Thursday, February 28, 2013

Have Cancer Will Travel

Update (2013-03-06): I found a few nasty catches in a few policies that everyone needs to be aware of.

  1. Some policies will not cover you if you have ever had a bone marrow transplant.
  2. Some travel medical insurance policies will not cover you if you have ever been diagnosed with lung cancer or metastatic cancer.
  3. Some travel medical insurance policies will not cover you if you wind up having to have chemo between the date you purchased the policy and your date of departure.
  4. I came across one plan that requires you to inform the company if there is a change in a previously stable pre-existing condition before your date of departure. The company will then decide if they wish to continue to honour your insurance policy, whether that be for the travel medical portion of your policy (which makes some sense) or for the trip cancellation portion of your policy (seriously not cool).
I will be writing a few reviews of policies in both Canada and the US, in order to give you all a feel for what is out there.

For me, travel is an artform. It is my favourite past-time. It's relaxing. It's exciting. It's educational and emotional. Travelling and planning to travel are some of my favourite ways to escape my every day stresses. So imagine the suckage when I realized that having had cancer could interfere with travel insurance coverage.

I have only really needed travel insurance twice: first when a minor diving accident resulted in over $20,000 in medical bills and then again a few years ago when I fell down a few steps doing a face plant into cement a few days before I was scheduled to fly to Hawaii. If I had not had travel medical insurance the first time and trip cancellation insurance the second time then I would be a little poorer today. But speaking of today - I now have a few pre-existing conditions which make insurance coverage more complicated.

When purchasing trip insurance, always read the full policy before handing over your credit card. In the policy you will be looking for details to confirm that you are eligible for coverage and that any pre-existing conditions will be covered.

Pre-existing Condition Exclusions

Most travel insurance will cover pre-existing conditions that have been stable for a minimum number of days. If you have had a serious illness, the first thing you will want to look up in a policy is the definition for a "Stable Condition" in order to determine how long your condition has been stable. Here is one example definition:

Stable and Controlled means a medical condition for which:
  • There have been no new symptoms, and existing symptoms have not become more frequent or more severe or there have been no test results showing deterioration; and
  • A physician (or other medical professional) has not determined that the condition has become worse; and
  • A physician (or other medical professional) has not prescribed or recommended a change in medication taken for that condition; and
  • A physician (or other medical professional) has not prescribed or recommended a change in treatment for that condition; and
  • There has been no admission to a hospital or you are not awaiting results of further investigation for that medical condition

The second thing you will want to find in the policy is the number of days for which a condition must be considered stable in order to be covered by the plan. Most of the plans I have reviewed require a condition to be stable for a minimum of either 90 or 180 days before the effective date in order to be covered.

So in my case, using the example definition of "stable" above, I was declared in remission with no evidence of disease last September (174 days ago). However, I had radiation treatment in October and November, a change in treatment which reset my "stable" date to the last week in November (92 days ago). So if the policy requires my condition to have been stable for 180 days, then any claims related to my cancer will not qualify for coverage since my last change in treatment was 92 days ago. If the policy requires my condition to have been stable for 90 days, then I'm in luck. However, my case has one more complicating factor. I am still receiving Herceptin as a preventative measure, and will continue to receive it until June of this year. Will the end of my Herceptin infusions be considered a change in treatment? Will it be considered a change in medication? Does it matter since my course of treatment was decided almost a year ago? To learn the answers to these questions I will need to call the insurance company.

When reading the definition of "stable" look for phrases like:
  • "no new tests results" (regardless of whether the test results are positive?)
  • "a condition for which you have consulted a physician" (even if the consultation was inconsequential or a follow up?)
  • "change in dosage or treatment" (even if that change was a decrease in dosage or cessation of treatment?)

If you find anything that seems unclear, either call the insurance company to get clarification, or move on to a different insurer.

If you have been diagnosed with an incurable cancer, you should also look up the plan's definition of "terminal" and any coverage eligibility exclusions. Most of the plans I have reviewed have a terminal illness clause that allows the insurance company to opt out of any and all claims, regardless of the reason for the claim, if the insured has been diagnosed with a terminal illness. The definition of terminal illness differs from policy to policy. One policy I came across defined it as an expected survival of 30 days or less whereas another policy defined is as a condition for which a physician has given a prognosis of eventual death. The only exception to this rule seems to be the "Cancel for Any Reason" benefit described in the next section, although even then I would suggest speaking with a representative before committing.

In Canada, Desjardins has a slightly nicer definition of "stable condition": any condition for which in the past 90 days you have not been hospitalized and treatment and dosages of medication not changed, except to decrease (excludes warfarin and medications for diabetes for which dosages are often changed in response to diet). See page 18 of the policy to see if your pre-existing condition would be covered.

For people living in the US, many of Travel Guard's trip plans cover trip cancellation for pre-existing conditions if insurance is purchased within 15 days of your initial deposit for the trip. TravelGuard also offers optional Cancel for Any Reason add-ons (see next section).

Cancel For Any Reason

If your medical condition cannot yet be considered "stable", then look for a cancel for any reason benefit which will allow you to cancel within a certain number of days (varying from 14 days to 3 hours) of your trip for any reason for a partial reimbursement. The amount reimbursed is usually less than 100%, but it's better than nothing. If you need to cancel for a reason that is covered by your regular trip cancellation policy, then you will still be eligible for full reimbursement up to your departure. Note that this will not cover any medical costs incurred while travelling.

Charter vacation companies often offer better cancellation benefits through policies bought through them (for vacation packages also bought through them). For example, Sunwing allows you to cancel for any reason up to 3 hours before a vacation when you buy their insurance package.

In Canada, Marlin Travel offers Transat Travel Insurance Concierge Club policies that include a Cancel for Any Reason benefit if you purchase the insurance within 48 hours of making the initial trip deposit. The plan will reimburse 75% of the cost if the trip is cancelled at least 14 days before the scheduled departure date. They offer all inclusive and trip cancellation only policies, so you can match your coverage to your needs. You can only purchase this policy over the phone or in one of their offices, not online.

In the US, as mentioned above, Travel Guard offers optional Cancel for Any Reason add-ons which will reimburse 50% of the trip cost if cancelled at least 48 hours before the departure date.

Also in the US, the RBC TravelProtector Deluxe Plan has a Cancel for Any Reason option which allows you to cancel for any not-normally-insured reason up to 48 hours before your travel date for a 75% reimbursement of your costs. You must purchase the insurance within 15 days of your initial deposit for the trip to be eligible for the Cancel for Any Reason option.

Common Mistakes That Can Come Back And Bite You

Most trip cancellation policies require you to insure the FULL value of your trip. There have been cases in the past when claims were denied because the insured amount was off by a couple of dollars from the actual amount paid.

Also, make sure you have provided the correct departure and return dates on your contract. If any details of your trip (dates, destination, or cost) change, be sure to inform your insurance company promptly.

If you are travelling with a group of people, look for any clauses restricting the number of claims that will be accepted per group - for example, Desjardins will only cover the cost of three people canceling when a number of individuals cancel due to the same travelling companion.

Check the limitations on cancellations due to acts of terrorism - some policies cover this completely, some only partially, some not at all.

If a medical situation arises be sure to contact your insurance provider as soon as you are able to, otherwise  your reimbursement may be delayed or even diminished.

Not in North America?

My research did turn up some options in the UK. insurepink provides insurance for people who have been treated for breast cancer. They are much more lenient for claims related to breast cancer treatment. Maggie's has published a document listing insurers in the UK who offer packages available to people who have been treated for cancer.

If Insurance Is Not An Option

If you can't get insurance, consider the following tips:
  • Buy a class of ticket that will allow you to change your departure or return dates with minimal financial penalty
  • Only reserve hotels with generous cancellation policies (most major hotels only require you to cancel by 6pm to avoid a charge)
  • Don't travel to places where your regular health insurance won't cover your care (if you cannot afford health care and medical evacuation at your destination)
  • Don't travel if your doctor(s) advises against it

Here's one last resource to check out regarding travel in general after a cancer diagnosis. Wellspring published a great article last year about traveling with cancer, covering everything else you need to consider when planning a trip.

Happy trails!
The information in this blog post is for informational purposes only. It is not intended as legal advice to any person or persons on any subject matter. The author of this blog expressly disclaims all liability to any and all persons in respect of actions taken or not taken in reliance upon the whole or any part of the content of this blog post. No person should take any actions without seeking appropriate legal counsel or other professional advice based on the particular facts and circumstances at issue.


  1. Whew! What a useful blog post. Thanks for all the tips on buying insurance. I travel often, and post-cancer it's become a confusing area to navigate. ~Catherine

  2. Thanks Catherine! Unfortunately the more I read, the more tricky terms and conditions I find. I plan to do a more in-depth review of several policies over the next few months that will hopefully be useful.

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