If you have a pre-existing medical condition such as diabetes or high blood pressure, you might assume that you can’t get private health insurance.
However, while most private health insurance policies are likely to exclude any health conditions you’ve previously received or are currently receiving treatment for, you should still be able to take out a policy.
Here we explain what private health insurers consider to be pre-existing conditions, what sort of cover you might be eligible to apply for, and where to find it.
Contents
- What is a pre-existing condition?
- How far back do insurers look for pre-existing conditions?
- Why are pre-existing conditions not covered by private health insurance?
- What private health insurance can I get with a pre-existing condition?
- Where can I find private health insurance with a pre-existing condition?
What is a pre-existing condition?
When it comes to private health insurance, a pre-existing condition is any health condition that you’ve already been diagnosed with or received treatment for. Some insurers will also include illnesses that you had symptoms of before the start of your policy as pre-existing conditions, even if you weren’t actually diagnosed before you took out cover.
Pre-existing conditions are not normally covered by private health insurance, but having one doesn’t mean you can’t take out a policy. Instead it means that treatment for these conditions will be excluded from your insurance.
Typically the most common pre-existing conditions include:
- Diabetes
- High blood pressure
- Heart disease
- Asthma
- Osteoarthritis
- Strokes
- Cancer
- Back pain that you needed surgery for
Other conditions such as chronic issues that need regular checkups or tests, or that flare up sporadically are also normally considered to be pre-existing conditions.
It’s also worth noting that some insurers also take into consideration whether a close family member has one of the above conditions. So if your parents have been treated for any of the above, an insurer might also apply exclusions to you as a result.
Each insurer will have its own list of the pre-existing conditions they won’t cover, so it is important to check this to understand what is and isn’t covered by each policy.
How far back do insurers look for pre-existing conditions?
Insurers will usually look at your medical history over the past three to seven years when considering pre-existing conditions. So if you’d been treated for a condition several years ago, but haven’t had any symptoms of or treatment for since, it might not be excluded from your policy.
For example, if you’d been treated for high blood pressure a decade ago, but have had it under control since then, it may be covered by your policy. However, if your treatment was more recent, it’s likely to be excluded.
Why are pre-existing conditions not covered by private health insurance?
In general, private health insurance is designed to help cover the cost of private medical treatment for health issues that are curable, and not for prolonged illnesses or conditions.
One of the main reasons for this is that it would be prohibitively expensive for insurance companies to pay for extended private medical care. This means that usually, the most common long-term illnesses, such as those listed above, will not be covered by a private health insurance policy.
What private health insurance can I get with a pre-existing condition?
If you have a pre-existing health condition, then as mentioned, you should still be able to take out health insurance, but usually with your condition excluded.
One key thing you’ll want to consider when searching for the right policy for you is what type of private health insurance underwriting you want. Underwriting essentially outlines how your insurer works out your coverage and for private health insurance, there are two main options:
Full medical cover underwriting
As the name suggests, full medical cover underwriting is the more extensive underwriting option of the two, where you’ll provide your complete medical history to your insurer when you apply for cover.
This option often takes longer to get set up as your insurer will be looking for in-depth information about your medical history, including details of any pre-existing conditions. You’ll often be asked to provide your GP’s details too so they can contact them for any further information they might need.
That being said, once your policy starts, making a claim can be quicker as your insurer should already have all the details they require. It can also work out cheaper in the long run as your insurer will have been able to build a clear picture of exactly what they will and won’t include, and there’s less chance you’ll be paying for cover that’s not appropriate for you.
Moratorium underwriting
This is a less in-depth underwriting option, and is easier to set up than full medical cover underwriting, although you may end up with less comprehensive cover.
When you apply for moratorium underwriting, you’ll answer a few yes or no questions before taking out the policy, but you won’t need to outline your pre-existing conditions at this point. Instead, when you make a claim, your insurer will ask you to provide your medical history and your pre-existing condition at this point. Your insurer will then decide whether you’re covered for that particular claim.
So while this option might be quicker to set up in the first place, it can take longer during the claims process, and it’s possible that you may not actually be covered for the treatment you need.
Where can I find private health insurance with a pre-existing condition?
When looking for private health insurance with a pre-existing condition, there are a number of providers to choose from, so it’s really important to shop around to find the policy that’s right for you.
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