Can I get health insurance with pre-existing conditions?

What is a pre-existing condition?

Insurers use different definitions for different things. It’s one of the reasons so hard to make like-for-like comparisons on policies. We can check with your insurer to understand what’s covered at the moment, and your GP will have a record showing what medical treatment you’ve received in the past.

But it could also be something that isn’t yet diagnosed – you’re having tests for, to try and understand what a problem might be. That includes all tests, consultations, medication, surgery, or other treatments from the NHS or private companies.

Most insurers extend that definition to look at five years of your medical history or more. This is why it’s so important to work through your medical history carefully.

If you take out a health insurance policy, but haven’t declared a pre-existing condition, then the likelihood is you won’t be able to make a claim for treatment connected to that illness or injury if something happens in the future (We also refer to these policies as ‘private medical insurance’.).

Can I get cover for those conditions?

This might sound strange. Why would you take out the health insurance if you can’t get treatment for something you’re suffering from? It’s not all bad news. The insurers we work with will look at the circumstances around pre-existing conditions. We have good relationships with their underwriters: we only recommend insurers who offer 5-star Defaqto-rated policies. If it was a minor condition, or one that’s unlikely to re-occur, they’ll tell us if they would consider covering it. We can explain this in more detail if you give us a call.

What’s more, most of these insurers will also consider extending cover to include a specific condition providing you haven’t suffered the symptoms of it in a period of five years or more.

Many people don’t realise this. If, in the past, you suffered from a condition but haven’t had any symptoms connected to it for a long period of time, then you may be able to get cover for it now.

Will my policy exclude those conditions specifically?

Health insurance is detailed. Because every person is an individual, cover is issued on an individual basis: insurers look at your medical history and other factors to understand what kind of premium they can offer you. If you’ve had a minor condition previously, or if you want to be certain what medical problems are included in a policy, we can explore full medical underwriting for you. This means you complete a detailed health questionnaire and give the insurer detailed information about your medical history. The underwriters will then weigh up the risks and offer a policy with a premium that reflects your health and lifestyle. That policy may exclude pre-existing conditions, include them after a period of time has passed, or indeed, cover them from the start of the policy.

It’s very important to be completely transparent when you’re arranging health insurance. In the event of a claim, you want to be sure your illness or injury’s treatment would be covered. Leaving the details of a medical condition out simply isn’t an option – it’s the reason why we ask you to double check the paperwork so carefully when it comes through to you from the insurer.

Talk to our expert Healthcare Consultants.

As a regulated insurance broker, our advice is impartial. We’re experienced, and very aware you might want to talk about medical conditions that are sensitive. It’s okay, we understand this.

Contact us now. You can be sure that we’ll be working on your behalf to get the best possible cover at the right premium. And we only recommend insurers who offer 5-star Defaqto-rated policies – you can be confident you’re getting impartial advice.

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*Based on the average across 465 private medical insurance policies sold between 1st August 2019 and 31st December 2019

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