Many Canadian travellers with an unstable health or medical condition are under the false impression that their travel medical insurance policy will cover them for treatment costs related to their pre-existing medical conditions while travelling.
However, the reality is that standard travel insurance policies won’t cover you for pre-existing medical conditions unless they meet the policy’s “stability” requirements. Any medical conditions that are not “stable” will be excluded from coverage under your policy.
This can have serious implications for travellers, as failing to meet your policy’s stability clause requirements is the second most common reason for having a travel insurance claim rejected1.
This problem is particularly common among Canadian snowbirds, boomers and seniors who often have one or more pre-existing medical condition.
It’s essential for you to understand how stability clauses work, determine whether or not you meet the stability requirements of your policy and what your options are if you don’t meet these requirements.
Individuals who don’t meet the stability clause requirements included in most standard travel insurance policies should strongly consider a personalized travel insurance policy that provides coverage for pre-existing medical conditions with NO stability period requirement.
What is a Stability Clause & How Does it Work?
Most standard travel medical insurance policies contain what is commonly referred to as a “stability” clause.
These clauses require your pre-existing medical conditions to be “stable” for a defined period of time prior to the date you leave on your trip. The stability period varies from policy to policy, but is often 90, 180 or even 365 days leading up to your departure date.
If there are any changes to one of your pre-existing medical conditions during the stability period, that condition will be excluded from coverage, meaning your policy will not cover any expenses you incur that are related to that condition while travelling.
Any Changes Means ANY Changes…
Keep in mind that any changes really means any changes, including some you may not think of such as starting or stopping a medication, increasing or decreasing the dose of a medication or seeing a doctor or receiving diagnostic testing about a potentially new medical condition, even if that condition has not yet been diagnosed.
Beware of related medical conditions…
It’s also very important to be aware that under a stability clause, any medical treatment for a condition related to an excluded condition would also be excluded from coverage. To better illustrate this point, take the following example:
Let’s say Bob has diabetes that doesn’t meet his policy’s stability terms. In this case, it’s quite clear that Bob would not be covered for any treatment related to his diabetes while travelling.
What you may be surprised to learn is that Bob would also not be covered for any condition related to his diabetes. For example, if Bob was to have a heart attack while travelling, and the heart attack could be linked to having been caused by Bob’s diabetes, it is quite possible that treatment for his heart attack would also not be covered by his insurance, even though most people would consider diabetes and a heart attack to be two different and unrelated medical conditions.
The Bottom Line
If you are purchasing a standard travel insurance policy with a stability clause, make sure you meet the terms of that stability clause or you could run into a serious problem if you need to make a claim.
What if I Don’t Meet the Stability Clause Requirements?
Travellers with pre-existing medical conditions who don’t meet stability clause requirements are essentially left with three options:
- Wait until your medical conditions are “stable” before purchasing your policy. This is often not a realistic solution, as it would likely prevent you from travelling during your preferred travel dates. There’s also a good chance your medical conditions may never meet the stability requirements.
- Purchase the policy knowing your non-stable medical conditions and any related conditions won’t be covered. This is a very risky strategy and not advisable, as you’d be exposing yourself and your family to serious financial risk if you require treatment while travelling and need to file a claim. Note that other medical emergencies unrelated to your existing conditions (such as a fall or food poisoning) could be covered.
- Find a policy that provides coverage for pre-existing medical conditions with NO stability clause requirement. While these policies are not as well known or widely available as standard travel insurance policies, they can be a real lifesaver and are often the best option for many Canadian snowbirds, seniors, boomers and other travellers with pre-existing medical conditions.
Coverage for Pre-Existing Conditions with NO Stability Period
There’s good news for travellers who either don’t meet the stability clause requirements commonly found in standard travel insurance policies or simply want the peace of mind of not having to worry about stability clauses altogether.
For individuals who fall into these categories, there’s a lesser-known type of “personalized” travel insurance policy that completely does away with the dreaded “stability” clause and provides coverage for pre-existing medical conditions with NO stability period requirement.
How are These Policies Different?
Standard travel medical insurance policies determine your coverage eligibility and premiums by grouping you into categories with other travellers whose health and age may be different than yours.
On the other hand “personalized” travel medical insurance policies base your coverage eligibility and premiums exclusively on your personal medical history and characteristics.
As a result, personalized travel insurance plans are better able to accurately determine your coverage risk and the appropriate premiums based on those risks. This personal element also allows them to provide coverage for pre-existing conditions with no stability period requirement.
How Do I Qualify?
In order to qualify for a personalized policy, you’ll need to fully and accurately disclose all of your pre-existing medical conditions at the time you apply, and as long as your conditions are eligible for coverage, you’ll be covered for all pre-existing medical conditions, regardless of how long they have been stable for.
Keep in mind that just like standard insurance policies, some medical conditions may make you ineligible for coverage.
And just like a standard policy, you’ll still be required to inform your insurance provider of any changes to your health that occur after you purchase your policy and prior to any departure date.
How Much Do These Policies Cost?
While you might think a personalized policy with the added benefits it offers would be more expensive than a standard policy, that’s often not the case.
In many situations, the cost of a personalized policy is the same or less than a standard policy because personalized policies are tailored specifically to your conditions and risks - so you won’t be grouped into a category with other travellers who may have more serious or numerous medical conditions.
Of course, there are situations when a personalized policy will cost more than a standard policy, but this is often due to certain pre-existing medical conditions being covered that would otherwise be excluded from coverage under a standard policy.
1KPMG survey of Canadian insurance providers commissioned by the Travel Health Insurance Association of Canada (THIA) (November 2014)
Disclaimer: The material provided in the Snowbird Advisor Insurance Learning Centre is for informational purposes only and does NOT constitute insurance, legal, financial or other advice, and should not be relied on as such. If you require such advice, you should speak with a qualified professional to assist you.