Need to know
- You must declare a pre-existing medical condition if you want it covered by insurance
- Insurance cover for pre-existing medical conditions varies widely
- You may have to pay more to get cover for your pre-existing medical condition
Travel insurance is essential in the case of illness or injury while travelling. Overseas medical costs can be extortionate, and if you have an existing medical condition, it increases the chance you may need medical attention on your trip – that's why insurers charge you extra.
So if you can get cover for your pre-existing medical condition, it'll take a bit of worry out of your trip. But even if you're willing to pay extra, getting cover for an existing condition isn't always easy.
On this page:
- What is a pre-existing medical condition?
- What's covered, and what's not
- Comprehensive policies that may cover your pre-existing medical condition
- Travel insurance for seniors with pre-existing medical conditions
- Pregnancy and travel insurance
- Credit card travel insurance and pre-existing medical conditions
- What to do if you can't get cover for a pre-existing medical condition
What is a pre-existing medical condition?
A pre-existing medical condition is a medical condition that you had before you bought your travel insurance.
Different travel insurers will have their own specific definitions, but it's usually a diagnosed medical condition that you've had or received any form of medical advice, treatment or medication for, in a specified time period before you bought your policy.
Most insurers would cover a condition if it hadn't led to treatment in the one to two years before you booked your trip, but others may specify five years or longer
The 'specified time period' wording is worth paying attention to. If, for example, your condition last showed symptoms 18 months ago, but the time period specified by the insurer is 12 months, then you'll be covered subject to the other conditions of the policy.
The insurance contract regulations set the time period as six months by default. Unfortunately, insurers can get around this six-month rule and exempt themselves simply by burying an exclusion or limitation in the product disclosure statement (PDS).
Insurers' definitions vary as to what the specified time period is. Most insurers would cover a condition if it hadn't led to treatment in the one to two years before you booked your trip, but others may specify five years or longer.
What's covered, and what's not
There are often a lot of hoops to jump through to get cover for pre-existing conditions.
Insurers can:
- exclude pre-existing medical conditions altogether
- include a list of accepted pre-existing medical conditions (specified in the PDS)
- restrict cover for generally accepted conditions depending on other conditions you might have, or only cover some symptoms (for example, allergies may be covered, but not anaphylaxis)
- subject you to an assessment for cover of your medical condition and charge a fee to complete this assessment (whether you get cover or not)
- deny you cover for a medical condition on application.
Even if you survive that minefield, you may then have to fork out several thousand dollars for the privilege of getting cover for your condition.
Comprehensive policies that may cover your pre-existing medical condition
Check the insurer's PDS for a specific list of conditions. If a condition is not listed as automatically covered, then you may be able to apply to the insurer to cover your condition.
For the specified time period, the lower the number, the better. Read on below the table for more information.
| Brand – Policy | Time period (months)* | Covered conditions list | On application |
| 1Cover – Comprehensive | 12 | Yes | Yes |
| 1Cover – Essentials | 12 | Yes | Yes |
| 1Cover – Medical Only | 12 | Yes | Yes |
| AHM – Comprehensive | 12 | Yes | Yes |
| AHM – Medical Only | 12 | Yes | Yes |
| Allianz – Basic | N/A | No | No |
| Allianz – Comprehensive | 24 | No | Yes |
| Bupa – Essentials | N/A | No | No |
| Bupa – Comprehensive | 24 | No | Yes |
| Cover-More – Basic | 12 | Yes | Yes |
| Cover-More – Comprehensive | 12 | Yes | Yes |
| Cover-More – Comprehensive Plus | 12 | Yes | Yes |
| Fast Cover – Basics | 36 | No | Yes |
| Fast Cover – Comprehensive | 36 | No | Yes |
| Fast Cover – Standard Saver | 36 | No | Yes |
| Flight Centre – YourCover Essentials | 12 | Yes | Yes |
| Flight Centre – YourCover Plus | 12 | Yes | Yes |
| Go Insurance – Go Basic | 3 | Yes | Yes |
| Go Insurance – Go Plus | 3 | Yes | Yes |
| InsureandGo – Bare Essentials | 12 | No | Yes |
| InsureandGo – Gold | 12 | No | Yes |
| InsureandGo – Silver | 12 | No | Yes |
| Medibank – Comprehensive | 12 | Yes | Yes |
| Medibank – Medical Only | 12 | Yes | Yes |
| NIB – Comprehensive | 6 | Yes | Yes |
| NIB – Essentials | 6 | Yes | No |
| NRMA – Essentials | 12 | Yes | Yes |
| NRMA – Comprehensive | 12 | Yes | Yes |
| NRMA (NT, SA, WA) – Essentials | 3 | Yes | Yes |
| NRMA (NT, SA, WA) – Premium | 3 | Yes | Yes |
| NRMA (NT, SA, WA) – Platinum | 3 | Yes | Yes |
| Simply Travel Insurance – Essentials | N/A | No | No |
| Simply Travel Insurance – Comprehensive | 24 | No | Yes |
| Southern Cross Travel Insurance – Medical Only | 36 | No | Yes |
| Southern Cross Travel Insurance – Comprehensive | 36 | No | Yes |
* The time period before booking your trip that a medical condition, that isn't specifically excluded, would be covered if it has not given rise to symptoms or required medication or treatment.
If your medical condition is on the insurer's 'Covered Conditions' list, then the time period might be longer than what's specified above.
For example, Go Insurance's specified time period is 90 days (3 months), but if your condition is on their 'Covered Conditions' list, and you've been hospitalised for that condition within 24 months of booking the trip, then it may not be automatically covered. You'll need to fill out a form to apply for cover.
CHOICE tip: Filling out assessment forms for your medical condition can be time-consuming and frustrating, but try at least three different insurers because premiums and cover vary widely.
How you're assessed for a pre-existing medical condition
Many Australian insurers use a 'black box' risk rating system to assess your condition, such as that provided by insurance technology firm Verisk.
The systems may contain a list of health conditions, each of which is assigned a risk factor. Depending on how high this risk factor is, the insurer can choose to rule out cover, or offer cover for an extra premium.
Travel insurance for seniors with pre-existing medical conditions
Older and wiser travellers with pre-existing medical conditions can still get travel insurance for their international travel. The drawback is that you'll have fewer policies to choose from, and you'll pay more for it.
Many travel insurance policies have age limits, over which they either don't offer cover, or they may offer restricted cover with lower benefit limits or a higher excess.
Cost of travel insurance for seniors
Our analysis of premiums across age groups shows that an older single traveller going to Bali for around 11 days to two weeks will on average pay more for their cover as they age, with premiums generally increasing more noticeably from age 50.
Travellers aged over 70 could pay up to 3.5 times more for their travel insurance than people in their 60s
In particular, travellers aged over 70 could pay up to 3.5 times more for their travel insurance than people in their 60s, prior to further underwriting and premium adjustments by insurers for coverage of pre-existing medical conditions.
| Age group | Weighted average premium |
| <30 | $108 |
| 30 to 39 | $119 |
| 40 to 49 | $116 |
| 50 to 59 | $126 |
| 60 to 69 | $153 |
| 70+ | $682 |
Visit our travel insurance comparison and use the filter to find travel insurance policy options for people across a range of ages up to 100 or even unlimited.
Pregnancy and travel insurance
Pregnancy cover will protect you in circumstances such as if you need to cancel your trip due to doctor's advice, or if you're on holiday and incur medical costs that are a result of unexpected complications (something that you weren't already being treated for or had no history of).
Note that travel insurance won't usually cover you for childbirth or for medical costs relating to your newborn if you give birth while on holiday.
Different policies will cover you up to different stages of your pregnancy, so which provider you go with will depend on when you plan to travel (and return home). Not all policies will cover IVF or similar medically assisted pregnancies.
CHOICE tip: Check with your airline before you travel – many airlines will only let you fly up to a certain stage in your pregnancy, and may require medical certificates or other documentation.
Credit card travel insurance and pre-existing medical conditions
Some credit cards come with travel insurance policies that may cover pre-existing medical conditions.
However, policies that come with credit cards vary just as much as standalone travel insurance policies, so you need to read the terms and conditions carefully to understand whether you're automatically covered, whether you need to apply for cover, or if there's no cover at all for pre-existing medical conditions.
Bear in mind that some credit card travel insurance policies require you to activate your insurance before you leave. Some people may find this a bit of a pain, but with pre-existing medical conditions it may actually be an advantage, since it will prompt you to check your cover.
What to do if you can't get cover for a pre-existing medical condition
If you're denied cover for your pre-existing medical condition, or if you can't afford the extra premium, you may still be able to buy a travel insurance policy.
You'll need to declare your condition to your insurer. They may then offer you travel insurance cover, but will issue a certificate that says you won't be covered for any claim that arises because of your pre-existing medical condition.
Stock images: Getty, unless otherwise stated.
