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Last updated: 23/07/2020 | Estimated Reading Time: 3 minutes

Private medical insurance - chronic conditions

Private medical insurance can be a great way to give yourself peace of mind in the event that you find yourself needing medical attention and you don't want to receive your treatment on the NHS. The main reason that people choose to sign up to a health insurance policy is the fact that, by receiving your treatment privately, you can ensure that you have a shorter waiting time and a higher quality of care when you need it.

There are many different illnesses that are covered by most health insurance plans, these can be summarised as "curable, acute conditions". This can be understood as any short term illnesses, injuries or curable diseases. This means that if you have what is known as a chronic condition, you will probably find that you are not covered for treatment that are required for it. This does not mean that you won't be covered for anything on a health insurance plan, you will still probably be able to insure yourself for treatment of any other unrelated, acute conditions that you may develop.

This guide will explain exactly what type of conditions are typically classified as "chronic" and are therefore not covered by most insurance plans. This guide will also explain reasons why you may still be able to claim for some treatments associated with these chronic conditions.

In This Guide:

What are chronic conditions?

As a general rule the majority of health insurance policies do not cover either chronic conditions or conditions that you had prior to the start of the policies term. The main reason that is given for this trend is the fact that doing this allows insurers to keep their policies' prices down and make sure that people can afford to insure themselves against any acute conditions. If insurers had to cover people for chronic conditions as well as acute ones, they would have to charge a great deal more because there would be more claims and therefore a higher rate of payout by the company.

Chronic conditions can be defined as illnesses, diseases or injuries that need to be treated indefinitely or at for the very long-term. The treatments for these conditions are usually aimed at helping the afflicted individual learn how to live with the illness, as opposed to curing it. This type of treatment normally takes the form of a long rehabilitation programme that has no specified end. Many of these conditions are incurable with current medical technology or are very likely to recur once they have happened once. There are normally a series of repeated consultations and check-ups that have to be done for the disease to be monitored.

One thing that should be noted is the fact that most health insurance plans do now include Cancer Cover and do not exclude it from their policy even though it can, in many ways, fall into the category of a chronic condition.

What aspects of chronic conditions are covered?

Even though treatments for chronic conditions are not covered in full by most health insurance companies, there are still aspects of chronic conditions that may be covered by your insurer. Treatments for chronic conditions that are normally included by insurance companies include any attempts to cure the condition or attempts to diagnose it in the first place. Once these attempts have been exhausted, treatment normally passes onto a "maintenance" phase that is designed to manage and control the disease, if not cure it.

Another time in which you may receive covered treatment for chronic conditions is if a new treatment option becomes available. Again, the reason for this is because this new treatment option will be aimed at curing the disease instead of merely managing the condition. To find out exactly what your insurance policy covers you should contact your insurer directly or read the fine print in your policy. It is recommended that you read the terms and conditions of any policy carefully before you sign up to it, so that you know exactly what you are paying for and won't get caught out somewhere down the line.