Medical Questionnaire Help

What do you consider a heart condition?

A heart condition is ANY condition involving your heart. If you are unsure if you have ever had a heart condition, please consult your doctor. Heart conditions include, but are not limited to the following:

Angina (or chest pain coming from your heart)
Myocardial infarction (heart attack)
Atrial fibrillation
Heart failure (water on the lungs or swelling of the ankles)
Heart valve problems
Irregular heart beat for which your doctor has prescribed medication, or for which you have had surgery, treatment or a pacemaker
Rapid or slow heart rates for which your doctor has prescribed medication, or for which you have had surgery or a pacemaker
Heart murmur (however, if you had a murmur as a child and no longer have the murmur as an adult, this does not count)
If you have a pacemaker, then you have a heart condition
Pericarditis

What is a lung/breathing condition?

A lung/breathing condition can have several names. If you are unsure, please speak with your doctor. Lung/breathing conditions include, but are not limited to the following conditions:

Asthma
Bronchitis (including chronic bronchitis)
Pneumonia
Chronic obstructive pulmonary disease (COPD)
Emphysema
Asbestosis
Fibrosis of the lungs
Respiratory failure
Lung cancer
Pulmonary Emboli

I was treated for bowel cancer 5 years ago. I saw my doctor for a checkup and I was told I was cancer free, does my check up count?

You can answer “No” to Question 2 as it pertains to cancer. Follow up visits do not count if there were no findings of cancer or treatment provided.

I had surgery, radiation and chemotherapy for breast cancer 7 years ago. My doctor has prescribed medication such as Tamoxifen to prevent recurrence. How do I answer Question 2?

Your answer to Question 2 is “No.”

I have a history of prostate cancer. I completed radiation 3 years ago and I am currently taking hormone therapy medication to help prevent recurrence. How do I answer Question 2?

Your answer to Question 2 is “No.”

Question # 3 on the Medical Questionnaire, refers to “ongoing basis.” What does this mean?

Ongoing basis means medication prescribed on a regular basis for the treatment or prevention of lung symptoms.

These medications can include puffers, inhaled medications or oral medications.

Example: Your doctor has advised you to take your puffers daily for an indefinite period of time, this would be considered “ongoing basis.”

I had a stroke two years ago. My doctor has prescribed Plavix (or Clopidogrel). How do I answer Question 5?

Your answer to Question 5 is ‘Yes.”

I had a stroke or TIA 3 years ago. My doctor has advised me to take ASA. How do I answer Question 5?

Your answer to Question 5 is ‘Yes.”

My doctor prescribed medicine to treat diabetes, how do I answer Question 6?

Your answer to Question 6 is “Yes.”

My doctor informed me recently that I have diabetes (or my blood sugars are a bit on the high side). He has referred me to a dietician because of my blood sugar levels. How do I answer Question 6?

Your answer to Question 6 is “Yes.”

I developed gestational diabetes when I was pregnant many years ago, how do I answer Question 6?

You may answer “No” to Question 6 if you no longer require treatment for diabetes and are not monitoring your blood sugar. You may also answer “No” to Question 6 if you have had Diabetes Insipidus.

What does change in medication mean?

A complete list of our definitions will be included in your Travel Policy. Following is the definition of stable which includes reference to change in medication:

Stable - A medical condition is considered stable when all of the following statements are true:

there has not been any new treatment prescribed or recommended, or change(s) to existing treatment (including a stoppage in treatment), and
there has not been any change to any existing prescribed drug (including an increase, decrease, or stoppage to prescribed dosage), or any recommendation or starting of a new prescription drug, and
the medical condition has not become worse, and
there has not been any new, more frequent or more severe symptoms, and
there has been no hospitalization or referral to a specialist, and
there have not been any tests, investigation or treatment recommended, but not yet complete, nor any outstanding test results, and
there is no planned or pending treatment.

All of the above conditions must be met for a medical condition to be considered stable.

Exceptions relating to change in medication:

an adjustment in the dosage of insulin or Coumadin (Warfarin), if you are currently taking these drugs;
a change from a brand name drug to an equivalent generic drug of the same dosage.