Travel Insurance for Pre-Existing Conditions: Digital Nomad Guide

Travel insurance coverage for pre-existing medical conditions

Peter Schneider

January 16, 2026

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Having a pre-existing condition doesn't mean you can't be a digital nomad. But it does mean standard travel insurance won't fully protect you. Understanding how pre-existing condition exclusions work—and finding coverage that addresses your needs—is essential for safe long-term travel.

This guide explains what counts as pre-existing, how look-back periods work, and which providers offer meaningful coverage options.

This article is part of our complete digital nomad travel insurance guide.

What Counts as a Pre-Existing Condition?

The Basic Definition

A pre-existing condition is any medical condition that existed before your insurance coverage began. Specifically, insurers look for:

Diagnosed conditions (whether currently treated or not)
Conditions for which you received treatment
Conditions for which you took medication
Symptoms you experienced (even if not formally diagnosed)

Common Pre-Existing Conditions

| Category | Examples | |----------|----------| | Chronic illness | Diabetes, asthma, hypertension, heart disease | | Mental health | Depression, anxiety, bipolar disorder, PTSD | | Musculoskeletal | Back problems, arthritis, joint issues | | Autoimmune | Crohn's disease, rheumatoid arthritis, lupus | | Neurological | Epilepsy, migraines, MS | | Respiratory | COPD, sleep apnea, chronic bronchitis | | Cancer history | Any cancer, even if in remission | | Cardiac | Previous heart attacks, arrhythmias, high cholesterol |

What Most People Don't Realize

Even "minor" or "controlled" conditions count:

High blood pressure controlled by medication = pre-existing
Seasonal allergies requiring prescription = pre-existing
Anxiety for which you saw a therapist once = pre-existing
Back pain you saw a doctor about = pre-existing

How Look-Back Periods Work

What is a Look-Back Period?

Insurers examine your medical history for a defined period before coverage starts—the look-back period. Any treatment, symptoms, or medication during this period makes a condition "pre-existing."

Common Look-Back Periods

| Look-Back | Meaning | Example | |-----------|---------|---------| | 60 days | Only past 2 months examined | Most lenient | | 6 months | Past 180 days examined | Moderate | | 12 months | Past year examined | Stricter | | 24 months | Past 2 years examined | Common for budget insurers | | Lifetime | Any prior diagnosis | Strictest |

How Look-Back Affects You

Example: You have high blood pressure

Last doctor visit: 8 months ago
Still taking daily medication

| Policy Look-Back | Pre-Existing? | |------------------|---------------| | 60 days | Possibly yes (ongoing medication) | | 6 months | Yes (medication ongoing) | | 12 months | Yes (recent treatment + medication) |

The key: ongoing medication almost always triggers pre-existing status, regardless of when you last saw a doctor.

Coverage Options for Pre-Existing Conditions

Option 1: Full Exclusion (Budget Insurance)

How it works: Conditions are completely excluded. Any incident related to the condition is not covered.

Example policies: SafetyWing, basic World Nomads, most budget options

What this means practically:

A diabetic emergency would NOT be covered
Heart attack for someone with heart history would NOT be covered
Asthma attack requiring hospitalization would NOT be covered

Understanding Exclusions

If your pre-existing condition leads to an emergency, you could face bills of $10,000-$100,000+ with zero insurance coverage. This is the critical risk with budget insurance and pre-existing conditions.

Option 2: Acute Onset Coverage

How it works: Covers sudden, unexpected onset of a pre-existing condition, but not ongoing treatment.

What's typically covered:

Heart attack (sudden acute event)
Diabetic emergency (unexpected crisis)
Severe asthma attack (acute episode)

What's NOT covered:

Ongoing cardiac monitoring after heart attack
Daily insulin and supplies
Regular asthma medication

Example policies: Some mid-tier plans, specific riders

Option 3: Pre-Existing Condition Waivers

How it works: You can get a waiver that covers your pre-existing condition—usually requiring medical underwriting.

Requirements typically include:

Medical questionnaire
Sometimes doctor's statement
Condition must be "stable" (no changes in 60-180 days)
Higher premium

Providers offering waivers:

Insured Nomads (select plans)
Some IMG Global plans
Various international health insurers

Option 4: Full Coverage (International Health Insurance)

How it works: Comprehensive international health insurance can cover pre-existing conditions similar to domestic health insurance.

Providers:

Cigna Global
Allianz Worldwide Care
BUPA Global
IMG Global (higher tiers)

Cost: $200-500+/month depending on age, conditions, and coverage level

Trade-off: Significantly more expensive but genuine comprehensive coverage

See our international health insurance vs travel insurance comparison.

Coverage Comparison by Condition Type

Diabetes

| Coverage Type | What's Covered | What's Not | |--------------|----------------|------------| | Budget (excluded) | Nothing diabetes-related | Everything | | Acute onset | Diabetic ketoacidosis, hypoglycemic emergency | Insulin, supplies, monitoring | | Waiver/Full | Emergency + ongoing care | Varies by plan |

Recommendations:

Never travel without some diabetes coverage
Carry emergency supplies (3-6 month buffer)
Research local insulin availability/cost
Consider international health insurance for extended travel

Heart Conditions

| Coverage Type | What's Covered | What's Not | |--------------|----------------|------------| | Budget (excluded) | Nothing cardiac-related | Heart attacks, arrhythmias, etc. | | Acute onset | Sudden heart attack | Follow-up care, cardiac rehab | | Waiver/Full | Comprehensive cardiac care | Varies by plan |

Recommendations:

Cardiac events can cost $100,000+ without coverage
Budget insurance with cardiac history is extremely risky
International health insurance strongly recommended

Mental Health

| Coverage Type | What's Covered | What's Not | |--------------|----------------|------------| | Budget (excluded) | Emergency psychiatric (maybe) | Ongoing therapy, medication | | Standard | Emergency psychiatric only | Outpatient mental health | | Premium/Full | Both emergency and outpatient | Varies; often limits exist |

Recommendations:

Most travel insurance excludes mental health entirely
Insured Nomads includes mental health coverage
Telehealth options may provide continuity of care

Asthma/Respiratory

| Coverage Type | What's Covered | What's Not | |--------------|----------------|------------| | Budget (excluded) | Nothing asthma-related | Attacks, medication, hospitalization | | Acute onset | Severe attack requiring hospitalization | Routine inhalers, follow-up | | Waiver/Full | Comprehensive respiratory care | Varies by plan |

Recommendations:

Carry sufficient inhalers and medication
Research air quality at destinations
Acute onset coverage may be adequate for mild asthma

Disclosure Requirements

Why Disclosure Matters

Failing to disclose pre-existing conditions can result in:

Claim denial for any related conditions
Policy cancellation (even for unrelated claims)
Fraud allegations in serious cases

What to Disclose

Be honest about:

All diagnosed conditions
All medications (including over-the-counter if regular)
All doctor visits in the look-back period
All hospitalizations ever
Symptoms you experienced even without diagnosis

How Insurers Verify

During claims, insurers can:

Request medical records from your doctors
Contact pharmacies for prescription history
Review hospital records
Access medical databases

They will investigate. Undisclosed conditions discovered during claims = denied claims.

Managing Medications Abroad

Before You Travel

Get extended prescriptions - Ask doctor for 3-6 month supplies
Get a letter from your doctor - Stating medical necessity
Research destination availability - Some medications unavailable or different names
Know generic names - Brand names vary by country
Pack in carry-on - Never check essential medications

During Travel

Track supplies - Know when you'll need refills
Research local pharmacies - Some countries allow prescription-free purchases
Find English-speaking doctors - Before you need them
Keep doctor contacts accessible - For prescription verification

Common Medication Challenges

| Issue | Solution | |-------|----------| | Running out | Research local purchase options before running low | | Different brands | Know generic/chemical names | | Import restrictions | Carry doctor's letter and original packaging | | Temperature-sensitive meds | Carry insulated case |

Finding Specialists Abroad

Before You Need Them

Research specialists at destinations - Before arriving
Use expat forums - Best doctor recommendations
Check International Association listings - IAMAT, ISTTM
Ask your home doctor - May have international contacts

Resources

IAMAT (International Association for Medical Assistance to Travellers)
International SOS (medical assistance network)
Embassy listings - Often maintain doctor lists
Expat Facebook groups - Local recommendations

Recommended Providers for Pre-Existing Conditions

Insured Nomads

Best for: Nomads wanting coverage options without full international health insurance

Offers pre-existing condition coverage on higher-tier plans
Medical underwriting required
Telehealth included (helpful for condition management)
Mental health coverage available

IMG Global

Best for: Flexible, customizable coverage

Multiple plan tiers
Pre-existing condition options on Global Citizen plans
Established international reputation
Good for older travelers

Cigna Global

Best for: Comprehensive coverage similar to domestic health insurance

Full pre-existing condition coverage available
Routine care included
Extensive provider network
Premium pricing ($200-400+/month)

Allianz Worldwide Care

Best for: Strong European presence and coverage

Pre-existing condition options
Extensive European network
Multiple plan levels
Good for EU-focused nomads

FAQ

Frequently Asked Questions

Yes, but coverage varies dramatically. Budget insurance (SafetyWing, basic World Nomads) will exclude diabetes-related claims entirely. Mid-tier may cover acute emergencies (diabetic ketoacidosis) but not ongoing care. For full coverage including insulin and supplies, you need international health insurance or plans with pre-existing condition waivers.

If discovered during a claim, your claim will be denied. In serious cases, your entire policy may be voided, potentially leaving even unrelated claims uncovered. Insurers can and do access medical records during claims investigation. Always disclose honestly.

Yes, if you've received treatment or medication for it within the look-back period. Even a single therapy session counts. Most travel insurance excludes mental health coverage regardless, so this may not affect coverage significantly—but it must be disclosed.

Insurers typically define 'stable' as: no new diagnosis, no medication changes, no new symptoms, and no hospitalization for the condition in the past 60-180 days. If anything changed recently, the condition may not qualify for waivers or enhanced coverage.

For serious chronic conditions (diabetes, heart disease, cancer history), yes—international health insurance provides meaningful protection that travel insurance cannot. For mild, well-controlled conditions, travel insurance with acute onset coverage may be adequate.

If controlled and stable, acute onset coverage (available in mid-tier plans) covers cardiac emergencies. For ongoing monitoring and medication coverage, international health insurance is better. The decision depends on how serious your condition is and your risk tolerance.

Pre-existing conditions require extra planning, but they shouldn't stop you from living the nomad lifestyle. Understand your coverage options, disclose honestly, maintain medication supplies, and choose insurance appropriate for your specific situation.

Budget insurance with pre-existing conditions is a gamble—one serious incident related to your condition could cost tens of thousands with no coverage. For peace of mind and genuine protection, consider the premium for proper coverage as part of your essential nomad budget.