non refundable (car rental for example or tours you don't pay for until the end of the tour). Be sure and increase your coverage as soon as you pay for your flights.

And yes you can wait until final pmt but that is not always the best way to do it.

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