Travel insurance: what changes as you get older, what to declare, and where to compare

Two things happen to travel insurance as you get older. It costs more, and the form gets longer. Neither is a reason to skip it; both are reasons to do it earlier and more carefully.

This is general information, not financial or medical advice. Policies differ, and a regulated adviser or broker can look at your own situation.

What changes with age

Age UK explains the mechanism plainly: some insurers set an upper age limit, often at 65 or 70, because there is “an increased likelihood of higher claims linked to age”, and older travellers are seen as riskier to insure, which affects premiums. There is no standard cut-off, and specialist insurers exist with no upper age limit — but the mainstream quote you got in your fifties may stop appearing in your seventies.

MoneyHelper, the UK government-backed guidance service, makes the same point: over 65 or with a medical condition, you might need specialist insurance. Age UK’s tips for keeping the cost down apply anywhere: compare several quotes, consider an annual multi-trip policy if you travel more than once or twice a year, take a shorter trip, and be aware that destinations with expensive healthcare — the US above all — push premiums up.

Pre-existing conditions: declare everything you are asked

This is the rule that matters most. MoneyHelper lists what insurers typically count as a pre-existing condition: any condition you are waiting for an operation on; any condition you are awaiting test results for; any condition, even a minor one, that you have seen a doctor about in the past year; and any serious condition — cancer, heart trouble, respiratory problems — that you have ever had. Insurers generally ask about the last two years and may go further back for certain conditions.

The consequence of leaving something out is often no payout at all. MoneyHelper’s advice: if you are not sure whether to declare something, do not assume it is covered — ask the insurer, “otherwise you risk any claim you need to make being rejected.”

Declaring costs more in premium. Not declaring can cost the entire medical bill and the flight home. If you are turned down or quoted a very high price, MoneyHelper runs a travel insurance directory listing providers who specialise in cover for particular health conditions and disabilities.

What good cover looks like

MoneyHelper’s guidance on the numbers: medical cover of at least £1 million in Europe and £2 million outside Europe, and personal liability of at least £1 million. Most policies also cover lost bags, cancellation, cutting a trip short and legal costs. Buy as soon as you book, so that cancellation cover starts straight away.

For long trips, check the maximum length of any single trip on an annual policy; a month or more may exceed it. Check activity exclusions if you plan to walk in the hills or cycle, and make sure medical repatriation — being brought home — is included.

Which? compares hundreds of policies across 120 areas of cover and warns readers to “be wary of policies that are great on paper but don’t pay out”; it uses claims data from the Financial Conduct Authority and the Financial Ombudsman Service to pick its recommendations. A policy’s claims record matters more than its list of features.

UK travellers: the GHIC is not insurance

The UK Global Health Insurance Card is free, lasts up to five years, and gives you access to state healthcare that cannot reasonably wait until you get home, in EEA countries plus a handful of others including Montenegro and Australia. It covers emergency treatment and care for pre-existing conditions on the same basis as a local resident.

What it does not do is the important part. The NHS says the card “does not replace travel and medical insurance”: it does not cover being flown home, private treatment, or ski and mountain rescue. The NHS itself advises private travel and medical insurance for the whole trip. Apply or renew on the NHS website only — you can renew up to nine months before expiry — and never through a site that charges.

US travellers: Medicare does not travel

Medicare.gov’s wording is: “Medicare usually doesn’t cover health care while you’re traveling outside the U.S.” The exceptions are narrow — certain cruise-ship situations within six hours of a US port, and rare cases where a foreign hospital is closer than the nearest US one that can treat you. Some Medigap (Medicare supplement) policies may cover emergency care abroad; check yours.

The State Department repeats it for travellers over 65: Medicare and Medicaid do not cover medical costs abroad, and the US government does not pay medical costs for its citizens overseas. It recommends insurance that covers emergency medical, dental and evacuation services, and “strongly” recommends medical evacuation cover for places with limited healthcare. The CDC gives a figure for why: emergency transport from a remote area to a good hospital “could otherwise cost more than $100,000”.

Where to compare

• UK: MoneyHelper’s guides and its specialist travel insurance directory; Which? for independent policy reviews (subscription).
• US: the State Department’s travel insurance page and the CDC’s Travelers’ Health insurance page, both of which explain what to look for without endorsing providers.

If you would rather work through it as a checklist — conditions listed, trip length, activities, repatriation, policy number saved — the insurance worksheet in our Slow Travel After 50 workbook covers it. Our complete guide to travel after 50 puts insurance in the wider picture, and long stays and house-sitting covers the trip-length problem.

This week

• Write the one-sheet medical list; it makes the screening call ten minutes instead of an hour.
• Get three quotes, including one specialist, and compare the medical and repatriation limits, not just the price.
• UK: check your GHIC date. US: ask your plan, in writing, what it covers abroad.
• Save the insurer’s 24-hour emergency number in your phone and on paper.