Travel Insurance: Trust But Verify.
More and more, I hear from people with medical conditions who want to travel but are afraid they can’t qualify for out-of-country health insurance. I tell them pretty well the same thing: there are plenty of plans that will cover stable pre-existing conditions, but before putting down any money, get the terms of your coverage on paper. Verbal confirmation of coverage is No confirmation.
I recently heard of a man with Type 2 diabetes who, when he applied for travel insurance, told the selling agent that his condition had been controlled for years with low dose medication and diet, but his doctor had recently put him on insulin. Could he get insurance? He said the agent said yes, so long as he had a note from his doctor stating that he was stable. STOP. I immediately put up a red flag and advised that by almost any definition of stability in Canadian travel insurance policies, this would not fly and he needed something better than the agent’s word that he would be covered. Diabetes is very common among middle aged and elderly people and virtually all insurer’s differentiate between insulin-dependent and non-insulin dependent cases.
People on blood pressure medication are in the same boat. Though their doctors consider them stable, they often change their medications, their dosages, the types of medications, and that in itself is a sign of instability. The exception to this is a change from a brand name to a generic of the same type. That’s usually OK. But changing the type of medication is a different story (e.g. going from a diuretic to a beta blocker to an ACE inhibitor, etc.)
Though there are as many different definitions of “stability” as there are policies, the basic premise is that if any condition has exhibited symptoms, required medical consultation or investigation, or had the type and/or dosage of medication changed within a specified period of time (e.g. 180 days before application) it is considered unstable and will not be covered. Doesn’t matter if you doctor considers it stable. If it doesn’t fit the insurer’s definition of stable—it isn’t. It’s too bad so many Canadian doctors stay uninformed about travel insurance. If they knew even some of the basics about how it works, they could help out their patients a lot more: with Canadians making some 20 million trips out of the country each year, you would think they should brush up on the subject.
Usually, if you have a pre-existing condition, you can be medically underwritten—which means—completing a medical questionnaire and allowing the medical underwriters to determine whether you qualify and under what conditions and for what price. If they judge your condition to be unstable according to their definition, they will exclude any treatment related to that condition, and cover you for other unexpected medical emergencies. Or, if they are satisfied your condition is stable, they will give you a written endorsement that your condition will be covered. Only then, can you be sure of coverage.
Increasingly, people are applying by phone and answering medical questions verbally. This is not as good as completing your questionnaire by hand and having the time to think your answers through. But even if you do it verbally, by phone, insist on getting a transcript of your answers so you can be sure they were reported correctly by the selling agent. People make mistakes.
During the Cold War years, when he was asked about making deals with the Soviets, President Ronald Reagan said “Trust, but verify.” Always the best policy.
