What Is a Pre-existing Condition? (2024)

In both trip insurance and travel medical insurance, you'll see the term "pre-existing condition." Most of the time, pre-existing conditions are included in the exclusions in the plan document. The term can be both intimidating and confusing.

Let us help clear some things up with the definition of a pre-existing condition and other important information. By the end, you'll understand what the term means and be better equipped to get the right coverage.

What Is Considered a Pre-Existing Condition?

In simple terms, if an issue started before your plan did, it’s a pre-existing condition. The fuller definition of a pre-existing condition varies by plan, as we’ll explain in the sections below.

Generally, an example of a pre-existing condition is something you may have had for much of your life, such as diabetes or asthma. Or it may be a more recently diagnosed condition, such as your knee that started hurting a few days before your trip.

You may be receiving treatment for a pre-existing condition, or you may have never received medical treatment for it.

Pre-existing conditions in Seven Corners Trip Protection

What Is a Pre-existing Condition? (1)With Seven Corners Trip Protection and Seven Corners Trip Protection USA, a pre-existing condition is an illness, disease, or condition you or your travel companion, business partner, or family member booked to travel with you has during the 60 days immediately before your plan starts.

During those 60 days before you purchased a plan, one of two things happens:

  • A test, exam, or treatment was received or recommended for a condition that first manifested, worsened, or became acute, or exhibited symptoms that would have prompted a reasonable person to seek treatment, or
  • Prescription medication was received or taken for the condition. However, if you took prescription medication, and your condition was controlled solely by that medication, and it remained controlled for 60 days before your plan began, your condition is not considered a pre-existing condition.

Our Trip Protection Choice and Trip Protection USA (if you purchase the medical bundle) plans provide coverage for pre-existing conditions if:

  • You buy the plan within 20 days of the date your initial trip payment or deposit is received; and
  • You or your traveling companion are medically able and not disabled from travel when you pay for the plan or upgrade your plan; and
  • You update your coverage to include the additional cost of subsequent travel arrangements within 15 days of paying your travel supplier for them.

Finally, there’s our Seven Corners Trip Protection Annual Multi-Trip plan, which provides coverage for as many trips as you want over the course of a year. With this plan, pre-existing conditions are covered after it has been in effect for 60 days.

Remember, regardless of the plan, there are some conditions and situations specifically excluded by travel insurance. You can find these by reading the exclusions in the plan document.

Waiver for pre-existing conditions

Some trip insurance offers a "waiver of pre-existing conditions" that can apply to your coverage. It is referred to as a waiver because it comes into play by waiving the exclusion for pre-existing conditions. The exclusion can be waived if you meet the requirements stated in the plan document.

Seven Corners’ Trip Protection Choice and Trip Protection USA (if you purchase the medical bundle) plans offer a waiver of pre-existing conditions, which eliminates the exclusion for pre-existing conditions. For Trip Protection Annual Multi-Trip, the waiver kicks in 60 days after the plan goes into effect.

Pre-existing conditions in Seven Corners Travel Medical Insurance

What Is a Pre-existing Condition? (2)With many travel medical insurance plans, a pre-existing condition is defined as any medical condition, sickness, injury, illness, disease, mental illness or mental or nervous disorder or resulting consequence, regardless of the cause, that existed with reasonable medical certainty during a specified amount of time prior to the start date of coverage. That length of time varies by plan. Additional terms apply, so please read your plan document carefully for a full explanation.

Seven Corners Travel Medical Insurance provides coverage for pre-existing conditions that is different from what you’ll find in our Trip Protection products just described. Below you’ll find some important information to note. As always, though, we recommend you review your plan document to understand your coverage and exclusions.

Acute onset of pre-existing conditions

Travel medical plans often have coverage for an acute onset of pre-existing conditions up to a stated dollar amount that typically varies by the age of the traveler, with reduced coverage for older ages. An acute onset can be described as a sudden flare-up, like an asthma attack.It’s best to review the plan document to see how a pre-existing condition is defined because this varies by plan.

In order to be eligible for coverage of these types of conditions, you must receive immediate emergency care, within 24 hours of the onset of symptoms.

Coverage for Acute Onset varies by plan.

Pre-existing condition exclusion period

Some plans provide this coverage only if the acute onset occurs after a specified waiting period. The length of the waiting period varies by plan.

Emergency benefits and non-insurance assistance services

The Emergency Medical Evacuation and Repatriation benefit applies regardless of whether your transportation is related to a pre-existing condition. Likewise, the Emergency Medical Reunion and Return of Children benefits apply regardless of whether your hospitalization is related to a pre-existing condition, and the Return of Mortal Remains and Local Burial/Cremation benefits provide coverage regardless of whether your death is due to a pre-existing condition.

Again, we encourage you to review your plan document for details.

Seven Corners Travel Insurance with Pre-Existing Conditions Coverage

As you can see, many of our plans have coverage for pre-existing conditions. If you still have questions, contact the licensed agents at Seven Corners. We’re ready to work with you and help you find the best travel insurance for your next trip.

Travel Like a Pro with The Wayfinder

Did you enjoy this blog? Get more articles like it before anyone else when you subscribe to our monthly newsletter, The Wayfinder.

Sign me up

What Is a Pre-existing Condition? (2024)

FAQs

What Is a Pre-existing Condition? ›

A medical illness or injury that you have before you start a new health care plan may be considered a pre-existing condition. Conditions like diabetes, chronic obstructive pulmonary disease (COPD), cancer, and sleep apnea, may be examples of pre-existing health conditions. They tend to be chronic or long-term.

What are preexisting condition responses? ›

A health problem, like asthma, diabetes, or cancer, you had before the date that new health coverage starts.

What counts as a pre-existing condition? ›

A pre-existing medical condition (PEMC) is an illness or injury you had before your policy began or was renewed. Examples of pre-existing medical conditions include, diabetes, asthma, high cholesterol or a long-term back condition.

What is considered a pre-existing condition? ›

Something you knew about before you applied for health cover (like a knee injury from football, or a bowel problem you've been waiting to see a specialist about) A condition, sign or symptom you've previously asked a health professional to diagnose or give you advice about.

What pre-existing conditions are not covered? ›

Health insurers can no longer charge more or deny coverage to you or your child because of a pre-existing health condition like asthma, diabetes, or cancer, as well as pregnancy. They cannot limit benefits for that condition either.

Can I be denied coverage for a preexisting condition? ›

Under the Affordable Care Act, health insurance companies can't refuse to cover you or charge you more just because you have a “pre-existing condition” — that is, a health problem you had before the date that new health coverage starts.

Which of the following are considered pre-existing conditions? ›

A medical illness or injury that you have before you start a new health care plan may be considered a pre-existing condition. Conditions like diabetes, chronic obstructive pulmonary disease (COPD), cancer, and sleep apnea, may be examples of pre-existing health conditions. They tend to be chronic or long-term.

How long ago is a pre-existing condition? ›

It applies to any medical condition that you saw your doctor about the five years before the start date on your health insurance. For example, you might take out a policy and then go and see your GP about some back pain you've been experiencing.

How far back does pre-existing condition last? ›

The length of time before the start date of coverage during which a condition would be considered pre-existing varies, and can be anywhere from 30 days to 6 months or longer.

What includes pre-existing? ›

As per IRDAI, if the insured was diagnosed with a disease or medical condition up to 48 months before buying the policy, it is termed as a pre-existing disease.

How does insurance know if you have a preexisting condition? ›

If you claim that you suffered injuries in a crash resulting of someone else's negligence, the insurance company may dig into your medical history. Your medical records will show what injuries or conditions you have endured in the past and compare them with your current claim.

What is the exclusion period for pre-existing conditions? ›

The time period during which a health plan won't pay for care relating to a pre-existing condition. Under a job-based plan, this cannot exceed 12 months for a regular enrollee or 18 months for a late-enrollee.

What is the difference between pre-existing and existing? ›

Existing is a certain thing that is present nowadays and can be seen in present time. Preexisting refers to something that has existed a long time ago, and forgotten, and has existed once more in our present time.

What is the waiting period for pre-existing conditions? ›

What is the Waiting Period for Pre-Existing Conditions? Under the Private Health Insurance Act 2007, a health insurer may impose a 12 month waiting period on benefits for hospital treatment for pre-existing conditions.

What is the 12 month waiting period for pre-existing conditions? ›

12-months Condition Specific Waiting Period – this is a period during which a member is not entitled to claim benefits in respect of a condition for which medical ad- vice, diagnosis, care or treatment was recommended or received within the 12 month period ending on the date on which an application for membership was ...

What if pre-existing conditions are not declared? ›

Failure to disclose pre-existing conditions not only jeopardizes the chances of successful claims but may also lead to the cancellation of the policy in extreme cases.

What is a preexisting condition quizlet? ›

HIPAA has defined pre-existing conditions to be health issues that have existed, treated of diagnosed within the last 6 months prior to employment.

Which of the following best describes a preexisting condition? ›

A preexisting condition is an illness or health condition that existed prior to applying for health or life insurance.

What is an example of a pre-existing condition that may affect insurance? ›

Due to the added risk health problems create for insurers, some pre-existing conditions can raise your premium or even disqualify you entirely from certain types of life insurance. A few common examples of pre-existing conditions include high blood pressure, diabetes, cancer, and asthma.

What is the meaning of existing condition? ›

Existing Condition means the condition of the Premises, “as-is”, on the date hereof. Sample 1Sample 2. Existing Condition means the initial condition of a project site prior to the proposed.

Top Articles
Latest Posts
Article information

Author: Kelle Weber

Last Updated:

Views: 6531

Rating: 4.2 / 5 (53 voted)

Reviews: 92% of readers found this page helpful

Author information

Name: Kelle Weber

Birthday: 2000-08-05

Address: 6796 Juan Square, Markfort, MN 58988

Phone: +8215934114615

Job: Hospitality Director

Hobby: tabletop games, Foreign language learning, Leather crafting, Horseback riding, Swimming, Knapping, Handball

Introduction: My name is Kelle Weber, I am a magnificent, enchanting, fair, joyous, light, determined, joyous person who loves writing and wants to share my knowledge and understanding with you.