Can you get health insurance with pre-existing conditions?

Can you get health insurance for pre-existing conditions? 

Insurance exists to take the sting out of an unfortunate event. In the case of a health insurance policy this means covering conditions that arise after you take out the cover. 

That said, insurers provide cover even if you have a pre-existing condition, it’s just that this health issue will probably be excluded.

What is a pre-existing medical condition? 

A pre-existing condition is one that you’ve been diagnosed with, or had symptoms or tests for in the past. It includes both acute – such as broken bones or pneumonia – and chronic conditions. Examples of chronic conditions, which are on-going and can be controlled but not cured, include:

• Asthma

• Arthritis

• Cancer

• Hypertension

• Strokes

Many policies won’t cover you for chronic conditions you’ve had. But, cover for acute conditions is easier to come by, as the British Medical Association makes clear: “providing that you are treatment free in that 2-year period, you then become eligible for cover.” 

Can I get private health insurance with a pre-existing condition? 

Companies shy away from providing health insurance for pre-existing medical conditions, because they’re more likely to lead to claims. For people with a pre-existing condition can make finding the right cover harder, but not impossible. 

The key thing when looking for protection is to be as clear about what you need and honest about your current health and medical history.

When looking at policies, bear in mind there are two main types, which differ in how your medical status is established, and what you’ll be covered for:

• Moratorium: where you’d give the insurer permission to speak to their GP about their medical record

• Fully underwritten: where you’d speak to a doctor, who has full access to your medical records

How do insurers deal with pre-existing health conditions? 

When it comes to health insurance pre-existing conditions providers take into account anything that anything that might increase the chance of a claim. In practical terms this means pre-existing conditions are often, although not always excluded. 

For example, if you’re a 40-year-old who had leukaemia as a child, this condition mightn’t be excluded (although, you’d still need to declare it). Of course, it would be if you only got the all clear a year back, as the risk of it returning is relatively high. 

The main types of medical insurance

There are two main types of medical insurance:

Full medical underwriting

• This policy requires you to agree to release your full medical records, and to attend a consultation with an insurer-appointed doctor. Armed with information gathered from your records and your consultation the insurer will decide whether to insure you, to what extent and for what cost.

Moratorium underwriting

• These policies are more straightforward. You apply on the understanding that any subsequent claim will be considered only after your medical background has been checked. Pre-existing conditions are usually excluded unless you’ve been all clear for five years up to the point of applying for cover, and for two years from taking out the policy. 

These two policies exist because, as Bupa puts it: “Pre-existing conditions, and ailments related to it, are often excluded from your policy because health insurance is designed to treat new conditions that occur after your cover has started.”

The key word here is ‘often’. Whether a particular pre-existing condition would be covered will depend in part on whether you have a fully underwritten or a moratorium policy. 

How to choose health insurance for pre-existing conditions 

Moratorium and fully underwritten policies differ in what you can expect from health cover. If you have a pre-existing condition, consider the following.

Fully underwritten policies:

• If it’s important to know what pre-existing conditions are and aren’t covered opt for an underwritten policy

• Claims on underwritten policies are quicker to process, as the insurer already knows your medical history. This means quicker access to treatment

• You may be able to cover conditions that have arisen in recent years, at the insurer’s discretion

Moratorium policies:

• A moratorium policy might be more suitable if you’ve been symptom- or diagnosis-free for five years prior to applying for cover as there will be no automatic exclusions 

• You’d need to go two years without any need to lodge a claim from taking out the moratorium policy

• Moratorium policies tend to be cheaper, as the application and assessment process is quicker, and there’s no need for a doctor’s appointment and medical report

The verdict: 

Consider underwritten policies if you’ve only had a minor health condition within the past five years, as it might be covered. 

If you’ve experienced no health issues in the past five years, a moratorium policy could prove better, although you’d need to be claim-free for a further two years.

Here is how to choose a health insurance policy

Contact a health insurance broker