Private Health Insurance for Pre-Existing Conditions

A pre-existing medical condition is any health issue you had before your insurance policy started. It doesn’t matter if you knew about it or not. These can range from chronic conditions like diabetes or asthma to previous injuries that might affect you long-term. Mental health conditions, ongoing prescriptions, and even conditions you’ve recovered from can also be considered pre-existing by insurers.

In the eyes of insurance companies, the main concern is risk. They want to know if your past health might predict future claims. But here’s the good news: not all conditions are treated the same, and some may have little to no impact on your ability to get cover. The key is understanding how insurers view your specific condition.

It's important to be open about your medical history when applying for insurance. Hiding a condition can lead to problems, like your insurer refusing to pay out when you need it most, so when in doubt, disclose. There are options out there for everyone, and being upfront helps ensure you get the right coverage for your needs.

Having a pre-existing condition doesn't automatically stop you from getting private healthcare insurance. However, it's likely that your condition may not be covered, or there could be specific criteria you need to meet. It’s vital to scrutinise any health insurance policy you’re considering to fully understand what is and isn’t covered, along with any other limitations or conditions.

Some insurers may be open to covering certain pre-existing conditions, especially if you’ve been symptom-free for a set number of years. This varies widely between insurers, so it’s essential to communicate with potential insurers to understand the specifics of their coverage.

Generally, health insurance policies are more accommodating towards ‘curable, acute conditions’ — those that are short-term or can be completely treated. If you have a chronic condition, you might find it's not covered for ongoing treatments. However, this doesn’t leave you without any coverage at all. Health insurance can still provide valuable support for treating new, unrelated acute conditions that may arise.

Health insurers in the UK have a nuanced approach to dealing with pre-existing medical conditions. Their primary goal is to assess risk and decide how it affects your policy's terms and coverage. Here's a closer look at how insurers handle pre-existing conditions:

• Medical Underwriting: This is a key process where the insurer assesses your medical history. Based on this review, they decide which conditions to cover, exclude, or apply a waiting period to. There are generally two types:
  • Full Medical Underwriting: You provide a detailed medical history, and the insurer uses this information to tailor your policy. This could mean excluding certain conditions or modifying the policy terms.
  • Moratorium Underwriting: No detailed medical history is required upfront. Instead, any conditions you've had in the last few years (typically five) are not covered until you've been symptom and treatment-free for a period under the policy.
• Exclusions and Limitations: Many policies exclude pre-existing conditions outright or include them with certain limitations. For example, a condition might be covered if you haven’t needed treatment for it in a certain number of years.
• Waiting Periods: Some insurers may cover pre-existing conditions after a waiting period. This could range from a few months to several years, depending on the policy and condition.

In many cases, having pre-existing medical conditions can indeed mean paying more for your health cover in the UK. This is largely because insurers see these conditions as higher risks, which could lead to more frequent or costly claims. The way your condition is assessed during the underwriting process plays a significant role in this.

If you go through full medical underwriting, where you disclose your entire medical history, the insurer might decide to cover your pre-existing condition with certain limitations or at a higher premium. On the other hand, policies with moratorium underwriting don't require detailed medical history upfront, but they might still exclude recent conditions for a set period, indirectly affecting your costs.