I ran out of insulin in Medellin due to a supply chain issue. I went to a pharmacy, bought replacement pens ($300), and filed a claim. Denied. “Diabetes is a pre-existing condition.” I knew that, but I thought my “comprehensive” policy covered me. Turns out, I was paying for a placebo.
Key Takeaways
- The “Lookback” Period: Insurers look back 6 months to 3 years. If you took meds, saw a doctor, or had symptoms for anything in that window, it is “Pre-existing” and excluded.
- Acute Onset of Pre-existing: Some plans (World Nomads) cover “Acute Onset” (e.g., you go into diabetic shock), but they do not cover maintenance (buying insulin or routine checkups).
- The “Chronic Condition” Rider: You need a policy that specifically covers “Chronic Conditions.” These are rare and expensive.
- Underwriting: To get real coverage, you must go through “Medical Underwriting” (answer a questionnaire). If you buy a policy online in 5 minutes, it definitely excludes your condition.
The “Why” (The Trap)
The trap is “Acute Onset vs. Maintenance.”
Travel insurance protects against the unexpected. You needing insulin is expected. Therefore, it is not an insurable risk in their eyes; it’s a budget item. Even if they cover “Acute Onset,” they will only pay to stabilize you (ER visit), not to restock your meds.
The Investigation: I Called Them
- Insured Nomads: They have a plan called “World Explorer Multi” that offers a small benefit for “Acute Onset of Pre-existing Conditions.” It helps if you have a crisis, but it won’t buy your daily meds.
- GeoBlue (Xplorer Premier): This is one of the few that covers pre-existing conditions if you have creditable prior coverage in the US. No waiting period if you switch directly from a US plan.
- Cigna Global: They allow you to add coverage for pre-existing conditions, but they will likely “load” the premium (charge you 20-50% more) or exclude that specific organ.
Comparison Table: Pre-Existing Condition Coverage
| Feature | Standard Nomad Insurance | Insured Nomads | GeoBlue Xplorer Premier |
| Routine Meds | NO | NO | YES |
| Emergency (Shock) | Maybe (Acute Onset) | YES (Acute Onset) | YES |
| Checkups | NO | NO | YES |
| Application | Instant (Excludes all) | Instant | Medical Underwriting |
[IMAGE: Close up of an insulin pen and a pill organizer on a passport, with a blurred denial letter in the background]
Step-by-Step Action Plan
- Budget for Meds: Assume insurance pays $0 for your diabetes/asthma meds. Check prices in your destination (e.g., Insulin is cheaper in Colombia than US, but expensive in Thailand).
- Buy “Acute Onset” Coverage: Ensure your policy has at least $100k for “Acute Onset of Pre-existing Conditions.” This saves you if you end up in the ICU.
- Carry a Doctor’s Note: You need a letter explaining your condition to cross borders with large amounts of meds.
- The “GeoBlue Hack”: If you are American, keep your US insurance until the day you activate GeoBlue Xplorer. This “continuous coverage” waives the pre-existing lookback.
FAQ
If I break my leg, is it covered even if I have diabetes?
Yes. As long as the broken leg wasn’t caused by the diabetes (e.g., a dizzy spell), it is covered.
Does SafetyWing cover high blood pressure?
No. If you have a stroke related to HBP, they might deny the claim based on medical history.
Can I lie on the application?
In 2026, AI scans your medical records globally (MIB Group). If you lie, they will find out at claim time and deny everything.