“I nearly fell over when I saw the travel insurance quote,” says Bernie Lawrence. The 77-year-old retiree from Fleet, Hampshire, had always been active – he was out running when chest pains struck in 2018. Nine days later he underwent quadruple bypass surgery. Before that, he and his wife Barbara, 79, paid under £100 for an annual policy covering European travel. After the operation and as they grew older, the price began to climb sharply. In 2022 they paid £302 for the same level of cover. Then, after a brief episode of atrial fibrillation – a common heart rhythm disorder – and being placed on an NHS waiting list for an echocardiogram, they were quoted £1,200. “I just couldn’t believe it,” he says. “All I was waiting for was for them to tell me something I already knew: that it had gone and probably wasn’t going to come back.” Unable to wait months for NHS confirmation, he paid privately for the scan. Once he had the all-clear, his quote fell to £584. The couple paid £805 in 2024 and then £1,009 this year for annual cover before a Mediterranean cruise. He says he thinks insurers treat older people as “a bit of a cash cow”, but adds: “You can’t really argue with them because they say: ‘Well, you’re 77 years old and you’ve had all these things in the past.’”
The cost of pre-existing conditions and the risk of travelling uninsured
Lawrence has never made a claim on his travel insurance, but he says it is vital to have cover. Yet millions of holidaymakers with pre-existing medical conditions plan to travel abroad this summer without insurance, according to a survey by the specialist insurer AllClear. The survey suggested 18% of Britons will risk not buying cover, leaving them exposed to enormous bills if something goes wrong. Two years ago, insurers paid out £262bn for medical expenses for UK travellers who needed emergency care or treatment while on holiday. James Daley, founder of the research and rating agency Fairer Finance, warns that countries such as the United States and Canada charge hundreds of thousands of pounds for treatment if you fall ill. “Travel insurance can get very expensive if you’ve got a pre-existing medical condition,” he says. “But it’s incredibly important that you take out insurance that covers you for your condition – particularly if you’re travelling to countries like the US where there’s no reciprocal health agreement with the UK. If you end up having a medical emergency in the US without insurance, the costs can run into the tens and even hundreds of thousands of pounds.”
The price of a policy depends on your age, the specific condition, where you are travelling and for how long. Price comparison websites allow you to search for policies even if you have pre-existing conditions, but it is essential to check the small print with the insurer before you pay. You should also confirm that anything you declare to the comparison site is included in the policy details once you go through to buy. If you cannot find cover via a mainstream site or traditional insurer, specialists such as Medical Travel Compared and PayingTooMuch, or AllClear, may be able to help. You can also find a broker through the British Insurance Brokers’ Association at biba.org.uk.
When applying for cover, an insurer will ask about any medical issues you have had during a certain period – typically the last five years. However, the questions can go back different lengths of time depending on the provider and condition, sometimes covering the previous two years or five years, or even longer for serious illnesses such as cancer or heart disease. If you had a condition and have recovered and received no more treatment since then, you do not need to disclose it. You may consider buying a separate policy for the person with pre-existing conditions rather than a couple’s policy, but Tommy Lloyd, managing director of Medical Travel Compared, says his company generally recommends that the entire travelling party is insured under the same policy. “This helps ensure that cancellation and curtailment cover applies consistently across the group,” he explains. “For example, if a traveller’s medical condition unexpectedly worsens before departure and the holiday has to be cancelled, a joint policy is more likely to provide protection for all insured travellers who are unable to travel as a result.” He adds that while cost is understandably important, travellers should not focus solely on the cheapest premium: “The scope of cover and how it responds when travelling companions are affected by a medical condition can be just as important as the price paid.”
Some common conditions – such as anxiety, high blood pressure, arthritis and asthma – add only a few pounds to a typical policy. However, you may face high costs if you are still under investigation for a condition or waiting for treatment. Disclosing any medical conditions is essential, as failure to do so could invalidate your policy. A price check for a 57-year-old traveller on a seven-night trip to Spain, using the Medical Travel Compared website, illustrates the variation. With no condition declared, the premium was £12.43. Declaring diagnosed anxiety disorder did not increase the price. Declaring asthma taking up to two medicines added a small amount to £14.65. A diagnosis of angina with one previous heart attack, no new symptoms and currently fit pushed the premium to £18.76. A history of breast cancer with last treatment three to five years ago and given the all-clear came to £13.94. Being diagnosed with angina and having had a heart attack had the biggest impact of those checked, adding about 50% to the price.
It may not always be possible to find cover easily, depending on your condition and how recent your diagnosis is. In 2021, the Financial Conduct Authority introduced rules for insurers to help customers with pre-existing conditions: if an insurer is unable to provide cover or if the premium is more than £200, it must signpost you to a specialist company that can offer insurance. An Association of British Insurers spokesperson says that when people are looking for travel insurance, “we recommend shopping around for a policy that meets your needs, and comparing factors such as trip length, destination and policy excess”. The spokesperson adds: “Improving access to insurance is a key priority for our industry, and we continue to engage with members and stakeholders on this issue.”
Case study: ‘It’s just ridiculous’
The experience of Ian Wardle highlights how steep premiums can become. Wardle, 68, a part-time parish clerk from Hatfield Peverel in Essex, was diagnosed with non-Hodgkin lymphoma in July 2020, during the height of the Covid pandemic, after discovering a golf ball-sized lump in his neck. Scans and biopsies revealed 26 cancerous lymph nodes, some “the size of an orange”. He underwent chemotherapy from September 2020 until January 2021, followed by maintenance treatment until the end of 2022. He has since been given the all-clear. Once recovered, he and his wife returned to travelling, including a trip to the Maldives for which he was able to find affordable cover. But when he tried to arrange insurance for a solo motorbike road trip to visit his brother in South Carolina in 2024, he was shocked by the quotes on comparison websites. “Some of them, even just for a week’s cover, were like £5,000 or £6,000,” he says. “I was just thinking: ‘No, I’m not paying that. It’s just ridiculous.’” He says the high premiums almost stopped him travelling: “It just put everything in perspective. I just couldn’t justify spending that sort of money for a week’s trip.” He found more affordable cover through AllClear Travel Insurance and says he was happy to call rather than buying online. “Being able to talk to someone was quite important,” he explains. “There’s always a worry that if you don’t tick the right box or miss a detail, then they won’t pay.” He now pays about £1,000 for an annual policy that covers travel to the US.