Travel Insurance Exclusions
When choosing a travel insurance policy, it is important to review the limitations and exclusions of the travel plan before you make the final purchase. Although these exclusions are somewhat standard from one insurance company to another, there may be variances that can make a difference in your decision. In addition to certain exclusions, many travel insurance policies will place dollar limitations on certain travel insurance benefits. Aside from your pre-selected medical maximum, some benefits have pre-set limitations, regardless of your selected level of coverage. Some travel insurance policies that offer optional benefits, such as emergency evacuation, will put a maximum on the claims that will be paid toward this medical service. Other covered services that may be subject to these limitations include dental coverage, emergency reunion, trip interruption and repatriation of remains. We suggest reviewing our Guide to Choosing Travel Insurance to gain a better understanding of all of the considerations that should be made when comparing travel insurance plans.
Most all travel insurance plans will have a list of items that are excluded from the policy. In the event that your medical requirements fall under this list, you will not receive reimbursement for these expenses. The most common exclusion, and typically the one of most concern to insured members, is the exclusion for pre-existing conditions. Under the health insurance benefit of a travel policy, there is usually limited or no coverage for any treatment related to a pre-existing medical condition. This includes office visits, hospitalization and medications. A pre-existing condition is often defined as any medical condition for which you have received treatment for a pre-determined number of months or years prior to the purchase of your travel insurance. The length of time an insurance goes back in determining a pre-existing condition is referred to as the look-back period. This look-back period may vary from one insurance company to another, so make sure to review this in the policy description before making your choice on which plan to purchase.
In addition to using this look-back period to determining eligible claims, the insurance company may also consider treatment for a medical condition pre-existing if it was manifested. This means that it was apparent that this condition existed prior to the purchase of coverage, even if the insured person was not aware of the condition. An example of this would be a person who purchased a travel insurance policy 2 weeks prior to being diagnosed with cancer or some other serious ailment. Since cancer, as well as many other medical conditions, takes time to become symptomatic, these are assumed to have existed prior to your purchase of coverage. When purchasing a travel insurance policy, it is important to keep in mind that you are purchasing coverage primarily for unexpected medical emergencies, and not to treat your existing health conditions. This is true if you are aware of your current conditions or not.
Another common exclusion of a travel insurance policy is home country coverage. This means that if you return home prior to the termination date of your policy, no claims within your home country can be made. Your insurance policy will usually terminate immediately upon your return home. Some insurance companies offer optional coverage that may provide you with continuing coverage for incidental return trips home. In some cases, your insurance company may pay for claims that were incurred internationally and which require continued medical attention upon your return home. These disclosures should be explained in your travel insurance policy, so make sure to understand them fully.
A travel insurance company may exclude from reimbursement any charges that they deem unreasonable or excessive. The amount that they will pay toward a claim is based on the Usual, Reasonable and Customary rates for that service in the region in which you received medical treatment. Any charges in excessive of these amounts may be the full responsibility of the insured.
Other exclusions might be any treatments that were not considered to be medically necessary, acts of war or terrorism, suicide attempts, drug or alcohol problems, injury sustained while engaged in professional sports, injuries sustained while performing a dangerous activity, treatment for sexually transmitted diseases and services related to pregnancy. Other exclusions may apply and this is only a brief summary of common exclusions found on most travel insurance policies.
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