What Travel Medical Insurance May Not Cover

When you buy travel medical insurance for a trip abroad, you might assume you have coverage for all injuries, illnesses, or travel mishaps you might face overseas—and you’re not alone. However, travel medical insurance does not cover everything. You can save yourself stress down the line by reading through the benefits and exclusions of any policy you’re considering to get the full picture.

In the meantime, be sure to review this list of 9 times your travel medical insurance may not cover you:

1. Your Expenses Stem From a Pre-Existing Condition

Many people assume travel medical insurance covers the same types of expenses as their regular health insurance while they are outside their home country. However, the exclusion of pre-existing conditions is a key factor that sets many travel health policies apart from your standard health insurance.

What Is a Pre-Existing Condition?

The general definition is an injury, illness, disorder, disease, or other physical or mental condition that exists in a defined period (usually 180 days – 5 years) before your policy goes into effect.

What Is the Definition of a Pre-Existing Condition Under Atlas Travel?

Pre-existing condition means any injury, illness, sickness, disease, or other physical, medical, mental, or nervous disorder, condition, or ailment that, with reasonable medical certainty, existed at the time of application or at any time during the 2 years prior to the effective date of this insurance, whether or not previously manifested, symptomatic or known, diagnosed, treated, or disclosed to us prior to the effective date, and including any and all subsequent, chronic, or recurring complications or consequences related thereto or resulting or arising therefrom.

You don’t want to travel abroad and seek treatment for an ongoing issue only to discover that your plan excludes pre-existing conditions—and that the entire cost of treatment is your sole financial responsibility. That’s why it’s important to carefully review the benefits and exclusions of any plan you’re considering before you buy.

Read through the Description of Coverage (this is the document that describes your benefits and explains what is and is not covered by the insurance) to determine:

  • Whether the plan includes any pre-existing condition coverage
  • How pre-existing conditions are defined
  • The stipulations for any pre-existing condition coverage

What Is Acute Onset of a Pre-Existing Condition?

Some travel health policies—like Atlas Travel—include a benefit for the Acute Onset of a Pre-Existing Condition. This benefit may be available to both U.S. and international citizens, but has benefit limits.

The general definition of Acute Onset of a Pre-Existing Condition is a sudden and unexpected occurrence of a pre-existing medical condition that occurs without warning and rapidly progresses.

In most cases:

  • You must obtain treatment within the defined period required by the policy
  • The condition must not be chronic or congenital

Review the Description of Coverage for any plan you’re considering to see whether it offers an Acute Onset of a Pre-Existing Condition benefit. This is where you’ll find the benefit’s full definition as well as limitations and exclusions.

What Is Covered Under Atlas Travel’s Acute Onset of a Pre-Existing Condition Benefit?

Atlas Travel provides members younger than 80 with a limited Acute Onset of Pre-Existing Condition benefit up to the medical coverage life­time maximum for eligible medical expenses. This also includes up to a $25,000 lifetime maximum for emergency medical evac­uation.

Here’s how Acute Onset of a Pre-Existing Condition is defined under WorldTrips’ Atlas Travel plan:

An acute onset of a pre-existing condition is a sudden and unexpected outbreak or recurrence that is of short duration, is rapidly progressive, and requires urgent care. A pre-existing condition that is a chronic or congenital, or that gradually becomes worse over time, is not acute onset of a pre-existing condition.

The Acute Onset of Pre-Existing Condition benefit will only apply if all the following conditions are met:

  1. The Acute onset of a Pre-Existing Condition does not directly or indirectly relate to a chronic condition or congenital condition;
  2. Treatment must be obtained within twenty-four (24) hours of the sudden and unexpected outbreak or reoccurrence;
  3. You must be under eighty (80) years of age;
  4. You must not be traveling against or in disregard of the recommendations, established treatment programs, or medical advice of a physician or other healthcare provider;
  5. You must not be traveling with the intent or purpose to seek or obtain treatment for the pre-existing condition;
  6. You must be traveling outside your home country

2. You Need a Routine Medical Exam or Preventive Care

Travel medical insurance is typically designed to cover eligible expenses resulting from unexpected injury or illness and unanticipated trip-related mishaps as you travel outside of your home country. Unlike regular health insurance, travel medical insurance may not cover wellness exams, preventive care, and regular prescriptions for pre-existing conditions.

Examples of Situations Where Travel Medical Insurance May Cover You

You come down with an unexpected illness and you’re admitted to a hospital.

Medical emergencies are challenging enough when you’re in your home country, let alone a foreign country.

A good travel medical insurance policy will cover eligible costs resulting from local ambulance transportation (only if admitted as an inpatient), hospital room and board, the intensive care unit, doctors and nurses, imaging and labs, and surgery required to treat your covered injury or illness.

You’re hiking through a remote region of Europe when you fall and become seriously injured.

If the local emergency medical facility does not have the staff or equipment required to provide the necessary treatment, you may be transported by helicopter to the nearest hospital that does.

A travel health plan that includes an Emergency Medical Evacuation benefit could cover eligible costs resulting from a covered evacuation. According to the Centers for Disease Control and Prevention, emergency evacuations can exceed $250,000.

3. You Decide to Cancel Your Trip Prior to Departure

Travel medical insurance often includes benefits like Trip Interruption or Travel Delay in addition to coverage for eligible medical expenses. However, it does not typically include a Trip Cancellation benefit that reimburses you for the cost of your trip if you must cancel unexpectedly prior to departure.

What Are Trip Interruption, Travel Delay, and Trip Cancellation?

  • Trip Interruption (often included in travel medical insurance)
    This benefit could cover the cost of your transportation if you need to return to your home country due to a covered reason. Depending on your policy, a covered reason could be the death of an immediate family member, destruction of your house in a fire, etc.

  • Travel Delay (often included in travel medical insurance)

This benefit could reimburse you for reasonable meals and accommodations if a covered delay results in an unplanned overnight stay at a hotel or other lodging. Depending on your policy, a covered delay could be a flight delay, traffic accident, etc.

  • Trip Cancellation (typically excluded from travel medical insurance)

    This benefit may reimburse you for non-refundable travel investments like airfare, hotel costs, and tour expenses if your trip is unexpectedly canceled due to a covered reason. Depending on your policy, a covered reason could be a family member passing away, your flight being canceled due to storms, etc.
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Need Trip Cancellation Coverage?

If you’re looking for a Trip Cancellation benefit to protect your travel investment in case of unexpected cancellation, consider travel insurance, also known as trip cancellation insurance.

For example, the Atlas Journey trip cancellation plans from WorldTrips include the following benefits:

  • Trip Cancellation
  • Travel Delay
  • Trip Interruption
  • Emergency Accident & Sickness Medical Expense
  • Medical Evacuation & Repatriation of Remains

See how much it would cost to protect your travel investment with an Atlas Journey trip cancellation policy. Or learn more about the differences between travel insurance and travel medical insurance.

4. You Need Pregnancy Care

Your travel medical insurance may not cover you for pregnancy or childbirth while traveling abroad. If this is the case, then you likely won’t be covered for expenses related to:

  • Routine prenatal care
  • Childbirth
  • Postnatal care
  • Medical expenses incurred by a baby less than 14 days old
  • Termination of pregnancy

However, some plans (like our Atlas Travel plan) do cover certain expenses that fall under a “Complications of Pregnancy” clause or other similar clause.

Complications of Pregnancy

The phrase “complications of pregnancy” generally refers to illnesses that are distinct from the pregnancy and either:

  • Adversely affected by the pregnancy OR
  • Caused by the pregnancy and not associated with normal pregnancy

Read the Description of Coverage for your plan to determine whether it offers a “Complications of Pregnancy” clause or any other pregnancy and childbirth coverage. Pay attention to the restrictions and exclusions of any pregnancy clauses or benefits as well.

Example: Restrictions of Atlas Travel’s “Complications of Pregnancy” Clause

For example, the Atlas Travel plan covers certain complications of pregnancy (ectopic pregnancy, spontaneous abortion, hyperemesis gravidarum, pre-eclampsia, and more), but only up to 26 weeks. Atlas Travel’s Description of Coverage also notes exactly which pregnancy complications are not included under this clause (false labor, edema, prolonged labor, prescribed rest, and morning sickness).

5. You Need Mental Health Coverage

Travel medical insurance may not cover expenses resulting from mental health disorders such as:

  • Anxiety
  • Bipolar disorder
  • Depression
  • Post-traumatic stress disorder (PTSD)
  • Psychosis
  • Schizophrenia
  • Other disorders

For example, say you’re planning to travel Europe for a month this summer. You’ve suffered from anxiety for the past few years and take your anxiety medication every day. Anxiety is a mental health disorder, so it would not be covered under a travel health plan that excludes mental health disorders. (Since your anxiety is ongoing and this isn’t the first time you’ve experienced it, your anxiety is also a pre-existing condition.)

If your travel health plan excludes mental health disorders and/or pre-existing conditions, then you will not be covered for:

  • Refills of your anxiety medication
  • Any psychiatric appointments that occur during your travels
  • Any other medical expenses you incur as a result of your anxiety
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For Example

Say you’re planning to travel Europe for a month this summer. You’ve suffered from anxiety for the past few years and take your anxiety medication every day.

Anxiety is a mental health disorder, so it would not be covered under a travel health plan that excludes mental health disorders. (Since your anxiety is ongoing and this isn’t the first time you’ve experienced it, your anxiety is also a pre-existing condition.)

If your travel health plan excludes mental health disorders and/or pre-existing conditions, then you will not be covered for:

  • Refills of your anxiety medication
  • Any psychiatric appointments that occur during your travels

Any other medical expenses you incur as a result of your anxiety.

6. You Plan to Participate in Some Extreme Sports

Adventure travelers and risk takers beware: many travel medical insurance policies may exclude coverage for certain extreme sports and risky activities, such as bungee jumping or whitewater rafting. If you’re planning to participate in any sports or recreational activities during your time abroad—from the mundane to the extreme—it’s important to know whether they’ll be covered by your plan. Review the section of your Description of Coverage that tackles sports and activities and pay special attention to the exclusions.

Note the Specific Circumstances Required for Sport and Activity Coverage

Travel medical insurance does not generally cover organized athletics, activities performed professionally, or activities that provide any wage, reward, or profit. Many travel health policies require you to wear the appropriate safety equipment (protective helmet, life jacket, etc.) to be eligible for coverage. Additionally, some policies will cover a sport only under specific circumstances.

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Example: Circumstances Required for Atlas Travel’s Mountaineering and Scuba Diving Coverage

To explain what we mean by “only under specific circumstances,” let’s take a look at a couple of extreme activities that could be covered by Atlas Travel insurance:

  • Mountaineering: Covered only at elevations under 4,500 meters.

  • Scuba diving: Covered only at depths fewer than 10 meters while accompanied by a certified instructor (unless PADI/NAUI/SSI certified).

You can see the full list of sport and activity conditions and exclusions for Atlas Travel on the “Sports and Activities” page of the Atlas Travel Description of Coverage.

7. Your Drug or Alcohol Use Results in Injury or Illness

Many policies will not cover you for injury or illness due in whole or in part to the effects of intoxication or drugs. Note that this does not typically refer to drugs taken in accordance with treatment prescribed by your physician.

8. You Travel Abroad for Medical Treatment

Many travel health policies will not cover you if you’re traveling abroad for the purpose of seeking medical treatment in your destination country. It doesn’t matter if you’re heading overseas with the intention of cutting costs, receiving a higher standard of care, finding a provider that speaks your native language, or obtaining some type of treatment, surgery, or therapy not available in your home country. If the purpose of any part of your trip is to obtain medical care abroad, then it will not be covered under the typical travel medical insurance plan.

DID YOU KNOW? Medical tourism “has been associated with complications, including infections caused by antibiotic-resistant strains of bacteria,” shares the Centers for Disease Control and Prevention (CDC). If you’re traveling abroad for one of the reasons listed above, be sure to follow the CDC’s pre-travel advice.

9. You Choose to Travel Against Government Advice

Travel medical insurance plans may not cover expenses incurred in your destination country if you traveled there against government advice. Each plan has its own rules and regulations regarding what constitutes government advice.

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Example: What “Against Government Advice” Means for Atlas Travel Insurance

To provide an example of what “against government advice” may mean for your travel health policy, let’s look at the Atlas Travel policy from WorldTrips.

This policy does not provide benefits for terrorism or political evacuation if you incur these expenses in a country where the U.S. Department of State has issued a level 3 “reconsider travel” or higher travel advisory if:

  • the advisory was in effect at any point during the 60 days immediately prior to your arrival date (Terrorism) OR

  • you fail to depart the country or location within 10 days of the date the warning was issued (Terrorism), or you fail to contact us within 10 days of the date the warning was issued (Political Evacuation)

Atlas Travel also does not provide benefits for expenses resulting from epidemics, pandemics, public health emergencies, natural disasters, or other disease outbreaks in a country for which the U.S. Centers for Disease Control and Prevention (CDC) has issued a warning/alert level 3 or higher for a location or destination, including common carriers, OR a global or worldwide warning/alert level 3 or higher if:

  1. the warning was in effect at any point during the 60 days immediately prior to your arrival date OR

  2. you fail to depart the country or location within 10 days of the date the warning was issued.

It’s important that you’re familiar with the specific details of your plan before you travel. Consult the Description of Coverage and make sure you understand the specific stipulations and exclusions for each benefit.

LEARN MORE! You can read more about U.S. Department of State travel advisories or see the travel advisory level for your planned destination here.

What to Do Before You Buy a Travel Health Policy

Now that you know what travel medical insurance may not cover, it’s time to start getting quotes and comparing plans. As you do so, read through the Description of Coverage (DOC) for each plan you’re considering. Reviewing the DOC is the single most important step you should take before you purchase a travel health policy.

Avoid Frustrations – Don’t Assume

Make sure you clearly understand the policy’s benefits and exclusions and pay special attention to the section on pre-existing conditions. Do not make assumptions when it comes to your coverage. This is the best way to avoid potential frustrations down the line. If you find that you’re confused about any part of the policy, contact the insurance provider directly. They can help clarify your coverage and help you understand your benefits.

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WorldTrips is a service company and a member of the Tokio Marine HCC group of companies.

WorldTrips’ Atlas Travel Series and StudentSecure international travel medical insurance products are underwritten by Lloyd's. WorldTrips has authority to enter into contracts of insurance on behalf of the Lloyd's underwriting members of Lloyd's Syndicate 4141, which is managed by HCC Underwriting Agency, Ltd.

WorldTrips' Atlas Journey, Atlas Cruiser, and Atlas On-The-Go trip protection insurance products are underwritten by Tokio Marine HCC's U.S. Specialty Insurance Company (USSIC). USSIC is a Texas-domiciled insurance company operating on an admitted basis throughout the United States. Coverage is available to U.S. residents of the U.S. states and District of Columbia only. This plan provides insurance coverage that only applies during the covered trip. You may have coverage from other sources that provides you with similar benefits but may be subject to different restrictions depending upon your other coverages. You may wish to compare the terms of this policy with your existing life, health, home, and automobile insurance policies. Coverage may not be available in all states.

In the State of California, operating as WorldTrips Insurance Services. California Non-Resident Producer License Number: 0G39705