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What is a pre-existing medical condition?

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What is a pre-existing medical condition?

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For the purposes of this insurance a Pre-existing Medical Condition is considered to be: • any past or current medical or psychological sickness, disease, condition, injury or symptom that has given rise to symptoms or for which any form of treatment or prescribed medication, medical consultation, investigation or follow-up/check-up has been required or received during the 2 years prior to the commencement of cover under this policy and/or prior to any trip: and • any cardiovascular or circulatory condition (e.g. heart condition, hypertension, blood clots, raised cholesterol, stroke, aneurysm) that has occurred at any time prior to the commencement of cover under this policy and/or prior to any trip. IMPORTANT: If there are any changes in your health or prescribed medication, prior to commencement of the period of insurance or departing on any trip, the Underwriters must be informed of these changes, by contacting Our Medical Helpline.

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It is a condition for which you, during the 180 days preceding and including the policy effective date: 1) Received, or received a recommendation for, a diagnostic test, examination, or medical treatment, or 2) Took or received a prescription for drugs or medicine. Item 2 of this definition does not apply to a condition that is treated or controlled solely through the taking of prescription drugs or medicine, and remains treated or controlled without any adjustment or change in the required prescription throughout the 180-day period before coverage is effective under this Policy. This exclusion is waived if: Purchase the plan by the final trip payment date; and you are not disabled from travel at the time you make your plan payment; and the booking for the Covered Trip must be the first and only booking for this travel period and destination.

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Any respiratory condition (relating to the lungs or breathing); any heart, circulatory, kidney, liver or cerebral condition; any stroke or central nervous system disorder; for which you have ever received treatment. B: Any cancer for which you have received any diagnosis or treatment within the last five years. C: Any disease, illness or injury for which you have received surgery, in-patient treatment or investigations in a hospital or clinic within the last two years.

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Under AB 1672, group health insurance defines a pre-existing medical condition as a condition for which an individual received treatment within the past six months prior to enrollment. Treatment is defined broadly and includes physician consultations and prescription medication.

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A pre-existing medical condition is a health issue that started before your current insurance. Usually this is evidenced by notations in your medical records. Examples of medical expenses frequently not covered as pre-existing medical conditions are long term prescription drugs and seasonal allergy treatments.

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