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Travel insurance for CML, without screening

As a search shows that it has not previously been mentioned on this forum, I thought it would be worth posting about a type of travel insurance that has a different approach to pre-existing medical conditions (PMCs). This could be a good option for some (but not all) CML sufferers.

Most travel insurance starts with quite a wide definition of PMCs. Cancer is almost always specifically named as being a PMC, even if it has been in full remission and treatment free for years or even decades. Even if it isn't mentioned specifically, the definition usually includes anything you are taking medication for or seeing a medical professional about, so CML sufferers will be caught. No cover is given for PMCs unless they are declared and accepted under medical screening. 

This approach has a number of disadvantages for CML sufferers (and indeed non-CML sufferers).

  1. Many insurers will not cover CML at all.
  2. Most other insurers want big extra premiums, in return for covering CML. 
  3. It is very time consuming going through the medical screening. If you want to shop around to find a company that will offer cover at a reasonable premium, you have to go through screening many times and it can take many hours.
  4. Screening is intrusive.
  5. Many of us have other medical conditions, so even though there are a few specialist insurers that understand that CML is low risk and will cover it for a small premium, they might want further extra premiums for, say, mild asthma or just for having raised cholesterol (even if this is not giving rise to any symptoms or illness). It can mount up.
  6. This is made worse by the fact that once you are into the screening process, you usually have to disclose any medical condition, even ones that are not themselves within the PMC definition.
  7. If you forget to disclose any medical condition, you may not be covered if it leads to a claim that the insurer can argue is connected. You're not going to forget serious things like CML, but you can't always be sure that you have remembered to disclose every piddling little medical issue. Sometimes, you have to go back to childhood!
  8. If you are travelling as a family, you will need them to be covered, too, so 3-7 apply for each family member.
  9. The restriction on PMCs may (depending on the wording of the policy) also apply to people not named on the policy, such as family members who are not travelling. So if your mother falls seriously ill 3 days before your departure and you want to cancel so you can be with her, this will not be covered if her illness relates to a PMC. 

There are, however, a couple of insurance companies (maybe others?) who have a very different system, which eliminates most of these disadvantages. The ones I know of are Eurotunnel and ETA.

Their approach is to have no screening. If your condition is what they define to be a PMC, you are not covered for it and there's no way to change that. So, if that's you, these insurers will be no use. However, they use a much narrower definition of PMCs, which means many people (including many CML sufferers) will not be considered to have PMCs, so you are covered at their standard premium, without any screening. 

With Eurotunnel, the definition of PMC is: 

1 You will be covered for claims arising directly or indirectly from any existing medical conditions, so long as your doctor can confirm that at the time of purchasing the insurance or booking the journey (whichever is later):

  • you were fit to travel;

  • your medical condition(s) were stable and there was no sign they would get worse;

  • you had not been diagnosed as suffering from a terminal illness

  • you did not know that you would need medical treatment or consultation at any medical facility during your journey;

    If you need to make a claim arising directly or indirectly from any existing medical conditions, your doctor will be asked to confirm all of the above in writing.

2  You will not be covered if you travel against the advice of a doctor or where you would have been if you had asked for their advice before beginning your journey.

3  You will not be covered if you travel specifically for the purpose of obtaining and / or receiving any elective surgery, procedure or hospital treatment. 

No insurer is going to cover you, and you would be unlikely to want to travel, if you are unfit for travel, or you have a terminal illness, or you know you will need treatment during your trip, or your doctor has advised you not to travel. So, the only restriction that matters is that "your medical condition(s) were stable and there was no sign they would get worse". For many CML sufferers on TKIs, with BCR ABL slowly falling or steady at low levels, this test will be met. So you are covered. What matters is what your consultant says, so just ask if they consider you stable and if there are any signs you might get worse (which is not the same thing as a promise that you will not get worse).

Eurotunnel only cover in Europe. They do single trip (no age limit) or annual cover (under 70).

ETA are slightly different. They exclude:

"1. Any trip, which you begin or is booked by you contrary to medical advice, or to obtain medical treatment, or after a terminal prognosis has been made.

2. Any claims or expenses arising directly or indirectly from any of your medical conditions for which medical advice or treatment has been given by
a medical practitioner or hospital during the 12 months prior to:
a) the date of booking the trip or date of issue of this insurance, whichever the later (in respect of single trip insurance)
b) the commencement of the period of insurance or the date of booking any trip covered by this insurance, whichever the later (in respect of annual multi-trip travel insurance)

This exclusion shall not apply to any condition (f)or which you take regular continuing medication provided that there has been no change in the type, frequency or quantity of drugs within the last 12 months. However, no claims or expenses relating to such condition will be admitted hereunder in the event of your failure to take such drugs in accordance with the medical advice given."

So, for anyone on TKIs, they should be covered for CML if there's been no change to the type of TKI, the dose or frequency in the 12 months before buying the insurance (or booking the trip, if later). Unfortunately, a reduction in dosage or switch to a different TKI would mean you would not be covered. And, illogically, you would not be covered if you were taken off TKIs altogether, if you were still being monitored to check your BCR ABL stays low.

ETA does cover outside Europe. Single trip up to age 69 and annual cover to age 75.

This is really useful - thanks! Travel insurance is very difficult if you want CML covered.

My opinion is that if you are a stable CML patient, it's very unlikely that any CML-related issue will occur when on holiday. A friend of mine who has AML have discussed this at length, and we both feel that it's highly unlikely to need leukaemia treatment so quickly that you could not get yourself home. We both though that if you had access to about £6-10,000 then you could effectively "self insure" against the residual leukaemia risk from anywhere in the world insofar that you can buy business class flights on the next journey home. Much cheaper when travelling closer to home - repatriation is often the biggest expense. Of course if you are not well, you will not have travelled in the first place so while being fully insured would be good, it's all down to risk appetite.

I am lucky - my travel insurance through work covers me for CML even now, as the policy was taken out before I was diagnosed. I am currently enjoying a long trip abroad and am confident that any health issues I may stumble across will not be CML related, and even if they were and even if I was not insured I could get myself home with the help of MasterCard!

Perhaps it is more complicated when an insurer claims an illness is CML related when it's not. I could imagine a claims adjuster trying to pin a run of the mill infection on a CML compromised immune or something. 


Hi All,

I have posted on a similar thread before.

Three key issues are:

1You may be asked if you are undergoing chemotherapy.There is the debatable issue of whether a tki is a form of oral chemotherapy or is it strictly speaking targeted molecular therapy?Many insurers would not be aware of the difference and in the event of a claim if this matter had not been answered according to the insurers interpretation your claim might be excluded.

2In.the event that you make a claim the insurers will ask your consent that they be able to access your medical history via your GP-if you decline to give consent your claim will not proceed.So there are perils in hiding any aspects of any previous medical condition should this be asked for when taking out the insurance.

3.Will your insurers cover the replacement costs of your tkis if they are lost or stolen or might this be covered on the all risks policy of your house insurance?.For instance on a two week trip one might take a three week supply of drugs on the basis that if you are delayed or fall ill you will need to take some more as a reserve.Three weeks supply purchased locally might cost upwards of £1500.

4.Making a claim whilst on holiday -this is usually a nightmare.Some years ago we were on holiday in Thailand and I had muscular inflammation/ myositis as a side effect of Glivec .We had to seek local medical treatment  and then deal with a the insurers call centre based in South Africa -fortunately we had a local SIM card so calls back to UK were reasonable but you may rack up substantial costs in logging your claim whilst abroad and asking for assistance.We delayed our return and we needed to fly lying flat in business or first class.

5.Davids suggestion of doing ones own thing or some form of self insurance is worthwhile but we found that two one way business class fares  Bangkok -London with BA totalled £4000;eventually we found another airline at just over £1000 each.We were successful in our claim but fraught with stress and so  on regarding information needed by the insurers.

To go to some far flung parts of the world with no travel insurance apart from what is on your credit card would be extremely risky. In Europe in an emergency in theory your EHIC (European Health Insurance  Card) should help but would not include costs of repatriation.We used World First  as insurers who pride themselves on insuring any condition but yes at  a premium and yes there is medical screening and if over 70 the rates multiply as well.

With best wishes




Your points 1 and 2 are good examples of why Eurotunnel or ETA might be better than the screening-type policies (if you meet their definition of PMC). They will not ask if TKIs are chemo, because it is irrelevant for the purpose of the policy. Nor will they ask to see your medical history if you make a claim; they will only ask your doctor if the condition that led to your claim existed at the time of buying the insurance or booking the trip and if so, whether it was stable, etc

I guess with generics coming in, the issue about the cost of replacing TKIs will not be such a big deal in future, as a few weeks of generic is not very expensive. (Though there are probably some countries where the patent still applies or where it is very difficult to get any imatinib.) As you say, better to take some surplus pills, and keep them in different places (eg, some in hand luggage, some in the hold, some with your travelling companion), in case you lose some. As long as you have enough until you get back, you should be fine.

If you need to make lots of calls back to the UK, again not so much of an issue these days. If you have a smart phone, tablet or laptop you could make calls over the internet for less than 1p per minute. (Skype, Vonage, etc)

I rarely post, but felt I should mention Alpha Travel Insurance, who insured me for a recent hiking trip to the USA. Their medical screening is based on asking what medication I was taking which prompted quite specific targetted questions for CML. Despite also having to  call them to advise a change of medication (from Nilotinib to Ponatinib) the overall additional premium for cover was £40 for a 19 day trip.

A couple of further points on ETA:

They cover winter sports at no extra cost. With other insurers, that can be an extra £40 or so.

Children are covered at no extra cost. This seems to include up to the age of 23 if they are in full time education.

They exclude "any claims due to any condition caused by, prolonged by, or aggravated by any psychiatric, mental or nervous disorder, including stress, anxiety and/or depression." That's a bit sweeping. Many people have stress or anxiety.


I have travel insurance through my HSBC Gold Mastercard.  They have specifically in writing included cover for CML and some other significant conditions with the proviso that I must tell them if my condition changes. 

I also have insurance through my bank/credit card but with an exclusion for anything CML related, including infection.

I previously used to believe that if I was stable, nothing would go wrong quickly, however we've recently found that while normal blood counts are ok, Dasatinib is affecting Immunoglobulin and is suppressing immune responses. This was after flu ended up with me in A&E and hospitalising me for 3 days - I managed to get back from France and went straight to A&E.

What that means in practice is that if I start to get an infection, I need to deal with it immediately, since it can escalate very fast, and possibly to the point where I would not be fit to return to the UK, which would be expensive as I'd need treatment, and be uninsured for the full treatment course.

If I were away, I would be sure to take a thermometer, and a heart rate monitor. If temperature went over 99 and heart rate was up, I would seek a medical check-up and seriously consider returning home immediately and bearing the cost of the flight and cancellation myself, because if things go wrong they go wrong quickly.

One other thing I now do is that if I start to feel ill, I stop the TKI, because then if I need antibiotics, all the issues around drug interactions go away. It won't fix the immunoglobulin quickly, but it may help. I wouldn't describe this as 'advised by my consultant', but it has been helpful recently and I used an antibiotic which would have otherwise been contra-indicated. For those of us in stable responses, it's my unqualified opinion that a few days off the medication isn't a big deal.

Just my experience, in case anyone else is on Dasatinib - worth getting immunoglobulin checked before you travel!




Hi Rod,

Given the half-life of TKIs, I'm not entirely certain that stopping taking them and then shortly after taking a contraindicated medication is advisable.

Generally speaking - and this is from my doctor, not from me - is that it takes at least two weeks for a TKI to "wash out" of your system. Though you may have stopped taking them a few days ago, the TKI is still active (though reduced).

Out of interest, what antibiotic was contraindicated? 


hello all

smileyfor my child with CML I booked my insurance throught a specialist service called insure with. It is owned by a lady who suffered breast Ca a number of times. We like to travel regularly with the support of our wonderful team.

We add in her medications and the relevant questions come up. Since she has had a MMR we normally get a good price but this site does cater for people with medical issues


greetings to all from sunny Ireland

It is perhaps worth some further comment about cover for cancellation or early termination, due to illness of someone who isn't travelling (issue 9 listed in my original post).

In many policies (such as ETA), if that illness is a PMC, no claim is allowed. In that case, it is good to have a narrow definition of PMC.

Eurotunnel is excellent in this respect, because it does not exclude PMCs at all. The policy says you can claim for:


If you cancel your journey before it begins because of reasons beyond your control and which happen after the date your policy or travel tickets for your journey were bought (whichever is later).


You cut your journey short (curtail) after it has begun because of one of the following:

  • The death, serious injury or serious illness of you, someone you were going to stay with, a travelling companion, or a relative or business associate of you or a travelling companion. 

Neither of these requirements have anything to exclude illness due to a PMC.

It is worth checking the cancellation clause before you book.

Hi - (long wait!) - it was Cipro, which has been discussed before.


I stopped taking Dasatinib as soon as I realised there was an infection brewing, in order to maximise the opportunity to use contra-indicated drugs.

I've recently started a dose de-escalation from 100mg to 50Mg, as my PCR is below 0.01%, and the risk from infection due to reduced immunoglobulin activity is probably more of an issue than the CML. We'll see how it goes, back to 3 monthly checkups!




One drawback of ETA that I just discovered: They won't currently give single trip cover for trips in 2018. Apparently, their underwriter still hasn't confirmed premiums for 2018 so they probably won't be able to cover single trips in 2018 until December. That's no way to run a travel insurance business. 

Hi Rod,

I've taken ciprofloxacin a couple of times whilst on dasatinib. The haematologist I see is perfectly happy with this, I specifically checked with her and she says it's something that they routinely prescribe to dasatinib patients.

As I'm sure you know, in general you'd want to avoid ciprofloxacin (and all fluoroquinolones) unless they're really necessary.


I withdraw my previous recommendation of ETA. They have changed they whole approach. You are now expected to buy the policy, then phone to disclose PMCs and see what extra premium they want. I imagine there's a way to get screened in advance, but even if there is, ETA no longer has any distinguishing benefit.

(Perhaps their former approach led to too many big medical claims?)

Hi. I found out when trying to renew my travel insurance with Eurotunnel that they no longer give travel insurance unless you are booking travel with them. Anyone found any other good companies? I have been free of CML since August 2016 & am currently not taking medication. Thanks 

I am planning on a trip to the US shortly.  i have called Worldwide for a quote and although coming out at the cost of another plane ticket, the person i spoke to on the phone was very helpful.