If you’ve got travel plans this fall or winter, now’s the perfect time to plan for your travel insurance purchase—particularly if you’re a mature traveller with a complex medical history.
Here’s why… when it comes to travel insurance, stability for pre-existing medical conditions can be a tricky topic to grasp. Today’s blog post will outline everything you need to know about what it means for a pre-existing condition to be stable in relation to TuGo® Travel Insurance, along with a few key definitions and short examples to help you understand how coverage applies in different scenarios. Let’s get started!
Why is understanding stability important?
Determining if a pre-existing medical condition is stable is important for travellers of all ages, but especially for seniors. It’s one of the three factors that can impact whether or not you’ll have travel insurance coverage for pre-existing medical conditions. (Age and trip length being the other two factors.)
What is a pre-existing condition stability requirement for travel insurance?
The policy’s stability requirement is important to adequate travel insurance coverage. As defined in TuGo’s Traveller Emergency Medical plan, a “medical condition” is considered “stable” when:
- There has been no deterioration of the medical condition as determined by a physician or other registered medical practitioner, and
- There have been no new symptoms or findings or more frequent or severe symptoms or findings, and
- There has been no change in treatment by a physician or other registered medical practitioner or any alteration in any medication related to the medical condition, and
- There has been no new treatment received, prescribed or recommended by a physician or other registered medical practitioner
Read more about “How Unstable Pre-Existing Medical Conditions Impact Claims”.
What other definitions and terms are important to understand stability?
There are three other key terms we define in our Traveller policy wording that are important to understand:
- “Medical Condition”: Any disease, illness or injury (including symptoms of undiagnosed conditions)
- “Treatment, treat, treated”: A procedure prescribed, performed or recommended by a physician for a medical condition. This includes but is not limited to medication, investigative testing and surgery.
- “Alteration”: The medication usage, dosage or type has been increased, decreased or stopped and/or a new medication has been prescribed.
Alteration doesn’t include any of the following:
- Changes in brand to an equivalent name brand or to an equivalent generic brand of the same or equivalent usage or dosage
- Routine dosage adjustments within prescribed parameters for insulin or oral diabetes medication to ensure correct blood levels are maintained; blood sugar levels must be checked regularly and the medical condition must remain unchanged
- Routine dosage adjustments within prescribed parameters for blood thinner medication to ensure correct blood levels are maintained; blood levels must be checked regularly and the medical condition must remain unchanged
- A temporary stoppage of blood thinner medication up to a maximum of 24 hours if the stoppage is required for a surgery or a procedure
- Usage changes due to the combination of several medications into one; the medical condition must remain unchanged.
What is a stability period for travel insurance?
A stability period is the period of time your pre-existing medical condition needs to be stable for before your departure date.
Traveller Emergency Medical Stability Period Requirements
Note: There isn’t a stability requirement for pre-existing medical conditions for the Travel Within Canada Emergency Medical plan.
What exclusions should you review?
As with all insurance policies, terms, conditions and exclusions apply. You should always review the policy and address any questions or concerns you may have before purchasing any travel insurance policy.
Traveller Emergency Medical Insurance Exclusions
The same goes for purchasing our Traveller Emergency Medical Insurance; you should review all exclusions; but for the purposes of today’s topic, there are a few specific exclusions we think are worth pointing out. That way, if you aren’t sure if or how they might apply to your own medical situation, you can follow up with your insurance professional and/or provider.
Exclusion 1. Any complications that develop after departure, related to a pre-existing medical condition that was not stable on or before the date of departure.
Exclusion 9. Medical conditions or any related medical conditions for which, on or before departure, tests to follow up on the effectiveness or response to a procedure, surgery or hospitalization were scheduled to take place or were recommended. This includes tests that were scheduled or were recommended on or before departure, but had not yet taken place at the time of departure.
Exclusion 10. Medical conditions or any related medical conditions for which before departure, medical procedures, surgeries and/or referrals to a specialist were scheduled to take place or were recommended but had not yet taken place at the time of departure.
Exclusion 14. Any medical condition for which you are registered on a waiting list in Canada for treatment or diagnosis.
Pre-existing medical conditions — How TuGo covered $80,000 for a senior snowbird
Sophia is a 90-year-old snowbird who resides in Arizona for the winter months. Upon arriving in Arizona, she began developing a persistent cough accompanied by increasing shortness of breath. She wasted no time in going to the hospital for evaluation. At the hospital, doctors admitted Sophia for an exacerbation of her chronic obstructive pulmonary disease (COPD). They required that she stay for ten days in the hospital and gave her oxygen to help with her breathing.
A year before she left for Arizona, Sophia had experienced some health challenges related to her COPD and high blood pressure, where she had to be admitted twice in the hospital due to flare-ups. She also saw her doctor just one month prior to leaving for a routine visit.
Because Sophia’s original complications happened more than 365 days before she departed on her trip, her pre-existing medical condition was considered stable. Her routine doctor’s visit did not affect the stability of her pre-existing medical condition because there was no change in treatment (or alterations to her medication), no new treatment prescribed, no new or more frequent symptoms discovered and no deterioration of her medical condition. As Sophia had also disclosed her history of chronic obstructive pulmonary disease at the time she applied for her policy, her claim was covered. This saved her $80,000 in medical expenses.
It’s important to understand your travel insurance policy before you leave on your trip. If the information within this blog post created more questions for you, we highly recommend that you reach out to your trusted insurance professional and/or TuGo’s Customer Service.
Happy travels,
Melissa
Editor’s Note: This post was originally published in August 2022 and has been updated for freshness and/or accuracy.
