A British Guide to Travel Insurance: Balancing Cost and Pre-Existing Conditions

This guide explains the rules and your rights. It is not medical or financial advice and does not recommend any insurer. If you are unsure whether a condition needs declaring, ask the insurer directly and keep a record of the answer.

Why medical conditions change your premium

Travel insurance mostly pays for emergency medical treatment abroad and for cancelling or cutting short a trip. A pre-existing condition increases the chance of both, so insurers ask about your health and price the policy accordingly. For a minor, well-controlled condition, the extra cost may be small. For serious or recent conditions, standard insurers may load the price, exclude the condition or refuse cover.

Your legal duty: take reasonable care

Under the Consumer Insurance (Disclosure and Representations) Act 2012, you have a duty to take reasonable care not to misrepresent anything when you answer an insurer's questions. You do not have to volunteer information the insurer has not asked for, but you must answer its questions honestly and carefully.

If you make a mistake, what happens depends on why:

The Financial Ombudsman Service applies this approach in practice. In one published decision (DRN-5860808), for example, it considered whether a consumer's failure to disclose was careless and what proportionate settlement followed.

Practical tip: answer every question about medication, tests, referrals and conditions under investigation, not just diagnosed conditions. Questions often cover the last two or five years. If your health changes after you buy the policy, tell the insurer before you travel.

The FCA signposting rule

If you have a serious condition, finding cover can be hard. The FCA's signposting rules require insurers and brokers to point you towards specialist help in certain situations. From 1 January 2026, the rule applies when a firm:

• declines to cover you because of a medical condition;
• excludes a medical condition from cover; or
• adds a premium of £200 or more because of a medical condition (up from £100).

In these cases, the firm must refer you to the MoneyHelper travel insurance directory, which lists firms that specialise in covering serious medical conditions. The FCA has reviewed how firms follow these rules in its signposting review.

You can also find a specialist broker through the British Insurance Brokers' Association on 0370 950 1790. A broker can search insurers on your behalf.

What the GHIC covers, and what it does not

The UK Global Health Insurance Card (GHIC) is free from the official NHS site. Beware of websites that charge to apply.

• Covers: medically necessary state healthcare in EU countries and some others, at the same cost as for local residents. This includes treatment for pre-existing conditions and routine maternity care.
• Does not cover: private treatment, mountain rescue, being flown home (repatriation), or costs such as extra accommodation and travel.
• Not free everywhere: you pay whatever locals pay, which in some countries includes a share of the cost.

The NHS says the GHIC is 'not a replacement for travel insurance'. Some insurers reduce or waive the excess if you use a GHIC for treatment, so carry it.

How much cover do you need?

GOV.UK's foreign travel insurance guidance advises buying insurance as soon as you book, so cancellation cover starts immediately, and checking exclusions carefully. Which? has suggested benchmarks for minimum cover:

Medical treatment in the USA, Canada and parts of the Caribbean is particularly expensive, so worldwide policies that include these regions cost more.

Keep the cost down without losing essential cover

• Compare single-trip and annual policies. An annual multi-trip policy can be cheaper if you travel two or more times a year, but check the maximum trip length.
• Choose the right region. Excluding the USA, Canada and the Caribbean often lowers the price substantially, if you will not visit them.
• Adjust the excess carefully. A higher excess lowers the premium but increases what you pay on each claim.
• Check packaged cover. Some bank accounts include travel insurance, but they often have strict medical conditions and age limits. Declare your conditions to the account insurer as you would for any other policy.
• Do not cut medical cover to save money. Emergency treatment and repatriation are the costs that can run to tens of thousands of pounds.
• Use a specialist if mainstream comparison sites only offer heavy loadings or exclusions.

Exclusions that catch people out

GOV.UK warns that most policies exclude claims linked to risky activities and to excessive alcohol or drug use. Other common exclusions include:

• travelling against medical advice, or to get treatment abroad;
• travelling to a country against FCDO advice;
• undeclared conditions, or changes in health not reported before travel;
• activities not listed in the policy, such as some water sports, skiing or scooter hire.

If your claim is refused

• Ask the insurer for its reasons in writing and for a copy of the policy wording it relied on.
• Make a formal complaint. The insurer has eight weeks to send a final response.
• If you are unhappy with the response, or eight weeks have passed, you can complain to the Financial Ombudsman Service for free. You normally have six months from the insurer's final response to do this.

Checklist before you buy

• List every condition, medication and pending test or referral.
• Answer each medical question carefully and keep a copy of your answers.
• If you are declined, excluded or loaded by £200 or more, use the directory you are given.
• Apply for or renew your GHIC on the NHS website.
• Buy the policy on the day you book the trip.
• Read the exclusions for your destination and activities.

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