I have a history of Atrial Fibrillation (AFib). I want to trek in Patagonia. I know my medical bills won’t be covered if my heart acts up, but I assumed I could at least buy evacuation coverage to get me off the mountain. I was wrong. Most policies link the two: No medical coverage = No evacuation coverage.
Key Takeaways
- The Linkage Rule: In standard travel insurance, Medical Evacuation is a benefit within the medical policy. If the medical condition (heart attack) is excluded as “Pre-Existing,” the evacuation for that condition is also excluded.
- Membership is the Loophole: Standalone evacuation memberships (Medjet, Global Rescue) are NOT insurance. They generally do not exclude pre-existing conditions for transport, provided you are fit to travel when you leave home.
- “Fit to Travel”: You must not be traveling against doctor’s orders. If your doctor said “Don’t go,” even Medjet will deny you.
- The Lookback Period: Standard insurance looks back 60-180 days. If your meds changed in that window, you are exposed.
The “Why” (The Trap)
The trap is “Exclusion Flow-Through.”
You read: “Evacuation: $500,000.”
You miss the clause: “We will not pay benefits for any loss arising from a Pre-Existing Condition.”
Since the need for evacuation arose from the heart condition, the “loss” (the jet cost) is denied.
The Investigation: I Called Them
- Medjet: “We do not ask medical questions on enrollment (under age 75). If you have a heart attack in France, we transport you, provided you weren’t traveling against doctor’s orders.” Winner.
- Allianz (Travel Guard): “If you buy the policy within 14 days of your initial trip deposit, we waive the Pre-Existing Exclusion.” Winner (if bought early).
- World Nomads: “If you have a pre-existing condition that is not stable, neither medical nor evacuation is covered.” Loser.
Comparison Table: Pre-Existing Evacuation
| Feature | Medjet (Membership) | Allianz (with Waiver) | Standard Policy (Late Buy) |
| Pre-Existing Evac | Covered | Covered | Excluded |
| Purchase Window | Anytime | Within 14 days of booking | Anytime |
| Medical Questions | None (<75) | None | Yes / Lookback |
| Cost | ~$300/yr | ~$200/trip | ~$100/trip |
[IMAGE: Decision tree graphic. ‘Do you have a pre-existing condition?’ -> Yes -> ‘Did you buy insurance within 14 days of deposit?’ -> No -> ‘Evacuation Denied’ warning]
Step-by-Step Action Plan
- Buy the “Waiver”: If you have a condition, you MUST buy your travel insurance within 14-21 days of your first trip payment (flight/hotel). This waives the pre-existing exclusion.
- Get a Medjet Membership: If you missed the 14-day window, buy Medjet. It separates the transport from the medical liability.
- Get a “Fit to Fly” Letter: Before you leave, have your cardiologist write a note: “Patient is stable and fit for travel.” This prevents the insurer from claiming you traveled against orders.
- Carry Meds in Carry-On: If you lose meds in checked bags and have a heart episode, they can deny for negligence.
FAQ
Does Global Rescue cover pre-existing?
Yes, generally, for the rescue portion, but they review cases carefully.
What if I just have high blood pressure?
If it’s controlled and meds haven’t changed in 60-180 days, it’s usually “stable” and covered by standard policies.
Does Medicare cover the evac?
No. Never.