What Does “Medically Stable” Mean?

Last Updated: June 21, 2016November 20, 2024

In the context of travel insurance, the term medically stable means that a health condition has remained unchanged for a specific period of time, known as a look back period, before your coverage begins. A look back period is typically 60-180 days long, depending on the policy.

If you experience worsening symptoms during your look back period, your travel insurance provider may deny coverage, leaving you responsible for out-of-pocket medical expenses.

How Do Travel Insurance Providers Assess Medical Stability?

In the event of a medical claim, your travel insurance provider may review your medical records to assess your level of medical stability before your departure date. Key indicators they will look for include:

• No New Symptoms: You haven’t experienced new or worsening symptoms related to a medical condition during the look back period.
• No Changes in Medication or Dosage: You haven’t had any new medications prescribed, or existing prescriptions adjusted for your condition.
• No New Treatments: You haven’t started any new therapies, medical investigations, or surgical procedures.
• No Hospitalizations: You haven’t been hospitalized or visited an outpatient facility for the condition.
• No Recommendations for Surgery: A doctor hasn’t recommended a procedure or treatment that hasn’t yet been performed.

Understanding How Your Provider Defines Medically Stable

While most travel insurance providers use common terminology, definitions can often vary dramatically from one company to the next. That’s why it’s important to understand your coverage and read through relevant policy documentation.

All travel insurance policies found on Squaremouth include a Certificate of Insurance. Within this document, most travel insurance providers will include a definitions section that outlines how they define terms like “medically stable” and “pre-existing medical condition.” Understanding these definitions can better inform you on the coverage a policy provides.

If you still have questions regarding your medical coverage, or if you’re considered medically stable by your provider, you should contact your travel insurance provider directly. Most providers offer 24 Hour Emergency Assistance to travelers before and during their trips.

Can You Travel If You’re Not Medically Stable?

Traveling while not medically stable may be possible, but will likely impact your travel insurance coverage. Most travel insurance policies have exclusions relating to pre-existing medical conditions, which refers to an illness or injury that existed at the time a policy was purchased.

If your travel insurance provider finds that you had pre-existing health problems that were not in a stable condition prior to leaving for your trip, they likely won’t cover medical care you receive during your trip.

With that said, some travel health insurance policies include a Pre-Existing Condition Waiver. With this waiver, a travel insurance provider won’t review your medical records, and will cover the cost of medical treatment relating to a pre-existing medical condition flare up during a covered trip.

Can You Cancel a Trip If You’re Not Medically Stable?

Yes, most comprehensive travel insurance policies will reimburse travelers for their prepaid, non-refundable trip costs if they are forced to cancel a trip due to an unforeseen illness or injury. Cancellations relating to a pre-existing medical condition may also be reimbursed as long as a policy includes a Pre-Existing Condition waiver.

In order to receive reimbursement under your policy’s Trip Cancellation benefit, you will likely be required to submit documentation from a physician or health care provider that indicates they advise against travel.

This information can vary based on the travel insurance policy. Please review the policy certificate to verify coverage. If you have questions about a specific policy, please contact us directly at 800-240-0369. Our customer service representatives are available from 8am to 10pm ET seven days a week and are delighted to help!