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Pre-existing conditions and the elderly


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I’m doing trip insurance research for an upcoming cruise.

 

Our biggest concern is my MIL has many medical issues, limited mobility, home bound living with full time in home care (she’s in her late 80s).  In other words, she’s old and has many ailments typical of old age.   At any point her current conditions could deteriorate to the point of hospitalization, or, worse, she could pass on.

 

As an example of what I assume is typical language,  this is the Pre-exisiting Condition definition from my CC:

 

Pre–existing Condition – illness, disease or accidental injury of You or Your Traveling Companion, Your Immediate Family Member or the Immediate Family Member of Your Traveling Companion, for which medical advice, diagnosis, care or treatment was recommended or received within the sixty (60) day period immediately prior to the initial deposit or booking date (whichever occurs first) of a Trip; the taking of prescription drugs or medication for a controlled condition throughout this sixty (60) day period will not be considered to be a treatment of illness or disease; <removed pregnancy related language>

 

I’m sure my MIL has received “medical advice, diagnosis, care or treatment” during the look back period that would probably be related if she were to significantly deteriorate or pass affecting the cruise.   Am I correct in thinking that if something we to happen there is a darn good chance the insurance company would claim it was a pre-existing condition?

 

It’s almost as if I am asking at what point is “being old” a pre-existing condition?  Is this a reason people seek CFAR coverage?

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You can get a waiver for pre-existing conditions by buying in the time-sensitive period defined in the policy. Usually it is within 14-21 days of making the initial deposit. Some policies allow it if purchased in proximity to final payment. 
 

The waiver exempts the policyholder from the look-back period as well as the exclusion for pre-existing conditions coverage so that you are fully covered. Without the waiver, you are correct. The claim would be denied for cancellation or medical treatment during the cruise if it could be attributed to a pre-existing condition. Only emergency care would be covered in that case.

 

Be aware that in some policies the pre-existing conditions provision also applies to family members not traveling with you so that even if your MIL stayed home, it could still impact your coverage if you had to cancel or interrupt your trip because of her health.

 

Health problems and medical issues are covered by travel insurance. It is just that it can be difficult for the layman to understand the intricacies of the policy language. I expect some people do buy CFAR as a fail-safe, but I’m not sure it is worth the extra cost. It might be better to consult a professional who can advise you based on your specific needs.

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17 minutes ago, PATRLR said:

I’m doing trip insurance research for an upcoming cruise.

 

Our biggest concern is my MIL has many medical issues, limited mobility, home bound living with full time in home care (she’s in her late 80s).  In other words, she’s old and has many ailments typical of old age.   At any point her current conditions could deteriorate to the point of hospitalization, or, worse, she could pass on.

 

As an example of what I assume is typical language,  this is the Pre-exisiting Condition definition from my CC:

 

Pre–existing Condition – illness, disease or accidental injury of You or Your Traveling Companion, Your Immediate Family Member or the Immediate Family Member of Your Traveling Companion, for which medical advice, diagnosis, care or treatment was recommended or received within the sixty (60) day period immediately prior to the initial deposit or booking date (whichever occurs first) of a Trip; the taking of prescription drugs or medication for a controlled condition throughout this sixty (60) day period will not be considered to be a treatment of illness or disease; <removed pregnancy related language>

 

I’m sure my MIL has received “medical advice, diagnosis, care or treatment” during the look back period that would probably be related if she were to significantly deteriorate or pass affecting the cruise.   Am I correct in thinking that if something we to happen there is a darn good chance the insurance company would claim it was a pre-existing condition?

 

It’s almost as if I am asking at what point is “being old” a pre-existing condition?  Is this a reason people seek CFAR coverage?

 

I think you mentioned Steve and www.TripInsuranceStore.com in another thread here just now, so "he's your guy!" 🙂 

 

What you quote above is apparently from a Credit Card ("CC", not Cruise Critic?).

There are quite a few reasons NOT to rely upon coverage from a charge card, and this is one of them!  (Low limits is another, for those who spend a bit more.)

 

"Pre-existing condition exclusions" can be completely waived if one purchases the travel insurance from several travel insurers within 10-20 day of making the FIRST payment (refundable or not).  The timing depends upon state of residence (and perhaps which insurer?).  You must be "fit to travel" the day the insurance is started.

And I'm not sure if all policies cover "immediate family members not traveling with you", so double check that.

 

The policy that Steve always recommends for us is from Travel Insured, and that very important waiver (of pre-existing condition exclusions) includes family members not traveling.

Indeed, our most recent travel insurance claim was for *very* elderly MIL (late 90's) when she was rushed to the hospital with heart problems, shortly before a Mediterrean cruise and land trip in Italy.  We thought we might be able to go, that she'd be discharged, at first.

NOTE:  We also take out CFAR, so IF we were still concerned about MIL after she was discharged, we still could have gotten 75% cash back, even if the physicians said there was no need for us to stay.

Anyway, we were waffling about whether to go, and then her new cardiologist told us that we "should stay close by" and *not* go overseas, etc., that her condition wasn't good, and she was already quite frail.  So we cancelled the trip with less than a week until our planned departure date.  She did recover well enough to return to her assisted living facility after several more days, but it was a worrisome few weeks from that point on.  Later, we were able to "recover" the land part of our trip, which was mostly visiting dear friends, but that cruise had a unique itinerary, and I haven't seen another one since (and then Covid hit, so "no cruises for us", etc.).

MIL passed in 2020, about 5 weeks short of her 100th.

 

But about that insurance claim:  her physicians needed to complete the insurer's regular medical form and explain that they recommended we not leave her just then.  We also had to send copies of her medical records from that episode.  But because of that waiver of the pre-existing condition exclusion, the insurer did *not* need any earlier medical records, because it was irrelevant.  She always insisted that we take our trips, and we did.  We were especially nervous about a trip to Japan, given the long time it would have taken us to get back, but she was just fine, except for her ongoing medical issues, all of which were "controlled".

I have no idea if a travel insurer would have spotted anything in her medical history for the previous 60 days that would have caused them to reject our claim, but again, that wouldn't have mattered.  (It probably would have mattered to *us* if she had been in more a more precarious state of health.  And that's one reason why we had the CFAR.  If *we* were just too worried to leave her, even though no physician would be able to say that we "shouldn't go", then we'd have that 75% back.  We also keep that CFAR in case we simply decide we shouldn't go for some other reason.)

 

So don't rely upon the written summaries of policies.  Speak with Steve or one of his associates, explain all of your concerns about the traveling and "what if's", and let them help you select a policy.  We keep taking the same policy from Travel Insured, although each time, I do ask, "Do we want that same policy from Travel Insured still?" 😉 

 

So with the right policy and one started at the right time, you wouldn't need to make a CFAR claim, and you would get 100% back if there was a covered "event".

 

GC

 

 

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Good catch, Geezer Couple. I skipped right over the part about CC. You are correct that credit card coverage is inadequate in most instances. It is not meant to replace a comprehensive travel policy. People who rely on it often do not realize that it does not cover pre-existing conditions or even if the term applies to them. 
 

The trip interruption and trip delay provisions provide little relief in case of delay caused by a covid positive test. Interruption will pay for prepaid nonrefundable costs and change fees, but trip delay is only for those caused by common carrier.

 

It is also a good point that CFAR, in addition to being an extra cost, does not refund 100%. No use to pay more to get less if you can have medical conditions covered.

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