Quest Travel Insurance and ‘Guaranteed Stability’ of Pre-existing Conditions

TuGo’s Quest Policy – Guaranteed Stability Insurance

This post provides a closer look at the details of the Quest policy which offers the guaranteed stability rider for enhanced coverage. I had a detailed question just today (October 18th) from someone who had a recent consultation for their lung condition, and wanted to travel in a week or so. They were interested in obtaining coverage for their pre-existing medical condition, and were wondering about ‘the possibility of qualification for the seven day stability plan’ with TuGo’s Quest policy.

My answer is re-posted here because it may be of interest to other snowbird’s looking into their own travel insurance options. You’ll see that I quote from the policy at length, narrowing down the possibilities…

Hi Ann,

Thank you for your interest in using BestQuote Travel Insurance Agency to research your travel insurance options. Here are the relevant definitions from the Quest policy:

PRE-EXISTING CONDITION means a medical condition, illness or injury known to you, and for which you have received medical consultation, diagnosis, and/or medical treatment by a physician prior to the commencement date of a covered trip and includes a medically recognized complication or recurrence of a medical condition.
STABLE means the medical condition is not worsening and there has been no alteration* in any medication for the condition or its usage or dosage, nor any medical treatment prescribed or recommended by a physician or received, within the period specified in this Policy before the commencement date of a covered trip.
* Alteration includes an increase or decrease in medication dosage, usage or a change in medication type, but does not include changes
in brand due solely to the availability of your usual brand or due to government regulations regarding reference-based pricing.
MEDICAL TREATMENT means any reasonable medical, therapeutic or diagnostic measure prescribed by a medical physician in any form including prescribed medication, reasonable investigative testing, hospitalization, surgery or other prescribed or recommended treatment directly referable to the condition, symptom or problem. Medical treatment does not include either: a) the unchanged use of prescribed drugs or medication for a stable condition, symptom or problem; or, b) a check-up where the physician observes no change in a previously noted condition, symptom or problem.

And, here is the policy wording concerning the coverage available for pre-existing medical conditions:

In addition to the general exclusions, the company will not be liable to provide coverage or services, or to pay claims for expenses incurred directly or indirectly as a result of: 1. Any pre-existing condition as defined, except as follows: Applicable to the Gold plan a) Pre-existing conditions that are stable in the 90 days prior to the commencement date of a covered trip. Applicable to the Silver plan a) Pre-existing conditions that are stable in the 180 days prior to the commencement date of a covered trip. Applicable to the Bronze plan a) Diabetes, heart and lung conditions that are stable in the 365 days prior to the commencement date of a covered trip. b) All other pre-existing conditions that are stable in the 180 days prior to the commencement date of a covered trip. Pre-existing conditions that do not meet the criteria set out above are not covered.

If you have purchased the Guaranteed Stability Option or the Future Stability Option, refer to that section heading for pre-existing condition coverage.
2. Any condition(s) for which you are registered on a waiting list in Canada for treatment or diagnosis.
3. Conditions or any related conditions for which, prior to departure, testing or investigative consultation took place, was scheduled to take place or was recommended for the purpose of establishing a diagnosis (not including routine check-up or routine monitoring for a stable and controlled condition), and for which results had not yet been received at the time of departure. This includes tests that were recommended or scheduled prior to departure, but had not yet taken place at the time of departure.
6. A medical condition for which treatment or hospitalization could have reasonably been expected.

As you are referring to ‘the possibility of qualification for the 7 day stability plan’, you are correct to understand that the regular policy is not a possibility (for reasons outlined above), nor is the ‘Future Stability Option’ due to the recent medical consultations:

Future Stability Option

Eligibility
To be eligible to purchase this option, you must meet the following requirements at the time of application which are based on the plan you qualify for:
Applicable to the Gold plan
a) Your pre-existing conditions must be stable in the 90 days prior to the application date of the Policy.
Applicable to the Silver plan
a) Your pre-existing conditions must be stable in the 180 days prior to the application date of the Policy.
Applicable to the Bronze plan
a) Your pre-existing diabetes, heart and lung conditions must be stable in the 365 days prior to the application date of the Policy; and
b) all other pre-existing conditions must be stable in the 180 days prior to the application date of the Policy.

The traveler may be able to obtain coverage, by buying the ‘Guaranteed Stability Option’ outlined below with my further comments afterwards:

Guaranteed Stability Option

Benefits
The company will reimburse you for eligible medical related expenses due to sickness or injury incurred as a result of a medical condition which existed prior to the commencement date of a covered trip to a maximum of $150,000.
Exclusion
This Policy does not provide payment or indemnity for expenses incurred directly or indirectly as a result of:
1.Conditions for which symptoms arose or for which medical consultation was required or took place on the date of departure or at any time within the seven days prior to the date of departure, other than a minor ailment.
Conditions
When this coverage is purchased as an endorsement to an Emergency Medical plan, coverage is also subject to the terms and conditions specified in section entitled Emergency Medical Insurance, not including exclusion number 1.
Coverage is also subject to the deductible as specified in the section entitled Emergency Medical Insurance.

So, the traveler can purchase the policy and have insurance covering a maximum of $150,000 for any condition that was discussed today, as long as the date of departure from their home province occurs more than 7 days afterwards. To be more clear, the date of departure would have to be on the 26th or later. And, while the pre-existing medical condition exclusion #1 no longer applies with the purchase of the Guaranteed Stability Option, #2 and #3 above do still apply. So the traveler cannot have the policy cover a condition for which he/she is on a waiting list for treatment or diagnosis; nor can they be waiting for results of any tests that would be used to conclude or advance the current diagnosis.

It sounds like the diagnosis of the lung condition has been completed, and while routine monitoring of the chronic condition will be ongoing, no issues prevent the traveler from obtaining the coverage offered by the Quest policy and its Guaranteed Stability Option.

I do hope this is helpful. Please contact me at any time tomorrow to discuss further if you would like. The policy can be purchased online after receiving a quote and clicking on the ‘Answer Medical’ button beside the quoted price for the Quest policy (very bottom of quote). Answering the short medical questionnaire will alter the quoted price (which is based on perfect health). The traveler could then select the deductible level they would like, and see how that affects the price. Clicking on the Blue purchase button then guides the purchaser through the encrypted, secure checkout process. Emailed policy documents arrive shortly thereafter.

Regards,

Bob Hornal,
President
BestQuote Travel Insurance Agency