Travel Insurance for Pre-Existing Conditions: What You Need and Where to Find It

Approximately 15 million people in the UK have a long-term health condition, and the majority of them travel. Standard travel insurance policies exclude claims arising from conditions that existed before the policy was purchased, which means that for the 15 million people with diabetes, heart conditions, cancer histories, respiratory conditions, or any of hundreds of other medical diagnoses, the default travel insurance bought at checkout does not protect them for their most likely medical need abroad. The solution is not to avoid travel or hope nothing goes wrong: it is to declare every relevant condition accurately when purchasing insurance and to buy a policy that explicitly covers it. The cost of specialist pre-existing condition travel insurance is almost always lower than the cost of even one day in a US or Australian hospital, and the difference in cover is absolute.

Why Accurate Declaration Is Not Optional

Travel insurance is a contract of utmost good faith (uberrimae fidei in UK insurance law): the insurer relies on the policyholder to disclose all material facts accurately. A "material fact" is anything that would influence the insurer's decision to offer cover or the premium they charge. A pre-existing medical condition is always a material fact. If a claim arises from an undeclared or inaccurately declared condition, the insurer can legally decline the claim entirely, even if the condition is only tangentially related to the incident. This is not a technicality: the Financial Ombudsman Service consistently upholds insurer decisions to void claims where pre-existing conditions were not declared.

Insurers ask about conditions using different question formats. The most important is the "standard of care" question: "Are you taking any medication or receiving treatment?" and "Have you been diagnosed with any medical condition in the past X years?" Answer every question accurately; the temptation to omit a condition to reduce the premium eliminates all cover, not just cover related to that condition.

What Counts as a Pre-Existing Condition

The definition varies by insurer but typically includes any condition for which you have:

• Received a diagnosis
• Received or are receiving medication
• Had symptoms that were investigated, even if no diagnosis was made
• Had surgery, been admitted to hospital, or attended a specialist clinic
• Been referred to a specialist (even if the appointment has not yet occurred)

Common conditions that must be declared: type 1 and type 2 diabetes, heart disease, atrial fibrillation, coronary artery disease, heart attack history, stroke history, asthma (if controlled by daily medication), COPD, cancer (active or in remission; the remission period required varies by insurer), Crohn's disease, epilepsy, kidney disease, hypertension (if medicated), depression and anxiety (if medicated or treated), and joint replacements.

Insurers Specialising in Pre-Existing Conditions

AllClear Travel Insurance

AllClear is the UK's market leader in specialist pre-existing condition travel insurance, covering over 1,300 medical conditions through a medical screening process. The screening is conducted by telephone or online questionnaire, with qualified nurses reviewing complex cases. AllClear can cover conditions that most standard insurers decline entirely, including active cancer treatment, recent stroke, and heart failure. Premiums for complex conditions are significantly higher than standard insurance; a 70-year-old with Type 2 diabetes and controlled hypertension travelling to Europe for 2 weeks might pay £150 to £300 for a policy that a healthy 30-year-old would obtain for £25 to £40. Annual multi-trip policies are available and economical for frequent travellers.

Staysure

Staysure specialises in travel insurance for older travellers (no upper age limit on single-trip policies) with pre-existing conditions. The online screening process covers most common conditions with instant pricing. Staysure's annual policies are well-priced for travellers over 60 with stable conditions. Medical emergency cover up to £10 million; cancellation cover varies by tier (Essentials, Standard, Premier).

Free Spirit (Health-on-Travel)

Free Spirit's Freestyle policy is notable for covering travellers who have been declined by other insurers and for covering conditions including HIV/AIDS, organ transplants, and complex cancer treatment that other specialist insurers may still exclude. The underwriting uses a point-based medical assessment; premiums reflect the actual risk profile of each applicant's condition rather than categorical exclusions.

Post Office Travel Insurance

The Post Office's travel insurance uses a comprehensive screening questionnaire covering over 1,500 conditions and is widely regarded as offering competitive premiums for stable, well-managed conditions in standard categories (type 2 diabetes, controlled hypertension, asthma). Less suitable for complex or recently active conditions where AllClear or Free Spirit's specialist underwriting provides more comprehensive cover.

What to Look for in a Pre-Existing Condition Policy

• Medical emergency cover: Minimum £2 million for Europe; minimum £5 million for USA, Canada, or Caribbean; £10 million preferred. The cost of a medevac flight from the USA to the UK is approximately £50,000 to £100,000; emergency cardiac surgery in a US hospital can exceed £200,000. Under-insuring medical expenses is the most dangerous economy in travel insurance.
• Repatriation: Cover for medical repatriation to the UK when ongoing treatment requires it. This is separate from emergency medical cover and is sometimes excluded or capped.
• Cancellation and curtailment: Cover for cancelling or cutting short the trip if a medical event occurs before or during travel. This should cover the full cost of non-refundable bookings.
• 24-hour emergency assistance: An emergency line that coordinates with overseas hospitals, arranges direct payment to hospitals (avoiding out-of-pocket costs), and organises repatriation. The quality of this service varies significantly; Europ Assistance and Allianz are the most commonly contracted assistance providers for UK travel insurers.
• Condition stability clauses: Many policies require that the covered condition has been "stable" for a defined period (commonly 3 to 6 months) before the travel date. "Stable" typically means no change in medication, no hospital admission, and no new symptoms in that period. If your condition changed recently, check whether the stability clause applies.

Cost Reduction Strategies

• Compare using specialist comparison sites (Confused.com, Compare the Market, MoneySuperMarket all have pre-existing condition filters; also check Medical Travel Compared and InsureandGo directly)
• Annual multi-trip policies are economical if you travel three or more times per year; the additional premium for pre-existing conditions is charged once rather than per trip
• Increasing the excess (deductible) reduces premiums; a £250 to £500 excess is typically the economical choice for medical cover, as small claims are rarely worth the administrative effort
• Disclosing only declared, diagnosed conditions rather than speculative ones; do not pre-emptively declare symptoms that have not been investigated or diagnosed

Related: Travel Insurance: What You Need Before Every Trip | International Health Insurance for Expats and Long-Term Travellers