Travel Insurance After 40: Pre-Existing Conditions and What Actually Costs More

There’s a deadline you probably don’t know exists, and for most people it passes weeks before they’ve even thought about travel insurance.

It starts the day you pay for the first piece of your trip. Usually that’s a flight, booked months before insurance has crossed your mind. At the two companies I compare here, World Nomads and Travelex, you then have seven days or twenty-one. Buy inside it and the policy can cover a condition you already have. Miss it and it usually can’t, no matter how much you’re willing to pay.

Nobody tells you this at the point you’d need to know it. There’s no reminder on the booking page. And the natural instinct, which is to sort out the flights and the hotel first and deal with insurance nearer the time, is precisely the thing that costs you.

Start here: what a pre-existing condition clause actually is

If you’ve never bumped into the phrase, the whole idea fits in one sentence. An insurer doesn’t want to pay for something that was already going on before you bought the policy. So nearly every plan carves out what it calls pre-existing conditions, and then defines that term a great deal more broadly than you would.

Two things make that matter more than it sounds like it should.

It isn’t only about hospital bills abroad. That’s what most people picture, and it’s the smaller half. The same exclusion reaches your trip cancellation claim, which for most of us is the bigger money. If something flares three weeks before you fly and your doctor tells you not to go, you’re claiming for deposits, flights, the tour you paid for back in January. A pre-existing exclusion can take all of it, and you’d never get on a plane to find out.

And it isn’t aimed at people who are seriously ill. It catches ordinary, managed, unremarkable health. The kind you don’t think of as a condition at all. Exactly how it does that is the next section, because that’s the part worth understanding properly.

Here’s the good news buried in all of it, and it’s the reason this article exists. Both companies I compare in this article sell plans that can lift the exclusion if you buy in time and meet the plan’s other conditions. That’s called a waiver. It isn’t a paid add-on, though it only comes on certain plans, and the deadline attached to it is the thing nobody mentions.

Why I’m writing this

One of you asked me.

That’s the whole reason for this article. She wanted to know whether travel insurance would actually cover a condition she already had, which is a fair question that I assumed had a short answer. I went to look it up so I could reply properly.

“Hi Lisa, I so appreciate your travel advice. I have a question about travel insurance – I have a thyroid condition. Does this pre-existing condition mean I can’t get travel insurance coverage? I can’t figure it out.”

The short answer didn’t exist. The comparison sites contradicted each other. And when I stopped reading articles about policies and started reading the policy documents themselves, I found something that changed how I’d buy insurance for myself.

I’ve written before about the month we spent in Vienna after Matt’s back gave out, and what our insurance did and didn’t pay. Between us we’ve filed three claims and that article details what each one actually paid. So I’m not new to this. I still had a piece of it badly wrong, and I’ll show you where.

I’m somewhere in the middle of the age range reading this, which means I’ve stopped being able to treat “any pre-existing conditions?” as somebody else’s question at the bottom of a form.

Everything below is what I found, and what I’d have told her if I’d known it at the time.

The short version, if you read nothing else today

This is a more complicated subject than it has any business being, and your situation may not be the one I’m describing. I’d genuinely encourage you to read the whole article and understand it, because the details are where this works or falls apart, and then to read the policy document issued for your own state.

But if you want my advice in one sentence it’s this:

Buy your travel insurance within a week of your first payment toward the trip itself. And if a pre-existing condition is any part of your thinking, choose a plan that specifically includes the waiver rather than the cheapest one on the page, and insure the full cost of the trip.

Do that and most of what follows takes care of itself. The rest of this article is why it works, where it doesn’t, and what to do if that deadline has already gone past you.

This article is current as of August 2026, taken from the insurers’ own pages and policy documents.

Two warnings before you rely on any of it. Coverage, deadlines and availability vary by state, and the plan document issued for your state controls if it differs from anything here or on an insurer’s website. And these terms change, so check before you buy rather than after.

And the honest one: I’m not an insurance agent and I’m not a lawyer. I’ve read these policy documents closely and quoted them where it matters, but I can’t see your policy, your state or your medical history. Read your own plan document before you rely on any of this.

Two clocks, and one of them may not be where you think

Before any numbers, here’s how pre-existing condition waivers work for travel insurance.

There are two clocks in a pre-existing conditions claim. They measure different things and they start from different days, and almost all of the confusion on this subject, mine included, comes from mixing them up.

Clock one is the look-back period. The insurer picks a date, counts back a fixed number of days, and looks at what your health was doing in that stretch. Ninety days is the common figure.

Clock two is the purchase window. It starts the day you make your first payment toward the trip and gives you a fixed number of days to buy your policy. Seven days at one of these companies, twenty-one at the other. This one is about your calendar rather than your body, and you control it completely.

The waiver is the connection between them. A waiver is the insurer agreeing to set clock one aside. Beat clock two on the right plan, fit to travel when you buy, with the full trip cost insured where they require it, and they stop holding your medical history against you. It isn’t an add-on you pay for and there’s no form to fill in. It’s a condition you either met or didn’t, decided by the dates on your paperwork.

Now the part I had wrong when I first wrote this article, and it’s the part worth your attention:

Clock one is not necessarily in your past.

I’d assumed the look-back always sits behind you, finished, nothing to be done about it. That’s right at Travelex, which measures the period immediately before your payment reaches them. It is not right at World Nomads, whose wording measures the ninety days immediately prior to your trip date.

Think about what that means. Buy a World Nomads policy in March for a trip in June, and the ninety days they’re measuring runs from roughly mid-March to your departure. Most of it hasn’t happened yet on the day you buy.

Now, who that actually bites, because I had this aimed at the wrong person in an earlier version of this article. If you buy the Explorer or Epic plan inside the seven days, the waiver sets the whole exclusion aside. World Nomads says it plainly: once you qualify, “the claims department won’t look back on your medical history.” The future-facing window is not your problem.

It’s the reader without the waiver who needs to hear this. Buy the Standard or Annual plan, or miss the seven days, and that window keeps filling until you fly. A dose change in April because the condition got worse, weeks after you bought, can still land inside the stretch they examine. Buying early does not freeze your medical history with World Nomads. Only the waiver does that. Under Travelex’s national wording, the window closes when your payment reaches them, waiver or no waiver, though state versions can differ.

One more reason not to over-read this: their own definition is inconsistent about the anchor date. The main clause measures from your trip date, while an exception inside the same definition measures from the date your coverage starts. Which one governs your policy is a question for the plan document issued in your state.

So, the shape of it:

The look-back is what the insurer examines. The purchase window is your deadline. The waiver is what stops the first one mattering. And where the look-back sits on the calendar depends on which company you buy from, which is not something either of them puts in front of you.

Clock one: what “pre-existing” actually means

Here’s the misunderstanding that costs people the most.

You probably assume a pre-existing condition means a serious diagnosis. Something you’d mention at a first appointment. Heart, cancer, diabetes.

That’s not how these policies work. What they define is not a category of illness but a set of things that happened inside a window of time, and the two companies define it differently enough that it’s worth taking them one at a time.

World Nomads uses a three-part test. A condition counts as pre-existing if, inside the window, you or someone traveling with you:

1. Received or were recommended a test, examination or treatment for a condition that first appeared, worsened, became acute, or produced symptoms that would have prompted a reasonable person to seek care, or
2. Took or received a prescription for drugs or medicine, or
3. Required a change in prescribed medication, meaning dosage or frequency reduced, increased or stopped, or something new prescribed, because an underlying condition worsened.

The first part is narrower than people assume. A genuinely routine appointment about a quiet, stable condition doesn’t automatically trip it, because the wording asks whether the condition appeared, worsened or became acute.

But look at the second part, because it has no such qualifier attached. Taking or receiving a prescription is enough on its own.

And then the exception that rescues a lot of people, which almost nobody knows about:

If your condition is treated only with prescription medication and stays controlled with no change to the prescription across the window, the definition doesn’t apply to it at all.

There are two changes that are specifically allowed. Switching between a brand name and a generic at a comparable dose, and an adjustment to insulin or anti-coagulant dosage. Neither counts against you.

So if you’re the reader who wrote to me about her thyroid, here’s your actual answer. On World Nomads’ wording, a condition treated only with prescription medication, still controlled, with no change to the prescription across their window, isn’t reached by their definition. That’s considerably better news than the internet will give you. What puts you at risk is change: a condition that newly appears, worsens or sends you in for testing, or a dose change made because something got worse.

Travelex’s definition is the broader of the two. It reaches treatment, testing, examination and prescription medicine within the window without the “manifested or worsened” qualifier that limits World Nomads’ first limb. If your history is complicated, that difference is worth reading properly in the actual policy rather than taking my summary for it.

One thing the two companies share, and it’s good news: Travelex’s own page says they don’t consider something pre-existing if it “remains treated and controlled by medication” across their window. So the stable-prescription reprieve isn’t only a World Nomads thing. The wording differs at each company, so read your own plan’s version, but the principle holds at both.

Two more things about this clock surprised me.

The cheaper the plan, the further back it looks. Travelex looks back 90 days on Ultimate, 120 on Advantage and 180 on Essential. The plan that saved you money is also the plan searching six months of your history instead of three.

And the number changes by state. Travelex’s policy documents adjust the look-back period for a number of states, shorter in some and longer in others, so the national figures are a default rather than a rule. It’s one more reason the plan document issued for your state is the version that counts.

One genuinely good piece of news, and it applies to one group of people. If you live in New Hampshire, Travelex’s pre-existing exclusion doesn’t apply to you at all. Not waived, not conditional. It simply doesn’t apply, on any of their plans, with no purchase window to hit. If that’s you, you’ve just saved yourself the rest of this section.

Clock two: the purchase window, and how to never miss it

This is the clock you control, so this is the one worth getting right.

The waiver isn’t automatic and it isn’t on every plan. You have to buy in time, on the right plan, and the terms aren’t the same at the two companies. Here they are side by side.

Five things in that table are worth highlighting, and the first one decides when the clock even starts.

“First trip payment” doesn’t mean only the deposit. If the tour deposit really is the first money you put down, it starts the clock. The trap is that anything earlier starts it too, and the big deposit is rarely the first money. A flight, a hotel, a tour, and World Nomads’ own examples go as small as a museum ticket. Money that isn’t a travel booking, like a suitcase or a passport renewal, doesn’t start the clock. Book a $180 flight in January, put the tour deposit down in April, and your window opened in January and shut long before April arrived. Nothing warns you, because in January you weren’t thinking of yourself as someone who had started booking a trip. If you’re not sure which payment started the clock, assume the earliest one and buy from there.

The plan restriction is as important as the deadline. You can buy on day one, well inside the window, and still have no waiver, because you bought the Standard plan or the Essential plan. The window is necessary. It isn’t sufficient.

With World Nomads, the Annual plan never gets the waiver. If you’re a multi-trip traveler who buys an annual policy for convenience, you don’t have this coverage at all and you may not know it.

Travelex’s full-trip-cost rule keeps running after you buy. Insure the flights in March, book the hotel in May, and that May booking has its own twenty-one days. Add it late and you can undo a waiver you’d already earned.

Both companies require you to be medically able to travel on the day you buy. Nobody checks at the point of sale. Travelex lists it as a condition and World Nomads says that when you buy, “you are declaring that you are fit to travel.” But it’s a condition of the waiver, so it gets tested against your records later, when there’s money at stake. It’s a box you tick casually and a claims adjuster reads carefully.

And one state note, narrower than it sounds. World Nomads lists two of its time-sensitive benefits as state-restricted: Travel Inconvenience isn’t available to residents of Missouri, Montana, New York or Washington, and Cancel For Any Reason isn’t available in New York. Their page puts no state restriction on the pre-existing waiver itself. The plan document issued for your state is still the final word. And if you’re reading from the UK, Canada or Australia, know that everything in this article is US policy wording; your versions run under different rules entirely.

Now the awkward part, said out loud, because you’d find it yourself in ten minutes anyway. World Nomads is the policy Matt and I carry, and on this particular measure they’re the tighter of the two. Seven days is the shortest window of any policy I compared, the waiver isn’t on their Standard or Annual plans, and if you don’t qualify for the waiver, their look-back is anchored to a date that hasn’t arrived yet when you buy. That doesn’t change what I think of them and it doesn’t change what our claims paid. It does mean that if a pre-existing condition is the thing you’re insuring against, you have to move faster with them, and I’d rather tell you that than have you find out in a claims letter.

So here’s the whole of clock two in one line:

Buy your policy the same week you book, in the same sitting if you can manage it.

Seven days clears both deadlines. You lose nothing by being early, and you never have to remember which company gave you which number.

You can use this calculator to figure out when the window for a pre-existing condition waiver would close for an upcoming trip:

Whose health are they actually looking at?

This is the part I’d never seen written down properly, and it’s the one I’d most want a friend to know.

When a policy defines a pre-existing condition, it isn’t only talking about you. Travelex’s wording covers a condition “of you, a traveling companion, or a family member traveling with you.” World Nomads’ is built the same way: you, your traveling companion, business partner, or a family member scheduled to travel with you.

So if you’re going with your sister and your sister had a stent placed in March. in March, that’s inside the definition, and it’s her health that could sink your claim. The waiver covers her too, which is the good news. But you have to know to ask her, and almost nobody does. Have that conversation before you buy, not after.

Now the harder half.

If you’re worried about someone who isn’t coming with you, a different set of rules applies, in a different place, and it’s easy to miss.

Notice the limiter in both definitions above: traveling with you, scheduled to travel with you. Your mother at home is outside that wording entirely. In an earlier version of this article I took that to mean the pre-existing rules simply don’t reach her. That was wrong, and it’s the kind of wrong that costs somebody a claim, so let me be precise about what World Nomads’ US pages actually say.

Her illness can absolutely be a covered reason to cancel. A non-traveling family member who dies or develops a medical condition that stops you traveling, certified by a physician, is listed as covered.

But there’s a separate pre-existing test waiting for her, on the same page, under what may not be covered: “A family member’s pre-existing condition that was not stable and controlled.”

So she isn’t outside the pre-existing rules. She’s under a different pre-existing rule, with a different standard, in a different place on the website, and nothing tells you the two are different. The waiver you bought is about the health of the people getting on the plane. It isn’t what decides a claim about your mother. Stable and controlled is.

That phrase is doing an enormous amount of work and it isn’t defined on the page. If your mother’s condition is progressive, or her treatment changed recently, that’s the language a claims adjuster will be reading. If cancelling because of someone at home is the risk you’re actually insuring against, read the plan document for your state on this specific point before you buy anything, and look hard at Cancel For Any Reason, which is the last section of this article.

One useful thing while you’re here. World Nomads’ US definition of family is much broader than people expect. Spouse or partner, children, stepchildren, foster children, siblings, parents, in-laws, step-parents, legal guardians, grandparents, grandchildren, and aunts, uncles, nieces and nephews. Most people assume it means parents and children.

Who won’t take you

World Nomads is what Matt and I carry, and I’ve written about three claims we’ve filed and what each one paid. What I’d want you to know is that they run a separate product for older travelers, Silver Nomads, described on their own site as travel insurance for travelers aged 70 and over and provided through their partner TripAssure, a Generali brand. If you’re over 70, that’s the door.

One caution about it. Silver Nomads’ page carries no pre-existing condition or waiver wording at all, and it’s a different product with its own plan documents. Nothing in this article can be assumed to carry over to it. If you’re buying it, ask about the waiver specifically rather than assuming what you’ve read here applies.

And one I want to be accurate about, because I’ve recommended it elsewhere.

SafetyWing is a good company and I’ve said so on this site. For most readers of this article it isn’t the right product, but the reasons are more particular than I first thought, and they’re worth getting right.

Their plans have different age limits. The Complete plan stops accepting new customers at 64. Their Essential plan takes new customers up to 69 and stops the day you turn 70. So “SafetyWing won’t take you” is wrong if you’re 66 and looking at Essential.

Their two plans define pre-existing conditions differently, and at this age the difference matters. Essential, the plan that takes new customers through 69, uses a 180-day look-back (their Essential policy document SWIII-DOC-NI4.0E, effective February 2026). Complete, the plan that stops at 64, uses a much harder test: anything you’ve had treatment or a diagnosis for in your life, plus anything you’ve had symptoms of in the last two years. Two products, two standards. Make sure the definition you’re reading belongs to the plan you’re being quoted.

Essential does cover pre-existing conditions in a genuine emergency, which surprised me. Sudden, unexpected, treated within 24 hours of symptoms starting, not in your first 28 days of coverage, and not for anything chronic or progressive.

Where that leaves you: it’s a travel medical product rather than a trip protection product, there’s no pre-existing waiver of the kind this whole article is about, and if you want your deposits protected it isn’t built for that. That’s not a criticism. It’s a different product for a different traveler, and for a woman insuring a $6,000 trip against a thyroid condition, World Nomads and Travelex are the ones set up for her.

For what it’s worth in the other direction: Travelex says on its site that its plans can cover travelers up to 99 years old. I’d treat that as marketing rather than contract, because I couldn’t find a maximum age stated in any of their policy documents either way. But they clearly aren’t shutting the door at 70.

For the woman this article is written for, Travelex is where I’d start. Not because it’s better insurance than the World Nomads policy we carry, which I can’t tell you. Because on the clearest difference between the two, it’s the more forgiving: three weeks to get the purchase right instead of one. If you miss the deadline at either company, what happens next depends on their definitions and on the plan document issued for your state, and I can’t honestly tell you one company treats a miss more gently than the other. The deadline is the part you control, so control that one.

If you’re under 70, both are worth comparing. If you’re not sure you’ll get the policy bought inside a week, start with Travelex, because three weeks forgives more than one.

What actually costs more

Age is a rating factor. Travelex says plainly that the cost depends on “your trip cost, state of residence, trip length, and age.”

I’m not going to print a premium, because any figure I put here would be wrong within a year and wrong for you today. What’s more useful is knowing which levers move the price.

Trip cost is on that list first, and it makes sense, because most of what you’re buying back is money you’ve already committed. Trip length and your state are on it too, and the state one surprises people.

What isn’t on the list is the waiver. On Travelex it isn’t a paid add-on at all. It’s listed as included, as long as you buy inside the window and insure your full trip cost. What it costs you is buying the top plan rather than the cheapest one, and buying promptly. That’s a real cost, but it isn’t a line item, and it isn’t the thing making your quote expensive.

The third clock, briefly: Cancel for Any Reason

Two clocks cover almost everybody. There’s a third, and it exists for the situation the first two can’t help with: the risk that something changes between booking and departure, especially for someone who isn’t traveling with you.

Cancel For Any Reason (CFAR) is an upgrade that lets you cancel for reasons a standard policy won’t cover. It’s the closest thing there is to an answer to the mother-at-home problem, because it doesn’t ask why.

It has its own deadlines, tighter than the ones above. Travelex reimburses up to 75 percent of each traveler’s insured trip costs, capped at $7,500 per traveler, if you cancel at least two days before departure. You can only add it to the Ultimate plan, you have to buy it inside the same 21-day window from your first trip payment, and at least 31 days before you go. Simplest is to buy the two together and never think about the deadlines again.

And a trap that catches careful people. Under the waiver you have 21 days to insure a later booking. Under CFAR you have 14. Insure an add-on on day 18 and you’ve kept your waiver and quietly broken your CFAR. Same trip, same policy, two different deadlines.

And one condition that will quietly disqualify some people: the insured trip cost has to be $10,000 or under per traveler. A solo traveler on a $12,000 trip can’t have it at all. A couple splitting that same $12,000 evenly can, because each of them comes in under the line.

It costs more, and for a lot of people it isn’t worth it. But for someone whose health, or whose mother’s health, could genuinely change in the months between booking and flying, it’s the piece that makes the trip bookable at all.

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My Safety Guide

This whole article is about buying travel insurance. The guide is about the day you have to use it.

Everything above happens at a keyboard, months before a trip, with time to think. That’s the easy half. The hard half is the morning something actually happens, and almost every claim I’ve filed turned on paperwork I could only have gathered while I was still standing there.

My book The Smart Woman’s Guide to Safer Travel has a full chapter on when things go wrong. What to do in a genuine medical emergency and in what order, which is not the order most people guess: emergency services first, your insurer second, and what that second call actually gets you. Their line can tell you which hospitals they work with directly and try to coordinate billing so you aren’t putting it all on a credit card the way we did in Vienna. They’ll arrange translation. In a serious situation they coordinate evacuation.

It has the resource I used to find the surgeon who operated on Matt’s back in Vienna: the US State Department’s destination information, which includes lists of local doctors and hospitals, and which almost nobody knows exists.

It has what to document while you’re still in the country, and why a police report matters for a theft claim months later. And it has a fill-in emergency card for your wallet with your policy number and your insurer’s 24 hour line on it, because the one thing you cannot do in an emergency is look up your policy number on the phone that just got stolen.

The rest of the guide is the part that means you never file at all: how to research where you’re staying before you book it, how to handle arrivals and taxis in a city you don’t know, how to protect your phone and your money, and a section on assault that’s in there because if you’re ever in that situation you deserve to know what to do rather than work it out alone.

Eight grab-and-go checklists. All for $19.99.

Get the guide – $19.99

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Frequently asked questions

What’s the difference between the look-back period and the purchase window? They’re the two clocks, and mixing them up is the most common confusion on this subject. The look-back period is the stretch of medical history the insurer examines: 90 to 180 days depending on the plan and your state. The purchase window is your deadline to buy: 7 to 21 days from your first trip payment. The waiver is what links them, and it’s the insurer agreeing to stop holding the first against you because you beat the second and met the plan’s other conditions.

Is the look-back period always in the past? No. Travelex measures it backward from when your payment reaches them, so it’s behind you when you buy. World Nomads measures the 90 days immediately before your trip date, so if you buy early, much of that period is still ahead of you. If you qualify for the waiver, this doesn’t matter, because the exclusion is set aside. If you don’t, because of the wrong plan or a missed deadline, something that happens after you’ve bought can still land inside it. Read the plan document issued for your state.

What counts as a pre-existing condition? Not what most people think, and the two companies differ. World Nomads uses a three-part test: treatment or testing for a condition that appeared, worsened or became acute; taking or receiving a prescription; or a medication change because something got worse. Travelex’s wording is broader and reaches routine treatment, testing and examination without the “worsened” qualifier.

I take the same medication I’ve taken for years. Am I caught by this? With World Nomads, probably not, and this is the exception worth knowing. If a condition is treated only with prescription medication and stays controlled with no change to the prescription through the window, their definition doesn’t apply to it. Switching brand to generic at a comparable dose is allowed, and so is an insulin or anti-coagulant adjustment. What catches you is a dose change made because the underlying condition got worse. Travelex states a similar carve-out on its own pages for conditions that stay treated and controlled by medication, so ask the same question there.

How long do I have to buy the waiver? Seven days from your first trip payment with World Nomads, twenty-one with Travelex. Buy within seven, on a plan that actually carries the waiver, and you’ve cleared both companies’ deadlines.

What counts as my first trip payment? The first money you put toward an actual piece of the trip: a flight, lodging, a tour, even a museum ticket. Not trip shopping like luggage. If you booked a flight in January and everything else in April, your clock started in January. If two payments could plausibly count, work from the earlier one to be safe.

I bought inside the window. Am I definitely covered? Not automatically. You also have to be on a plan that carries the waiver: Explorer or Epic at World Nomads, Ultimate at Travelex. Buying the cheap plan on day one gets you no waiver at all. With Travelex you also have to insure your full trip cost, including anything you book later. Both companies also require you to be medically able to travel on the day you buy.

Does the waiver cost extra? On Travelex it’s included rather than sold as an add-on. What it costs you is buying their top plan instead of their cheapest, and buying promptly.

My husband is fine but I’m not. Does that matter? It works the other way round too. The definition covers you, anyone traveling with you, and a family member traveling with you. His health history can affect your claim exactly the way yours can. Ask before you buy, not after.

What if I’m worried about my mother at home? Her illness can be a covered reason to cancel. But a different pre-existing rule applies to her than the one your waiver deals with. World Nomads’ US guidance says a family member’s pre-existing condition that was not stable and controlled may not be covered. That phrase isn’t defined on their page, so if this is your actual worry, read the plan document for your state on this specific point, and look hard at Cancel For Any Reason, which doesn’t ask why you’re cancelling.

Does any of this change depending on where I live? One state note, and it’s narrower than it sounds. World Nomads lists two of its time-sensitive benefits as state-restricted: Travel Inconvenience isn’t available to residents of Missouri, Montana, New York or Washington, and Cancel For Any Reason isn’t available in New York. Their page puts no state restriction on the pre-existing waiver itself. The plan document issued for your state is still the final word.

Should I just buy the cheapest policy? Look at the look-back period before you look at the price. Travelex looks back 90 days on its most expensive plan and 180 on its cheapest. The cheaper plan searches twice as much of your medical history, which is the wrong trade if you have any history to search.

What if I already booked two months ago? Then the purchase window has closed, and you should still buy a policy. It just may not help with claims that trace back to a condition that meets the plan’s definition. Set a reminder for next time, for the day you book the first thing.

I’ve bought the right policy. Is there anything else before I go? One thing, and it takes five minutes. Write your policy number and your insurer’s 24 hour emergency line somewhere that isn’t your phone, because your phone is the thing most likely to be gone when you need them. And find out the local emergency number where you’re going: 112 across the EU, 911 in the United States and Canada, and worth checking anywhere else. In a real emergency that’s the first call and your insurer is the second.

The bottom line

The reason women end up underinsured usually isn’t cost and it isn’t carelessness. It’s a deadline nobody mentioned, attached to a definition nobody explained.

Two clocks. One is the stretch of medical history the insurer examines, and where it sits on the calendar depends on which company you buy from. One is your deadline to buy, and it’s entirely yours.

So: buy your policy the same week you book, and buy a plan that actually carries the waiver. Ask whoever’s traveling with you what’s been going on with their health. Read the look-back period, and check whether it’s measured from when you buy or when you fly. Check the age wording before the price. And if you’re worried about someone at home, understand that your waiver isn’t what covers you there.

Then read the plan document for your state, because it’s the only version of any of this that pays claims.

None of that takes more than twenty minutes, and all of it happens before you go, which is the only time it can.

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