Pre-existing conditions travel insurance has a cost problem that millions of British holidaymakers are solving by simply not buying any. That is a gamble with consequences that can run into hundreds of thousands of pounds, and the evidence suggests far too many people are still taking it.
Bernie Lawrence, a 77-year-old retiree from Fleet, Hampshire, knows the other side of that equation. After quadruple bypass surgery in 2018, the annual European cover he and his wife Barbara, 79, once bought for under £100 became something else entirely. A subsequent episode of atrial fibrillation and a place on an NHS waiting list for an echocardiogram pushed one quote to £1,200. Unable to wait months for NHS confirmation, Lawrence paid privately for the scan. Once he had the all-clear, the quote dropped to £584. He paid £805 in 2024 and £1,009 this year, ahead of a Mediterranean cruise.
‘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,”‘ he says.
What Pre-Existing Conditions Travel Insurance Actually Costs
The numbers from a real price check make the picture concrete. Using the Medical Travel Compared website, a 57-year-old taking a seven-night trip to Spain was quoted £12.43 with no declared condition. Diagnosed asthma pushed that to £14.65. Angina combined with one previous heart attack, no new symptoms, currently fit, came in at £18.76, an increase of roughly 50% on the baseline. Breast cancer with the all-clear given three to five years prior cost £13.94. Declared anxiety disorder changed nothing: still £12.43.
The pattern holds in the wider market, though the extremes are sharper. Ian Wardle, 68, a part-time parish clerk from Hatfield Peverel in Essex, was quoted between £5,000 and £6,000 for a week’s cover to visit his brother in South Carolina after being diagnosed with non-Hodgkin lymphoma in 2020. He eventually found affordable cover through AllClear Travel Insurance by calling rather than buying online. He now pays about £1,000 for an annual policy that covers US travel.
‘Being able to talk to someone was quite important,’ Wardle says. ‘There’s always a worry that if you don’t tick the right box or miss a detail, then they won’t pay.’
The Risk of Going Without, or Telling Half the Story
Research published by AllClear found that 17% of UK travellers with pre-existing conditions said they would not buy travel insurance at all for their 2026 holidays. The snippet from which this piece draws rounds that figure to 18% of Britons; AllClear’s own published page states 17%. Either way, a substantial minority are travelling uninsured.
The exposure if something goes wrong is real. Insurers paid out £262 billion for medical expenses for UK travellers who needed emergency care abroad two years ago, according to the snippet’s figures. In the US and Canada, treatment costs without insurance can run to hundreds of thousands of pounds. As James Daley, founder of Fairer Finance, puts it: ‘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.’
Going without is one risk. Incomplete disclosure is another. A May 2024 AllClear study published via PA Media found that one in four people with pre-existing medical conditions said they would not declare all of their conditions when buying travel insurance. That is not a saving; it is policy invalidation waiting to happen.
A particular difficulty arises for travellers on NHS waiting lists or awaiting a diagnosis. Industry commentary in ITIJ notes that the general travel insurance market typically treats such risk as unquantifiable, which is why Lawrence’s quote dropped sharply once he had his echocardiogram result in hand. Certainty, even bad news, is priced. Uncertainty is not.
What the Regulator Has (and Has Not) Fixed
The Financial Conduct Authority (FCA) introduced signposting rules in 2021 under Policy Statement PS20/3, requiring insurers to direct customers with pre-existing conditions to a directory of specialist providers if they cannot offer cover, or if the premium exceeds £200. The intent was to stop people simply giving up.
The FCA’s own April 2024 post-implementation review found that policy sales to travellers with pre-existing conditions had increased, but concluded that access to affordable cover had still not improved sufficiently. The rules nudge people in the right direction; they do not guarantee a price anyone can afford.
Tommy Lloyd, managing director of Medical Travel Compared, argues for insuring the whole travelling party under one policy wherever possible. ‘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 says. His broader point is worth heeding: ‘Travellers should be careful not to 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.’
If a mainstream comparison site returns nothing usable, specialist brokers and the British Insurance Brokers’ Association (at biba.org.uk) are the next port of call. The £1,009 Lawrence paid this year is uncomfortable. The bill without cover, in the wrong country, at the wrong moment, would be something else entirely.
