Travel Insurance Add-Ons That Actually Matter: Pre-Existing Conditions and Sports Coverage

Most travel insurance policies are packaged plans. That’s good news—because you usually start with a strong foundation: emergency medical help for accidents and sudden illness, support for prescription medication (up to plan limits), and often travel inconveniences like delays or baggage issues (again, within limits).

But here’s what we see in real life: the biggest claim headaches rarely come from what a base plan includes. They come from what a base plan doesn’t fully cover.

Across many travel insurance policies, two gaps show up again and again:

1. Pre-existing / chronic conditions may be covered only up to a small cap.

2. Sports and “higher-risk” activities may be excluded unless you add the right upgrade.

This article breaks down these two add-ons in plain English—so you can avoid surprises and travel with coverage that matches your actual trip.

What Your Base Travel Insurance Plan Usually Covers

While benefits vary by insurer and plan, most packaged travel plans commonly include items like:

• Emergency medical assistance for accidents and sudden illness

• Prescription medication coverage (up to plan limits)

• Trip interruption/cancellation (if included in your chosen plan)

• Flight delays and travel inconvenience benefits

• Lost/delayed baggage support (up to plan limits)

If you want a quick overview of how travel insurance works in the Dominican Republic (and what typical benefits look like), see our Travel Insurance Made Simple page.

Now let’s talk about the two upgrades that often make the difference between “I thought I was covered” and “I’m glad we added that.”

Add-On #1: Pre-Existing / Chronic Condition Medical Upgrade

If you live with high blood pressure, diabetes, asthma, a heart condition, or another chronic condition, a base policy may treat care related to that condition as “pre-existing.” And even if the issue flares up unexpectedly during your trip, the base plan may apply a limited cap.

How the upgrade typically increases your coverage

This add-on is designed to increase protection for acute, unexpected episodes related to a chronic or pre-existing condition.

A common structure looks like this (example):

• The upgrade may cost about 30% of the base premium (varies by insurer/plan).

• It may cover up to 30% of your medical coverage, with an additional maximum cap (often up to USD $30,000).

✅ Example (simple math):
If your base plan has USD $50,000 in medical coverage, the upgrade may provide pre-existing/chronic coverage up to USD $15,000 (30% of $50,000), as long as it does not exceed the plan’s cap.

What “acute and unexpected” really means

In many policy wordings, this benefit is meant for sudden and unpredictable episodes, including a sudden worsening (sometimes called “decompensation”) of a known or even previously asymptomatic condition. It’s typically intended for primary emergency care that can’t reasonably be postponed until you return home.

In serious cases, the assistance center may coordinate the “most appropriate solution,” which can include treatment abroad or even medical repatriation if long-term care or non-urgent surgery is required.
(For a deeper explanation of evacuation logistics and why it matters, our Medical Evacuation & Air Ambulance guide is a helpful companion read.)

Common requirements you should know before relying on this add-on

Policies often include requirements such as:

• Stability requirement: commonly stable for more than 12 months

• Age limit: often available up to age 74

Also, if the trip is determined to be specifically for the purpose of getting treatment abroad for a chronic/pre-existing condition, coverage may be denied.

Common exclusions (always read the wording)

Exclusions vary by insurer, but examples commonly listed include items related to:

• Sexually transmitted diseases (including certain HIV/AIDS-related items in policy wording)

• Certain high-cost treatments and ongoing therapies (examples often referenced include dialysis, transplants, oncology, psychiatric treatment, medical devices, etc.)

• Substance use-related issues (drugs, misuse of non-prescribed medication, alcoholism)

Bottom line: If you have a chronic condition, this upgrade can dramatically reduce the risk of a tiny cap becoming a huge out-of-pocket expense—but only if you qualify and only for the types of events the wording defines as eligible.

Add-On #2: Sports / High-Risk Activities Upgrade

If your trip includes excursions like zip-lining, ATV rides, jet skis, scuba diving, skiing, rafting, mountain biking, or martial arts, you should assume some (or many) of those may be considered “higher risk” and excluded under a base policy unless you add the proper upgrade.

This is why our DR travel content often encourages travelers to match coverage to their itinerary—not just their destination. (Our Travel Insurance Checklist for 2025–2026 High Season also flags adventure sports as a common add-on need.)

How the sports upgrade typically works

A common structure looks like this (example):

• The upgrade may cost about 50% of the base premium (varies by insurer/plan).

• Example: a $100 base plan may become about $150 with the sports upgrade.

In general conditions, the benefit may cover medical costs from accidents during certain recreational high-risk sports—and sometimes even professional practice/competitions—up to the medical accident limit shown on your voucher, typically with an additional maximum cap (often not exceeding USD $100,000 for this benefit).

Categories matter more than the activity name

Many insurers organize sports into categories (often labeled Category 2, 3, and 4) ranging from moderate/high-risk to extreme, and they list examples across those categories. Examples commonly referenced include:

• Scuba diving (often up to specific depth limits such as 30 meters)

• Parasailing, water skiing

• Marathon/athletics

• Mountain biking, skiing/snowboarding

• Rafting (higher levels)

• Climbing/mountaineering

• Motocross/motorcycling

• Boxing/martial arts

• Bungee jumping, skydiving/paragliding

Typical age limits

Policy conditions often specify age rules, such as extreme sports coverage being available typically from minimum age 12 up to maximum age 65.

Bottom line: If activities are part of your trip (even “just one excursion”), the sports upgrade can be the difference between a covered accident and a denied claim.

Why transparency protects you (and saves you money)

The most painful travel insurance situations usually start with one of these sentences:

• “I didn’t think that counted as a pre-existing condition.”

• “I didn’t know that excursion was excluded.”

Being transparent with your broker isn’t about paperwork—it’s about ensuring that if you need help abroad, you have coverage that matches your reality and helps you avoid:

• Denied claims

• Unexpected out-of-pocket medical bills

• Stressful back-and-forth with assistance centers while traveling

And when you do need care, how you use the plan matters too. Keep our step-by-step guide on How to Request Assistance with Your Travel Insurance handy before you travel.

A quick checklist: do you need one or both add-ons?

Consider adding the Pre-Existing/Chronic Upgrade if:

• You have a chronic condition (even if well-managed)

• You’re concerned about small base-plan caps for condition-related flare-ups

• You meet stability/age requirements in the wording

Consider adding the Sports Upgrade if:

• Your itinerary includes adventure activities (ATVs, diving, zip-lines, rafting, etc.)

• You’ll participate in organized training, races, or competitions

• You want protection for accidents tied to higher-risk recreation

Why Choose Hernández Peguero Insurance Brokers?

Choosing add-ons isn’t about “buying more insurance.” It’s about buying the right insurance.

At Hernández Peguero Insurance Brokers, we help you match coverage to your real-world risks—especially the two areas most likely to cause claim issues: pre-existing conditions and sports/adventure activities. We’ll help you:

• Identify likely exclusions before you travel

• Confirm whether your health profile fits pre-existing/chronic eligibility rules

• Align your activity list with the correct sports category/upgrade

• Understand how to use your assistance line properly if something happens abroad

Ready to Get a Quote?

Protect your trip today with affordable travel insurance.

👉 Contact us now:
Phone / WhatsApp: +1 849-514-9838
Email: info@hernandezpeguero.com
Website: www.hernandezpeguero.com

We’ll guide you to the best plan for your trip so you can enjoy your stay with total peace of mind.