Travel insurance at affordable premiums

Guide to travelling with existing health conditions

1 Travelling with existing health conditions

   1.1 Introduction

   1.2 The basics

   1.3 Find out if you need vaccinations or visas

2 Insurance

   2.1 Why is travel insurance important?

   2.2 Why you must disclose pre-existing medical conditions

3 Airports

   3.1 Taking medications through airport security

4 Resources

   4.1 Links to general health websites

5 Summary


Introduction

In this day and age, existing health conditions are no longer the barrier to travel they might once have been. The infirm, the elderly and those with chronic medical complaints may all be standing with us at the airport check-in desk, on the train or waiting to board our next cruise ship.

What are pre-existing health conditions?

  • a number of things might be described as existing health conditions:
  • your need to take regular medication, for example;
  • a physical invalidity which affects your mobility;
  • an underlying deficiency or weakness that may affect your immunity over the longer term – if you have previously had heart bypass surgery even many years ago, your immune system may remain weakened and vulnerable to any infection you develop whilst travelling abroad;
  • or a host of other medical conditions which might be affecting your general state of health now, have done so in the past, or may leave you vulnerable to problems at any time in the future.

The basics

What this means is that when travelling you need to aware of your state of health – both past and present – and go prepared. The booklet Health Advice for Travellers, published by the NHS, for instance contains the important advice of taking with you a careful and detailed written record of any medical conditions you may have together with the drug name, rather than the trade name, of any medication you may be taking.

If it is prescription medication, try to take more than enough with you on your travels. It is still worth taking the doctor’s prescription with you, however, in case you unexpectedly run out or if the doctor has been unable to prescribe sufficient for your travels. You might want to discuss with your doctor whether the medication you need is likely to be available in the country or countries to which you are going.

It is worth remembering that different countries have different laws and regulations about drugs that may be brought into the country and different controls over the ways in which they may be prescribed. Medication which you may be able to buy over the counter at the chemists in Britain may need a prescription where you are going. On the other hand, drugs for which you may need a prescription in the UK may be available over the counter when you are abroad.

It may be important, therefore, to find out before you go what medication you may be bringing back into the UK with you.

For the avoidance of any doubt, you might want to take a letter from your doctor or a copy of your health record explaining the nature of the medication you need to take. Further advice about medicines you may need to be taking into a country – or buying there – may be obtained from the UK embassy, the high commission or the consulate of country you intend to visit.

Find out if you need vaccinations or visas

Vaccinations

Vaccinations may be necessary before you are granted entry to some countries. The requirements are as much for your own benefit as for the authorities of the countries you are visiting and may be especially focused on the most travel-related infections such as typhoid, yellow fever and hepatitis A.

The NHS publishes a useful webpage about travel vaccinations with links to websites that detail the requirements of practically any country in the world. In some cases, vaccination might simply be a sensible precaution, in others though you may need to prove that you have had the necessary injections by carrying an International Certificate of Vaccination or Prophylaxis (ICVP).

Depending on your state of health and any pre-existing medical conditions, you may be more vulnerable to infections than other people. With certain medical conditions, it may not be possible to give you the required vaccinations.

A number of vaccinations are available free of charge on the NHS and include:

  • diphtheria, polio and tetanus (a combined vaccination);
  • typhoid;
  • hepatitis A (which may also be combined with typhoid or hepatitis B); and
  • cholera.

Other vaccinations you may have to pay for either at your GP surgery, if they have the relevant vaccines, or at a private clinic.

Clearly, you do not need to be travelling for some vaccinations and boosters to be worth your while. So when visiting the surgery for your travel vaccinations, you might also want to consider a general review of your record and current validity of vaccinations you might need to renew.

Visas

Many countries may require you to hold a valid visa before you are granted entry.

Each country has different requirements, of course, and it may be wise to check directly with the relevant Embassy or High Commission in London, or if there is one, a consulate in certain large cities outside the capital. An excellent and authoritative resource for addresses and contact details of these offices may be found in the London Diplomatic List, published by the Foreign and Commonwealth office.

Bear in mind that applications for visa may often take quite a long time to process. When making your travel plans, therefore, it may be important to allow sufficient time for your application, its processing and final issue.


Insurance

Whenever you are travelling – whether or not you have an existing health condition – you are likely to give serious consideration to the protection of travel insurance.

Why is travel insurance important?

Travel insurance is able to protect you against the loss or damage of your baggage, cancelled flights, stolen possessions, your public liability and the like. But the most important element of travel insurance is almost certain to be the protection it affords against accidents and illness whilst you are travelling – as well as repatriation.

And for very good reason too. If you suffer an accident or fall ill whilst you are abroad, the consequences may prove very expensive. There is the cost not only of getting you to a hospital but also the expense – which may be considerable – of the care and treatment whilst you are there.

Plus, you may also need assistance getting back home, whether because you missed your flight due to the illness / accident; whether you need someone to travel with you to look after you; or even if you need a double or row of seats for yourself (for example, if you break your leg on a ski-ing holiday).

The Foreign and Commonwealth Office estimates that it may cost:

  • £15,000 to £20,000 on a scheduled flight with a doctor in attendance and the use of a stretcher if you need to fly back to the UK from Australia;
  • £12,000 to £16,000 if you need an air ambulance from somewhere as relatively close as the Canary Islands; and
  • £35,000 to £45,000 if you need medical evacuation from the east coast of the United States.

At a glance, therefore, it may be easy to see why travel insurance may pay for itself on the medical protection it offers alone.

That may be all well and good, but what if you have a pre-existing medical condition? Is it possible still to find insurers who may cover you during your travels?

In many cases the answer may be a resounding yes – it may simply be a question of declaring any pre-existing condition and, if necessary, paying a slightly higher premium.

The policies we write here at Bengo Travel, for example, may help to illustrate the way in which such health issues are managed. In order to ensure that we find the most appropriate cover to suit you, we ask a number of questions about your medical history – just as any other travel insurance provider is likely to do.

Even if you answer yes to some of the questions, however, all is not lost. It may still be possible to arrange travel insurance for you, even given your declared state of health, although it may be that an increased premium is levied.

Why you must disclose pre-existing medical conditions

Some travellers may think that the easiest way around any insurer’s reluctance to issue the desired cover is simply to withhold or “forget” to mention past or current medical issues. This is not a good idea.

Insurance contracts in the UK are based on a long-standing principle of English law called uberimae fidei – which literally means ultimate good faith. The insurance contract, therefore, relies on an absolute transparency on the part of the insurer and an absolute honesty on the part of the insured.

If you fail to mention any medical ailment or answer any of the proposal questions dishonestly, therefore, the insurer is perfectly entitled to rule the insurance contract null and void. What that means for you is that the cover you thought you had in place no longer applies and you may be responsible for meeting all of the costs of any medical emergency whilst you are abroad.

Absolute good faith, in other words, demands your honest and accurate disclosure of any pre-existing medical condition. The disclosure may mean that you are still able to arrange travel insurance – even if a higher premium is charged – whilst a failure to disclose what is asked might end up with your having the cover you thought you had.

A failure to disclose important medical information from the outset may lead to any subsequent claim on the insurance policy being rejected.


Airports

As if negotiating your way through any busy airport were not bad enough, if you are travelling with existing health conditions you may find the process even more tiresome and apparently bureaucratic.

The problems tend to arise because other countries may have different laws about the import of certain medicines and because of the border controls designed to prevent the importation of illegal drugs when you are returning to the UK.

The National Travel Health Network and Centre (NaTHNaC), for example, points out that many medicines containing codeine may be bought over the counter at chemists in England but are in fact banned substances in a number of countries.

Clearly, this is just one example, but you may want to make sure that your prescribed medicine may be imported into the country or countries you are intending to visit. If necessary you may need to have a letter from your doctor explaining why the medication is required and exactly what it contains.

Correspondence published in the Telegraph newspaper also raised the question about whether it is necessary to go through the red channel, with goods to declare, if you are carrying prescription drugs. The expert advice is that this is not necessary although any traveller needs to be prepared to reply to any questions which may be raised about the drugs being carried.

For this reason, it is imperative that any medication is clearly and accurately labelled and your need for it is supported by a letter from your doctor and copies of the prescriptions used to acquire the drugs.

Taking medications through airport security

Key tips for negotiating your way smoothly through most airports in the world are:

  • to keep your medication and any medical equipment in its original packaging;
  • do not use unlabelled or unmarked bottles or boxes;
  • be prepared to answer any questions raised by the frontier control agents at the airport;
  • remember that extremes of temperature – either very cold or very hot – may affect the efficacy of your medication;
  • take special advice on any medication that needs to be kept in refrigerated conditions – consulting the airline with which you are travelling if necessary in advance; and
  • remember that some of the issues relating to your travelling with certain kind of medication may take a while to sort out – doing so as early as possible, therefore, may help to ensure that travelling through airports is no serious cause for concern.

There is no international standard on the regulation of imported medicines, so you might want to make certain of the rules relating to the countries you intend to visit as early as possible during your travel planning.

Being forearmed lie this is likely to be one of the surest ways of negotiating airport security wherever in the world you happen to be.


Resources

In order to travel where you want to go, when you want to go there, and with as little bureaucracy but with all due security and peace of mind, you may want to draw on some the many resources currently available.

Links to general health websites

A website maintained by the NHS and called Fit for Travel, for example, has up to the minute news and a wealth of advice of travel to a wide range of countries. Destinations cover practically every country in the world, so you are unlikely to be stumped on advice relating to your own travel plans – with the appropriate travel health information.

A further website maintained by the NHS – Travel Health – also contains stories in the news and other features about travelling with an existing health condition.

A helpful one stop shop for any vaccinations you may need is a company called Masta, whose website walks you through the process of determining what vaccinations you are likely to need for the countries you intend to visit. The site also allows you to search for the nearest Masta clinic in order to book the vaccinations you need.

Travel Health is a further resource for anyone in search of practical advice and information – including advice for travellers with existing health conditions. In addition, the site offers advice on staying healthy whilst you are travelling and how you might help yourself to avoid common travel sicknesses and tropical diseases.

These are by no means the only resources available to anyone with an existing health condition wanting to travel. There are many more websites and authorities offering advice and information to such travellers and if you are one of them it might repay you to do your own research before you travel.


Summary

International travel these days is commonplace – it is enjoyed by people from all walks of life, including those who have existing medical conditions.

As with any travel plans, of course, those who have a health problem – past or present – may need to prepare themselves with some degree of care when it comes to ensuring adequate supplies of any medication that may be necessary, especially if any needs to be bought whilst you are away.

Frontier controls differ from one country to another and of course reflect the local laws and regulations governing the import and use of controlled drugs. Some that may be freely bought at your local chemists over the counter in the UK may be controlled or banned in other countries – whilst prescription drugs in the UK may be freely bought over the counter in some other countries.

These are some of the considerations you may wish to bear in mind whilst negotiating airport security checks wherever in the world you happen to be travelling.

Travel insurance is likely to be high on anyone’s list, but for those with an existing health condition it may prove even more critical.

An existing health condition, however, need not be a barrier to arranging adequate travel insurance. It is typically necessary to make a full and accurate declaration about any past or present medical issues and it is important to be entirely frank and honest in your response to such questions – failure to do may render any travel insurance null and void, leaving you with a potentially huge medical bill to settle on your own account.

This guide is by no means the last word in travel advice for those with an existing health condition and there are many other resources which you may find it helpful to explore.