Updated: December 14, 2022
Private Health Insurance with Pre-Existing Conditions
Looking for private health cover and have a medical condition? We'll look at which pre-existing conditions insurers typically cover, and how to find a provider if you have one
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Author: Richard Angliss - Finance Expert
Updated: November 20, 2019
A private health insurance policy (also known as private medical insurance) supplements the health care provision available in the UK from the NHS but does it cover pre-existing conditions?
This article looks at how private health insurance providers cater for anyone who is applying for cover with a pre-existing medical condition and whether this may affect the overall terms of a policy.
The following topics are covered below...
Once you’ve read the details below, if you’d like to know more about which private health insurance providers will consider covering pre-existing conditions give us a call on 0808 189 0463 or make an enquiry and we’ll arrange for one of the experts we work with to get in touch.
Will a private health insurance policy cover any pre-existing conditions?
In general, a private health insurance plan is designed to provide cover for any medical or health condition which develops after the policy has been put in place rather than for one which already exists.
If you suffer from a pre-existing condition you can still apply for private health insurance and, in most cases, the insurer will accept your application. However, your policy may include a waiver (or exclusion) for the particular condition you’re currently receiving treatment for.
Some insurers will provide cover for pre-existing conditions if they take the view that it is a minor ailment or if no further treatment has been given for a particular period of time (usually five years). This timescale will vary depending upon the provider and the type of policy you’re looking for.
Why are insurance providers reluctant to cover pre-existing conditions?
In a nutshell this is all comes down to affordability. Private medical insurance providers would have to significantly increase the price of their policies if they were to accept all pre-existing conditions. The number of claims would obviously rise as the treatment for certain illnesses could be required over an indefinite period of time.
If you’d like to know more about the circumstances where private health insurance providers may consider accepting someone with pre-existing conditions make an enquiry and we will arrange for one of the expert independent advisors we work with to get in touch.
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What is classed as a pre-existing condition?
Definitions of what exactly constitutes a ‘pre-existing condition’ will naturally vary depending upon the provider. However, typically it relates to a condition currently requiring regular treatment or where symptoms have been identified over the last five years.
These conditions could include:
- Heart disease
- High blood pressure
It could also include any condition which has previously required extensive surgery or regular ailments such as back pain.
Most insurers will only look back over the last five years. Although some will look as far back as seven years, a few will only look back over the previous three years.
The level of cover you receive, or any exclusions which may apply to your private health insurance plan will depend upon the type of pre-existing condition you currently (or previously) suffer from and when you last received treatment for it.
If you’re thinking about getting private health insurance but currently suffer with one of the above pre-existing conditions give us a call on 0808 189 0463 or get in touch for a no-obligation chat to see how we can help you find the right cover at the best available price.
One of the independent advisors we work with will be able to assist you in finding a provider who caters for such conditions.
Are pre-existing chronic conditions covered?
Most private health insurance providers would not cover pre-existing chronic conditions. The main reason for this – as outlined in the section above – relates to the cost involved with the level of treatment required and the inevitable high number of claims that would need to be made against a policy.
The definition of chronic disease is either an illness, disease or injury which requires an indefinite period of treatment (or at the very least over a prolonged period of time).
Chronic diseases include:
Many of these conditions are, by definition, incurable. Therefore, the type of treatment and medication required focuses upon helping sufferers live, day to day, with their illness.
However, the good news is, there are a few providers who are willing to offer additions to their policies in order to provide certain levels of cover for chronic conditions, although this would usually come at an extra cost.
It’s also worth noting that whilst the main aim of private health insurance is to provide cover for ‘curable’ illnesses, should treatment be developed which supports finding a cure for a chronic condition, this could also be included within the terms of a policy.
If you’d like to know more about which aspects of treatment for chronic conditions may be included within a private medical insurance policy, make an enquiry and we will arrange for one of the expert advisors we work with to contact you.
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Is private health insurance available that covers pre-existing conditions if my treatment is no longer required?
Yes, this is possible.
At the point when you apply for private health insurance you have two options available to you regarding how your policy will be underwritten:
This option involves the completion of a full medical history declaration and will typically include information from your local GP.
Following this, any pre-existing conditions identified will be excluded from any cover you receive throughout the life of the policy.
With moratorium underwriting you are not required to complete a full medical declaration. However, you are expected to declare any and all pre-existing conditions for which you have received treatment over the previous five years.
As a result, a provider will act on this information by automatically excluding these conditions within the terms of the policy agreement. However, if a condition you have declared becomes free of any treatment or symptom for two continuous years after the policy start date your insurer could reinstate cover for that condition.
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If you suffer from a pre-existing medical condition finding an appropriate, and affordable, private health insurance plan can be difficult. The good news is that the terms available can vary depending upon the provider and policy you’re looking for.
The advisors we work with can help you find a policy and provider best suited for your own circumstances. All advice is free and any information is always given in the strictest confidence. Call us on 0808 189 0463 or make an enquiry to get started.
The experts we work with are all independent financial advisors with access to all the insurance providers in the UK. They will be happy to answer all your questions and use their tools, knowledge and expertise to find you the right cover at the best possible price.
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About the author
Richard Angliss has made a career in financial services which stretches over 40 years.
His early career was spent learning about the various financial products and applying them to prudent advice, working for one of the largest life assurance and investment firms. After that he joined the financial services arm of a very well-known firm providing independent advice to their 8 million customers.
For the last 20 years he has been involved in building software solutions that help Advisers and clients work together to achieve good financial outcomes and helping to set up three independent advisory firms. He also has written many articles for financial services publications and provided commentary for newspaper journalists.
At an early stage in his career he realised the great satisfaction that comes with being able to help people achieve their goals and protect their families. “Regulation of financial services has hugely impacted on ensuring people get appropriate advice. The issue these days is access to that advice and just as importantly regular reviews to make sure that everything stays on track”.
With the growing development of online resources such as Online Money Advisor he sees a great future for people to access advice to make their pension and investment work harder for them. Plus, of course, to ensure they have insurance products in place that will be required when unforeseen events happen.
He knows getting that balance right is crucial to prudent financial planning and the wellbeing of individuals and their families.