Many older visitors to the U.S. manage an ongoing health condition, and "Is it covered?" is the first question they ask. While many modern visitors insurance plans cover acute onset or sudden and unexpected recurrence of a pre-existing condition, Safe Travels Complete adds a different option: coverage for an unexpected flare-up of a stable, managed condition, available to travelers up to age 89.
This article gives you the facts and talking points to bring up this coverage with confidence and to set the right expectations with your customers.
What "Stable" Means
The plan treats any condition that existed at the time of application, or at any point in the three years before the effective date, as pre-existing. To qualify for the stable pre-existing benefit, the condition must meet a stability test. During the 90 days before the coverage effective date, the condition must not have:
Required hospitalization or emergency medical treatment
Experienced an acute deterioration requiring immediate medical intervention
Been the subject of a physician's recommendation for surgery or other major medical intervention
Required a material change in treatment because of deterioration
Routine follow-up care, maintenance medications taken as prescribed, refills, routine monitoring, preventive care, and adjustments made only to maintain or optimize therapy are not considered a material change in treatment. The insurer may ask for medical records, prescription history, or physician statements to confirm that a condition was stable.
What Is Covered
Expenses related to a stable pre-existing condition are considered when all of the following are true:
The episode is sudden, unplanned, and first occurs after the coverage effective date.
It is a sudden and unplanned recurrence or acute exacerbation of the condition, or a sudden complication that results directly from it, beyond routine maintenance care or expected disease progression.
The treatment is medically necessary and cannot reasonably be delayed.
Multiple episodes can be covered during the same policy period, as long as each one is a separate acute exacerbation that happens after the traveler has been medically stabilized from the previous one, is not a continuation of the same course of treatment and is supported by medical records.
What Is Not Covered
The stable pre-existing benefit does not cover:
Routine or maintenance care, including scheduled physician visits, elective or planned procedures, long-term disease management, and medication refills that aren't tied to a sudden flare-up
Treatment that was recommended before the effective date or was reasonably foreseeable at the time of travel
Ongoing or continuous treatment with no evidence of a sudden recurrence or acute exacerbation
Dialysis, long-term rehabilitation, or custodial care
Treatment when travel was undertaken primarily to receive care for a pre-existing conditionPlan Snapshot: Safe Travels Complete
- Plan Snapshot: Safe Travels Complete
- Who it's for: Non-U.S. citizens who live outside the U.S. and are traveling outside their home country to visit the United States, up to age 89
- Pre-existing maximum: Choice of $25,000, $30,000, $40,000, or $50,000 for ages under 70; $20,000 for ages 70-89
- Pre-existing deductible: $1,500, $2,000, $2,500, $5,000, or $10,000 (separate from the plan deductible)
- Medical maximum: $60,000, $250,000, $500,000, or $1,000,000 per period of insurance
- Deductible: $250, $500, $1,000, $2,500, or $5,000
- Coinsurance: After the deductible, the plan pays 80% in network and 60% out of network (UnitedHealthcare PPO network with direct billing)
- Duration: 90-day minimum premium; extendable up to 364 days total
- Outside the U.S.: Up to 30 days of coverage outside the U.S. during the insurance period, after arriving in the U.S.
- Purchase timing: Coverage must be purchased before departure
- Underwriter: Zurich Insurance Europe AG, Belgian branch
Once the pre-existing maximum is reached, no further pre-existing benefits are paid, but the rest of the plan stays in force for eligible expenses unrelated to the condition. The pre-existing benefit does not increase the overall policy maximum. Other plan limits apply as well, such as the sub-limit for cardiac conditions, and treatment that requires pre-certification is reduced by 50% if the requirements are not met.
Talking Points
Who to bring it up with:
Customers buying for parents, grandparents, or other older relatives who are visiting for three months or longer
Customers who ask whether a health condition will be covered
Customers who have been told other plans won't cover anything related to a pre-existing condition
What to say:
"This plan doesn't just exclude pre-existing conditions. It covers an unexpected flare-up of a stable, managed condition."
"There's no medical exam to buy it."
"It's available up to age 89, which is older than many plans that offer any pre-existing coverage."
"The pre-existing benefit has its own maximum and its own deductible, so you know the limits up front."
"It's a full visitors medical plan, with network direct billing, evacuation and repatriation benefits, and COVID-19 treated like any other sickness."
Common Questions
Does it cover my customer's regular medications and checkups? No. Routine and maintenance care, refills, and scheduled visits for a pre-existing condition are excluded. The benefit is for sudden, unplanned flare-ups.
What if the traveler was hospitalized recently? A hospitalization or emergency treatment for the condition in the 90 days before the effective date means the condition isn't considered stable, so the stable pre-existing benefit would not apply to it.
Does a change in medication disqualify the condition? Only if the change was made because the condition was getting worse, such as starting a new medication or significantly increasing a dose. Routine adjustments to maintain or optimize therapy don't count.
Can it be bought for a trip shorter than 90 days? No. The plan requires a 90-day minimum premium.
Can it be bought after the traveler leaves home? No. Coverage must be purchased before departure.
