Mention the ‘C’ word and insurers either see pound signs or they slam the proverbial door in your face.
That’s how it feels for thousands of people with a complicated medical history or long-term health problem battling to get affordable travel insurance each year.
Chris Lewis, 62, a business consultant in London is a prime example, forced to forgo holidays with his family for years after his cancer treatment because, he says, insurers discriminated against him because of his health.
With one in two of us expected to be affected by cancer at some point in our lives by the year 2020, this issue is affecting more and more people.
We have put together a guide on where to look for insurance, what your options are and what you need to think about if you have, or have had a serious illness in the past.
Well-deserved break: Chris Lewis, 62, finally made it on holiday with his grandson after years of struggling to get cover after treatement
Chris, was diagnosed in 2007 with a stage 4 blood cancer. Since then he has been treated with chemotherapy and undergone a grueling stem cell transplant.
While he is thankfully still in remission, unfortunately having a transplant can have its own long-term complications and Chris still struggles with rejection issues.
He says: ‘For a long time after my treatment I didn’t want to travel as the problem of finding travel insurance was too much. So many companies wouldn’t touch me and others wanted crazy money.
‘Unfortunately, once you mention the word cancer, you are discriminated against by everyone! Banks, employers and insurers to name but a few.’
‘With most things in life there is no one size fits all approach that will work. Not everyone affected by cancer is dying, but you tend to get treated the same.
‘I have now been able to get affordable cover through a specialist insurer, InsuranceWith, which I found via social media.
‘But the industry doesn’t seem to want to help everybody find cover, this is an industry fraught with customer confusion.’
For those like Chris affected by a serious illness, a holiday is more than just a summer break, it’s often seen as a symbolic step in recovery or an aim to fix on during treatment – a dream they shouldn’t be forced to give up or risk financial difficulties to enjoy.
So here are our top tips to make sure you get the best and cheapest cover with a pre-existing illness such as cancer.
GET IN TOUCH WITH YOUR QUESTIONS
At This is Money we want to arm you with the tools you need to manage your money as easily as possible so you can focus your attention on your health and family.
This is the fourth in our ‘cancer and your finances’ series which will look at how to claim on health insurance, workplace and Government benefits and extra financial help if you’re ill among other things.
If you have a subject you’d like us to include in the series, email [email protected]
How it works
Travel insurance premiums are calculated according to the risk that you will make a claim.
With a history of ill health the likelihood you will need to claim, or the costs of medical treatment are deemed higher.
If the costs are deemed too high by an insurer they will often turn people away or apply a higher premium or excess to claims.
The other alternative you might be offered is to exclude your pre-existing condition from your policy, meaning that any medical expenses or cancellations related to your illness won’t be covered.
However with a pre-existing condition your top priorities for comprehensive cover will be cancellation cover in the lead up to your trip, medical expenses for treatment abroad, repatriation in an emergency and travel costs if medical treatment means you miss your return home.
Specialist insurers, which are often not widely known about, often offer more tailored quotes or work out premiums slightly differently, meaning more reasonable prices and better cover.
Where to look for specialist cover
Arguably the most important part of this guide – where you should look for cover.
Fiona Macrae from consumer awareness initiative travelinsuranceexplained.co.uk says: ‘The key is to find a travel insurance company that will treat you as an individual and recognise no two people or the treatment they receive is the same.’
‘Spend some time researching travel insurers. There are specialist providers who cover medical conditions and use a medication-led risk rating tool to fairly assess individual situations, these companies are often recommended on cancer charity forums. However, these companies are not on comparison sites so you would need to get a quote directly from their website.’
Richard Smith is managing director at tifgroup, which offers one of these medication-based medical risk rating tools, Protectif, used by specialist insurers.
He explains why a medication-led approach can lead to fairer prices: ‘We know that some medical risk rating tools are unsophisticated. For example, those who are well and are living normally with cancer and other complex medical conditions can be charged the same as a person who has metastatic cancer with recent complications from the treatment and/or the disease.
‘This is because other medical risk rating tools do not gather enough information about each person’s individual circumstances, so they are often charged based on a higher risk than is necessary for their personal needs.’
Looking specifically at the medication you take, rather than your list of conditions means insurers can better asses how stable your condition is, which can be a huge advantage to those who are well and living with cancer, or who have had treatment in the past.
The fact that they are not found on comparison sites means people are often unaware that specialist insurance companies exist and are a cheaper alternative to the more established and recognisable brands.
An FCA review recently highlighted this, and in a win for consumers, it will in future force insurers and comparison sites to flag to customers that they may be able to get a cheaper deal if they go to a specialist insurer that deals with pre-existing conditions.
In the mean time, it’s worth asking when you visit the hospital if other patients recommend any particular company, or checking comment sections and online forums to read about other people’s experience with insurers.
Here are a few This is Money has come across which have received good reviews through word of mouth or from those with cancer in online forums – Boots, Insurancewith, Ok to Travel, AllClear, Worldfirst, Eurotunnel (Europe only), Nationwide FlexPlus current account insurance, AXA PPP healthcare.
Using BIBA’s ‘Find Insurance Service’ may prove a useful starting point.
Got your own recommendation on top insurers for cancer patients? Share them at the bottom of the article in the comments section.
Special trip: Focusing on planning a holiday for the end of treatment can be the light at the end of the tunnel
WHAT INFORMATION YOU MIGHT NEED TO GET A QUOTE
Gathering quotes can be time consuming, stressful, and rehashing all of your medical history repeatedly can be upsetting.
There are often a lot of questions which require close detail so making sure you have all the info you need in one place to start with can be a big help.
Here are the types of details you might need.
Your details: Name, age, destination, who you are travelling with and how long for.
About your health conditions: What health problems you have have, how long ago they were diagnosed, what stage it was and if it spread or is terminal, any surgery you have had or have planned, what medication you are on, any side effects medication causes, any other supportive therapies you are on at the hospital, any treatments planned for the future, you may also need to know any medical equipment to travel.
Medical contacts: The hospitals and departments/specialists you are seen under or treated by, your GP’s details, information about your most recent visits or investigations.
A word of warning – the cost of travel without insurance
In the face of high costs from the larger insurers and without knowing about a specialist insurance firm it’s tempting to just say, let’s risk it and travel without insurance or just not disclose your medical history when buying a policy.
But proper travel cover is essential for everyone, and if you don’t inform your insurer about your history you won’t be properly protected.
Andrew Johnson, advice manager at The Money Advice Service said: ‘Travel insurance is essential if you are travelling aboard, especially if you need to pay for medical expenses or in serious cases flown home.
‘When shopping around you could be subject to additional underwriting requirements. So it’s important to disclose everything including any changes in your condition from the point of booking, to going on holiday. Failure to do this could lead to your claim being turned down.’
Covering a pre-existing illness doesn’t just mean you are covered if that illness gets worse abroad, it also affects cover for other related medical treatment abroad.
For example, if you get any sort of infection while abroad (one of the most likely risks after chemotherapy) you will only be covered if you have declared your cancer treatment as insurers will consider it related.
The cost to travellers of medical help abroad can be thousands, as the table below displays, showing the average claim values last year by customers of specialist insurer AllClear with the most common types of cancer.
|Condition declared||Claim cost (average)||Condition declared||Claim cost (average)|
|Ischaemic Heart disease||£7,000||Breast cancer||£6,800|
|Coronary angioplasty||£6,000||Bowel cancer||£7,500|
|Cholesterol levels||£6,000||Basal cell carcinoma||£7,100|
|High blood pressure||£6,000||Bladder cancer||£7,800|
|Diabetes mellitus||£5,000||Malignant melanoma||£16,400|
|Hypothyroidism||£5,000||Lymphoma (low grade or grade unknown)||£4,700|
|Back problems||£5,000||Bowel cancer diagnosed more than five years ago||£8,300|
Watch out for package bank account cover
Package bank accounts often come with travel insurance attached.
If you have a pre-existing condition you need to be careful as these polices won’t automatically cover you.
Most banks will require that you speak to their insurance department to see if they will cover you for your condition, often they come with restrictions and age limits so they should be approached with caution.
But sometimes it costs less to add the extra cover for an premium compared to a separate policy with another insurer.
After cancer treatment or a serious illness you may struggle to get annual cover, with most companies only willing to take on the risk for single trips.
However policies through your bank account often have the benefit of year-long multi-trip cover.
Some package accounts including those from Bank of Scotland and Lloyds give you a medical screening automatically when you sign up, others such as Barclays and Halifax stipulate that if you have a medical condition you must inform them to organise for a screening.
You may also be required to call up every time you book a trip, such as with First Direct and Natwest.
Paris vs St Lucia: The Caribbean is one of the most expensive places to receive medical care so travel insurance costs are much higher
Choose your destination carefully
Before you book, it’s a good idea to consider carefully where you travel to.
Firstly you need to make sure your consultant or doctor is happy for you to travel there.
Medical professionals may factor in any inoculations you might need, the location and quality of medical treatment, and the dangers of any diseases prevalent in the area.
Remember different countries have different rules on certain medications, particularly pain killers, so make sure to check the rules before you go.
Destination also plays a big part in how much you will be charged for insurance.
While it difficult to quantify, the medical costs, the costs of repatriation from destinations further afield and the strength (or rather weakness) of the pound have an impact on the premium you will be quoted.
The US is notoriously expensive, as is the Caribbean and Canada.
The cost of a hospital bed in the US for example can be up to $5,000 per day, or $10,000 in intensive care, according to MoneySupermarket data. Even countries closer to home can be expensive, with a price tag of €10,000 for a minor surgery or €750 per day for a bed in a Spanish hospital.
This of course has knock-on effects on the price you pay for cover in these countries. For example, someone with breast cancer, diagnosed 3-5 years ago still could expect to pay £18.80 for insurance for a two-week trip to France but £75.55 for a holiday in the USA according to AllClear.
Many companies and comparison sites therefore split policies into three camps, Europe, Worldwide and Worldwide excluding US.
A good way to help drop costs even further afield is to look for a country with a reciprocal health care agreement in place with the UK.
While it’s unclear what will happen after we leave the EU, your EHIC card still currently covers you for free or discounted treatment within Europe if you fall ill.
Remember though, this is not a substitute for insurance as it won’t cover you for getting home or cancellation cover, for ecample.
Other countries including Australia and New Zealand have similar agreements in certain circumstances such as inpatient treatment in an emergency. You can find out more on the NHS website.
Check first: Make sure you ask your doctor if they are happy for you to travel first, your insurer may ask for proof
Make sure you are covered for cancellations
It’s sensible to do your research on the destination first and make sure you can get cover before you book an expensive holiday.
That said, you must make sure to buy your insurance as early as possible, as soon as you have booked, to make sure you are covered for cancellations should you fall ill or anything happen before your holiday.
The devil’s in the detail
Travel insurance comes with a lot of small print, but it’s important not to ignore it particularly if you have a complicated medical history.
Here are a few bits of small print you should make sure to double check.
What’s the excess?
If the deal looks too good to be true, it may be that you will be expected to cover a large chunk of the cost yourself.
Therefore when choosing your policy make sure you factor in the excess, both the policy and medical excess.
It’s possible to get policies with no excess or set them higher yourself to cut the costs of your premium, but make sure it’s not so high you won’t be able to afford to claim.
What about friends and family travelling with you?
Don’t forget to check who your insurer will pay-up for.
If you get stuck in a foreign hospital you will likely want loved-ones close by so make sure it will cover replacement flights and accommodation for others you are travelling with.
Check the limits
Take a moment before you book to think about the level of cover and whether it suits your needs.
While price is important, you need to make sure the limits are high enough for you, all of them will be slightly different.
This doesn’t just mean medical cover, it also means the value of your belongings and any foreign currency you are taking for example.
The Foreign and Commonwealth Office suggests you need a minimum £1 million of medical expenses for holidays in Europe and as much as £2 million of cover for the USA and rest of the world.
What about repatriation?
If you fall ill while abroad only some policies will pay to get you home.
If you are seriously unwell, this won’t be as simple as a commercial flight – you might need specialist equipment, or a medical escort, which can be expensive.
Insurers often won’t cover your for certain activities abroad unless you add on extra sports cover or buy a more premium policy.
This doesn’t just apply to the most high risk activities such as whitewater rafting or bungee jumping, it can often apply to simple holiday activities such as scuba diving below a certain depth, jet skiing or horse riding.
PREPARATIONS TO MAKE BEFORE YOU GO
Travel Insurance Explained’s Fiona Macrae has some top tips on what to take with you if you are travelling with a serious illness and the key preparations to make.
- Ensure you pack enough medication in case you are delayed and are not able to return home as planned.
- Make sure you obtain a Doctor’s note and a copy of your prescription and keep your medication in their original packaging. Some medications are illegal in other countries and you may be required to show this documentation when entering your chosen destination.
- Research the local area and locate the closest public hospital – it may also be a good idea to note down the local emergency number too.
- After buying your travel insurance policy, make a note of the policy reference number and emergency assistance number – it may also be a good idea to leave a copy of these details with a relative or friend back home.
- Take a copy of your travel insurance policy and medical declaration away with you – just in case.
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