Is my medical condition covered?

We cover many pre-existing medical conditions but if you are worried or know that your condition is not automatically covered we can assist you to potentially upgrade your policy and be covered for your condition.

The purpose of medical cover in a travel insurance policy is to cover you for a serious injury or a sudden illness. You are only covered for certain medical conditions under our policies. It’s important that you consider your medical history carefully. Hospital and other emergency healthcare overseas can be expensive. On this page you can learn about:

1. Pre-existing medical conditions we do cover
2. Pre-existing medical conditions we don’t cover
3. Situations we don’t cover

1. Pre-existing medical conditions

While travel insurance is designed to cover only unforeseen medical events, Travel by Us will insure certain medical conditions that you know about before you purchase your policy. We refer to these as ‘pre-existing medical conditions.’

There are four things you need to consider relating to pre-existing medical conditions:

• medical conditions that are automatically covered
• medical conditions that are not covered
• any other medical condition we don’t list
• pregnancy

If you already have a medical condition before you buy a Travel by Us policy, it will only be covered if you meet the criteria for automatically covered conditions shown in this PDS and you are not receiving active treatment or investigations.

You may purchase cover for  non-included pre-existing medical condition as long as you pay the additional premium at the time you buy your policy.

WHAT IS A PRE-EXISTING MEDICAL CONDITION

A pre-existing medical condition is:

• pregnancy
• a medical condition where you are aware of the symptoms, or a related complication you know about
• a medical or dental condition where you have received, or are waiting for, medical treatment
• any condition for which you take prescribed medicine
• any condition for which you have received surgery or attended hospital
• any condition for which you have received, or are waiting for, tests, investigations or consultation with a medical specialist
• any condition for which you have received or been advised to attend a follow-up consultation; or
• any chronic or ongoing medical condition or terminal illness

This definition applies to you, your travelling companion, a close relative, or any other person.

PRE-EXISTING MEDICAL CONDITIONS WE COVER AUTOMATICALLY (WITH SOME RESTRICTIONS)

We will cover you automatically for a pre-existing condition listed below, as long as you have not been hospitalised for the condition within the last two years.

• acne
• allergies, limited to rhinitis, chronic sinusitis, eczema, food intolerance,
  hay fever
• asthma – providing that you: have no other lung disease, and are less than 60 years of age at the date of policy purchase
• Bell’s palsy
• benign positional vertigo
• bunions
• carpal tunnel syndrome
• cataracts
• coeliac disease
• congenital blindness
• congenital deafness
• *diabetes mellitus (type I) – providing you:
  –      were diagnosed over 12 months ago; and
  –      have no eye, kidney, nerve or vascular complications
  and
  –      do not also suffer from a known cardiovascular disease, hypertension, hyperlipidaemia or hypercholesterolaemia; and
  –      are under 50 years of age at the date of policy purchase.
• *diabetes mellitus (type II) – providing you:
  –      were diagnosed over 12 months ago; and
  –      have no eye, kidney, nerve or vascular complications
  and
  –      do not also suffer from a known cardiovascular disease, hypertension, hyperlipidaemia or hypercholesterolaemia.
• dry eye syndrome
• epilepsy – providing there has been no change to your medication regime in the past 12 months
• folate deficiency

• gastric reflux
• goitre
• glaucoma
• graves’ disease
• hiatus hernia
• *hypercholesterolaemia (high cholesterol) – provided you do not also suffer from a known cardiovascular disease and/or diabetes
• *hyperlipidaemia (high blood lipids) – provided you do not also suffer from a known cardiovascular disease and/or diabetes
• *hypertension (high blood pressure) – provided you do not also suffer from a known cardiovascular disease and/ or diabetes
• hypothyroidism, including Hashimoto’s disease
• impaired glucose tolerance
• incontinence
• insulin resistance
• iron deficiency anaemia
• macular degeneration
• Meniere’s disease
• migraine
• nocturnal cramps
• osteopaenia
• osteoporosis
• pernicious anaemia
• plantar fasciitis
• Raynaud’s disease
• sleep apnoea
• solar keratosis
• trigeminal neuralgia
• trigger finger
• vitamin b12 deficiency

* Diabetes (type I and type II), hypertension, hypercholesterolaemia and hyperlipidaemia are risk factors for cardiovascular disease. If you have a history of cardiovascular disease, and it is a pre-existing medical condition, cover for these conditions is also excluded.

PREGNANCY AS A PRE-EXISTING CONDITION

This section shows you what you are covered for relating to medical expenses, cancellation costs or additional expenses related to pregnancy under the following policy sections:

• Overseas medical and hospital expenses
• Overseas dental expenses
• Cancellation costs
• Emergency medical transport & repatriation expenses
• Out of pocket expenses when hospitalised.

However we will not pay medical expenses for:

• regular care following the birth
• childbirth, regardless of the stage of pregnancy
• newborn care
• repatriation of your child

You are not covered under this section if you are undergoing fertility treatment and are not pregnant, now or before your trip commences, for any treatment or any resulting pregnancy.

See pages 62 and 63 of the  Combined Product Disclosure Statement and Policy Wording for details on what cover you can get based on your stage of pregnancy.

2.Pre-existing medical conditions we don’t cover

We do not offer cover for the following pre-existing medical conditions if you:

• have a condition where you plan to have surgery or other medical treatment, including any fertility treatment
• have a condition that arises from signs or symptoms that you are currently aware of, but:

–      you have not yet sought a medical opinion regarding the cause; or
–      you are currently under investigation to define a diagnosis; or
–      you are awaiting specialist opinion.

• have any form of cancer that you have previously been diagnosed with, or secondaries from that cancer
• have a condition for which you have needed to go to hospital in the last two years unless specified under Pre-existing medical conditions we cover automatically (with some restrictions)
• have a condition for which you have ever required spinal or brain surgery
• have a condition that has caused a seizure in the past 12 months
• have a chronic or recurring pain (including back pain) requiring regular medication or other ongoing treatment such as physiotherapy or chiropractic treatment
• have a condition that requires ongoing treatment with immunosuppressant therapy (e.g. arthritis, colitis, chronic respiratory disease)
• have an HIV infection
• have a mental illness as defined by DSM-IV including
  –      dementia, depression, anxiety, stress or other nervous condition; or
  –      behavioural diagnoses such as but not limited to autism; or
  –      a therapeutic or illicit drug or alcohol addiction.

• have a new deep vein thrombosis (DVT) or pulmonary embolism (PE) if you have been diagnosed with one of these clots in the past and do not take preventative measures (as prescribed by a medical practitioner) for this trip
• have a heart or cardiovascular disease (CVD) if you have ever needed to see a specialist cardiologist, or been diagnosed with a form of CVD such as (but not limited to):

–      aneurysms
–      angina (chest pain);
–      cardiomyopathy;cerebrovascular accident (stroke)
–      disturbances in heart rhythm (cardiac arrhythmias)
–      previous heart surgery (including valve replacements, bypass
surgery, stents)
–      myocardial infarction (heart attack)
–      transient ischaemic attack (TIA)
–      any history of any form of cardiovascular disease

• have a chronic lung disease, its exacerbation, or new airways infections, if you have ever been diagnosed with a chronic lung disease including:

– emphysema
– chronic bronchitis
– bronchiectasis
– chronic obstructive airways disease (COAD)
– chronic obstructive pulmonary disease (COPD)
– pulmonary fibrosis, or
– asthma (in persons over 60 years of age).

• “Immunosuppressive therapy” means drugs prescribed to inhibit or prevent activity of the immune system. Clinically, they are used to:

–  prevent the rejection of transplanted organs and tissues (e.g. bone marrow, heart, kidney, liver)
– treat autoimmune diseases or diseases that are most likely of autoimmune origin (e.g. rheumatoid arthritis, myasthenia gravis, systemic lupus erythematosus, Crohn’s disease and ulcerative colitis)
– treat some other non-autoimmune inflammatory diseases (e.g. long term allergic asthma control and other respiratory diseases).

3. Circumstances we do not cover

We do not offer cover where the following circumstances give rise to your claim:

• You have been given the prognosis that you have a terminal illness with a life expectancy of under 24 months
• You will require oxygen for the trip or you require oxygen therapy at home
• You have chronic renal failure treated by haemodialysis or peritoneal dialysis
• You have been diagnosed with congestive heart failure