if my health insurance covers us completely including flights and I don't care about luggage loss and not worried about the flight cost and my trip is privately conducted when we get there don't I only need trip cancellation if we get sick or a parent/child dies.
None of our 27 providers offer a cancellation only plan. You would only be bale to get cancellation as part of a comprehensive plan, and you cannot remove the other coverages you feel you would not use. Your concern with cancelling due to an illness would be a covered cancellation reason on any comprehensive plan.
Regarding coverage for pre-existing medical conditions: Does the ACA mean that Travel Medical Coverage automatically applies to pre-existing medical conditions (i.e., heart desease)?
Pre-Existing conditions are different with travel insurance versus health insurance. Travel insurance does not follow the same guidelines as the ACA. Each plan has a Pre-Existing Condition Period, The Pre-Existing condition period is the number of days that the insurance company will "look back" from the date the insurance was purchased, to see if your claim is related to a Pre-Existing Medical Condition. If the reason you are canceling, interrupting or seeking medical coverage is related to pre-existing conditions there will be no coverage. A Pre-Existing Condition is any treatment, diagnostic tests or exams, any recommendations for diagnostic test or exams, or any adjustments in medication up or down within the pre-existing condition period stated (depending on the company, 60 days to 3 years prior to the effective date). Most policies will offer a waiver of pre-existing conditions if you meet the following conditions: You purchase the policy within 10 to 21 days of making your first trip payment; insure ALL prepaid non-refundable expenses prior to your departure date; and be medically fit to travel the day you purchase the policy.