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Travel insurance coverage for pre-existing medical conditions

Travel Insurance for Pre-Existing Conditions: Digital Nomad Guide

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

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

During Travel

  1. Track supplies - Know when you'll need refills
  2. Research local pharmacies - Some countries allow prescription-free purchases
  3. Find English-speaking doctors - Before you need them
  4. 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

  1. Research specialists at destinations - Before arriving
  2. Use expat forums - Best doctor recommendations
  3. Check International Association listings - IAMAT, ISTTM
  4. 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.

Related Guides

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.

About the Author

Image for Author Peter Schneider

Peter Schneider