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Who Should Not Buy Travel Medical Insurance?

While travel medical insurance is a recommended precaution for international travelers (see “Who Should Buy Travel Medical Insurance”), there are certainly those who may not benefit from the purchase of a travel medical policy.

The following types of travelers should re-evaluate their travel medical needs:

Medical Tourists

If you’re traveling outside of your home country for the purpose of seeking medical treatment, you’re practicing what’s typically referred to as “medical tourism”—and this is not covered by most travel medical insurance policies.

Whether you’re seeking treatment abroad in order to cut costs, see a provider with a culture similar to yours, or obtain treatment, therapy, or surgery not available back home, it’s important you understand this care most likely won’t be covered by a supplemental travel medical insurance plan.

PRO TIP! It’s also worth noting there are some risks associated with medical tourism. The Centers for Disease Control and Prevention (CDC) notes possible infectious complications associated with medical procedures performed outside the U.S., the risk of acquiring antibiotic-resistant infections in certain regions of the world, and risks of infectious diseases. If you’re traveling abroad for medical care, be sure to follow this pre-travel advice.

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Individuals Needing Pre-Existing Coverage

 

Medical expenses resulting from pre-existing conditions are excluded under most travel medical policies (see “What is Excluded from Coverage?”).

Not sure what a pre-existing condition is, exactly? “Pre-existing condition” means any injury, illness, sickness, disease, or other physical, medical, mental, or nervous disorder, condition, or ailment that, with reasonable medical certainty, existed at the time of application or at any time during the 2 years prior to the effective date of this insurance, whether or not previously manifested, symptomatic or known, diagnosed, treated, or disclosed to us prior to the effective date, and including any and all subsequent, chronic or recurring complications or consequences related thereto or resulting or arising there from.

Before you purchase a policy, review your plan’s definition of a pre-existing condition, and consider whether you have any pre-existing conditions that will not be covered. If you’re not sure whether a condition qualifies as pre-existing, feel free to call the insurance company and ask.

You can also inquire about pre-existing condition coverage on a plan-by-plan or company basis, as it may vary. Some plans will offer coverage for acute onset of a pre-existing condition. This is a sudden or unexpected outbreak or recurrence that is of short duration, is rapidly progressive, and requires urgent care. A pre-existing condition that is a chronic or congenital, or that gradually becomes worse over time, is not acute onset of a pre-existing condition.

Others may offer a pre-existing conditions waiver to travelers with chronic but stable medical conditions. Some may even allow you to purchase coverage for your pre-existing condition separately. Review your plan’s policy documents to understand the details of what is and isn’t covered for pre-existing conditions.

IMPORTANT! Pre-existing condition exclusions only impact coverage for medical expenses related to that condition. In other words, individuals who purchase a travel medical insurance plan can still get coverage for other qualifying emergency medical expenses not related to their pre-existing condition.

Travelers Requiring a Normal Health Insurance Replacement (Expats)

Long-term traveler? Expatriate? If you’ll be living and working abroad long term, you may be seeking more comprehensive coverage than a travel medical plan can provide. While travel medical insurance offers emergency medical coverage and some supplemental travel benefits, it will not provide coverage for things like wellness and preventive care or prescription drugs for a pre-existing condition.

Additionally, travel medical coverage is typically offered only up to 364 days (though you may be able to extend or renew your policy).

If you’re going to be living abroad long term, you may have different priorities than a short-term traveler. And, as a foreign national, you will likely not be entitled to free or subsidized healthcare.

An expatriate plan, or a travel major medical plan, may best align with your needs. These types of plans behave more like your standard, home country health insurance in that they typically provide the following coverages:

  1. Medical coverage including preventive care, medical evacuation, and repatriation benefits
  2. Worldwide prescription drug coverage
  3. Dental coverage (regular examinations and treatment)
  4. Vision coverage (regular eye exams and prescriptions)
  5. Life, accidental death and dismemberment, or long-term disability coverage
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Travelers Wanting Trip Cancellation Coverage

Travel medical insurance is a type of travel insurance that can cover health care costs incurred outside of one’s home country. Benefits often focus on covering medical expenses – and may feature a few travel-related benefits like trip interruption coverage and lost luggage coverage.

However, this type of travel insurance typical does not include trip cancellation coverage. If you’re a traveler looking for travel insurance with trip cancellation coverage, a travel medical insurance plan might not be the one for you.

Instead, you can seek out a trip cancellation plan (sometimes referred to, simply, as travel insurance). This type of insurance is comprehensive and covers an array of travel-related expenses – sometimes including emergency medical coverage. However, these types of plans are often more expensive and feature less coverage for medical expenses than a typical travel medical insurance plan. 

Learn more about the difference between these two types of insurance plans here.

What are the specific coverage options and limits for pre-existing medical conditions in travel medical insurance plans?

Travel medical insurance generally does not cover routine treatment or known expenses related to pre-existing medical conditions1, but some plans may provide limited coverage if a pre-existing condition suddenly and unexpectedly becomes a medical emergency during the trip. Coverage limits for these acute onset situations vary by plan. For example, Atlas Travel may provide coverage up to the overall medical maximum limit for eligible acute onset2 claims, including up to $25,000 lifetime maximum for emergency medical evacuation related to an acute onset event. Be sure to carefully read and understand pre-existing policy limitations before you purchase.

How do eligibility windows and time-sensitive periods affect qualification for pre-existing condition coverage in travel insurance?

Eligibility windows and time-sensitive requirements primarily apply to trip protection insurance. These benefits often require travelers to purchase coverage shortly after making their initial trip payment in order to qualify for enhanced protections, such as a waiver of the pre-existing conditions3 exclusion.

For example, with Atlas Journey Elevate, travelers qualify for a pre-existing condition waiver4 if they purchase coverage within 21 days of their first trip deposit and are medically able to travel on the coverage effective date. Missing this purchase window means that claims related to pre-existing conditions are not eligible for reimbursement.

Because these requirements are time-sensitive, travelers considering trip protection insurance should review deadlines carefully and purchase coverage early in the trip planning process to maximize available benefits.

1Pre-existing condition means any injury, illness, sickness, disease, or other physical, medical, mental, or nervous disorder, condition, or ailment that, with reasonable medical certainty, existed at the time of application or at any time during the 2 years prior to the effective date of this insurance, whether or not previously manifested, symptomatic or known, diagnosed, treated, or disclosed to us prior to the effective date, and including any and all subsequent, chronic or recurring complications or consequences related thereto or resulting or arising therefrom.

2Acute Onset of a Pre-existing Condition means a sudden and unexpected outbreak or recurrence that is of short duration, is rapidly progressive, and requires urgent care. A pre-existing condition that is a chronic or congenital, or that gradually becomes worse over time is not acute onset of a pre-existing condition. An Acute Onset of Pre-existing Condition does not include any condition for which, as of the Effective date, the Insured Person (i) knew or reasonably foresaw he/she would receive, (ii) knew he/she should receive, (iii) had scheduled, or (iv) was told that he/she must or should receive, any medical care, drugs or treatment.

3Pre existing condition means an illness, disease, or other condition during the 90 day period immediately before your coverage effective date for which you did any of the following:
- received a test, examination, or medical treatment
- received a recommendation for a test, examination, or medical treatment
- took or received a prescription for medication

Item (3) above does not apply to a condition that is treated or controlled solely through the use of prescription medication and remains treated or controlled without any change in required prescription throughout the 90 day period before your coverage effective date.

Change in required prescription means the dosage or frequency has been increased, reduced, stopped, and or new medication has been prescribed due to the worsening of the condition being treated. Exceptions include:
- switching between brand name and generic medication with equivalent dosage
- adjustments to insulin or anti-coagulant dosage

4Pre-existing Condition Exclusion Waiver: Pre-existing conditions are excluded from coverage unless you meet both of these requirements: 1) you purchase your Atlas Journey Elevate or Explore plan within 21 days or purchase your Atlas Escape plan within 14 days of the date you made your first payment toward your trip; and 2) you are medically able to travel on your coverage effective date.

If you do not purchase your Atlas Journey plan within the required time period, a 90-day lookback period will apply to pre-existing conditions. Coverage varies by plan and state of residency. Please review the policy documents specific to your plan and state of residency for a full list of covered reasons, conditions, and exclusions.

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WorldTrips is a service company and a member of the Tokio Marine HCC group of companies.

WorldTrips' Atlas Travel Series and StudentSecure international travel medical insurance products are underwritten through binding authorities with TMHCC (CI) Insurance SPC Ltd and Houston Casualty Company (HC).

WorldTrips' Atlas Journey, Atlas Cruiser, and Atlas On-The-Go trip protection insurance products are underwritten by Tokio Marine HCC's U.S. Specialty Insurance Company (USSIC). USSIC is a Texas-domiciled insurance company operating on an admitted basis throughout the United States. Coverage is available to U.S. residents of the U.S. states and District of Columbia only. This plan provides insurance coverage that only applies during the covered trip. You may have coverage from other sources that provides you with similar benefits but may be subject to different restrictions depending upon your other coverages. You may wish to compare the terms of this policy with your existing life, health, home, and automobile insurance policies. Coverage may not be available in all states.

In the State of California, operating as WorldTrips Insurance Services. California Non-Resident Producer License Number: 0G39705