If you currently have or have had health problems, you may be wondering whether they will affect your ability to get private health insurance. In this guide, we explain how pre-existing medical conditions you’re taking can affect your cover, highlighting one insurer that often covers more than others.
What is an existing health condition in relation to health insurance?
Technically, a preexisting medical condition is anything you’ve suffered from, been treated for, or sought advice about in the past, and unless you’re something of a superhuman, you probably have at least a couple.
When it comes to health insurance, you usually only need to worry about those you’ve suffered from in the past five years, thanks to the way moratorium insurance works.
Can you get health insurance with pre-existing conditions?
Yes, you can get private health insurance if you already have health problems, but anything you’re currently suffering from or have had in the last five years is likely to be excluded.
Will my insurer ever cover pre-existing conditions?
After acquiring a private health insurance policy with a take-up moratorium, if this condition is fully resolved during two continuous years; without symptoms or the need for medical advice or treatment for that condition, then that condition will automatically be covered if it reoccurs after that clear period. So if the condition goes away, it will likely be covered in the future.
Chronic conditions are excluded
A chronic health condition is one that, by its very nature, cannot be recovered from and instead requires lifelong monitoring and treatment. All health insurance policies exclude chronic medical conditions, regardless of whether they started before or after you acquired the policy. However, some will occasionally pay for treatment of acute exacerbations of a chronic condition, but not ongoing monitoring and management.
If you have outpatient insurance, your insurance company will often cover the cost of a private diagnosis, as your symptoms may be caused by something other than a chronic condition. However, as soon as it is established that it is a chronic rather than an acute medical condition, you will be referred to the NHS for further treatment.
Examples of chronic medical conditions:
- Diabetes
- Asthma
- Chronic fatigue
- Irritable bowel syndrome
Again, as with pre-existing conditions, while chronic diseases are excluded, you can still get or keep a health insurance policy, as many people do, only your chronic disease, and probably everything related to it, will be excluded from coverage.
Which private health insurance is best for pre-existing medical conditions?
Currently, the best and fairest health insurance provider for pre-existing medical conditions is The Exeter and their Health+ policy.
Whether you opt for their full medical guarantee or moratorium guarantee, you will usually find that they will cover more conditions related to pre-existing and chronic conditions than others.
Exeter will however exclude an actual pre-existing or chronic condition; it’s just that they usually do not rule out many, if any, associated conditions.
Surprisingly, The Exeter is somewhat coy about this unique selling point, and you won’t find anything about it on their website or in their policy documents. However, we have heard from a number of brokers and even The Exeter itself that this is true.
So why isn’t it on their website or in their terms?
Only The Exeter knows why this is not being pushed more publicly, as it is a huge selling point and a significant differentiator between them and the rest of the market. They are tell brokers but not include it in their terms or policy documentation. Therefore, caution is required when purchasing a policy.
Get that in writing from someone before you buy
As this USP is not part of Exeter’s terms and conditions, it is possible that they may change the wording of their new customer moratorium rule in the future. This article, written on 5 June 2024, could be out of date tomorrow, so please, if you are planning to get a policy from Exeter with the expectation that pre-existing conditions will be covered, GET IN WRITING first.
Ask your broker, or if you are going direct, Exeter itself, to write that the related conditions will not be excluded under their moratorium terms.
By doing this, you know that if this is suddenly withdrawn, you have first-hand proof that this is what they agreed to when you took out the policy.
How insurance affects what is covered by your policy
For people taking out a new health insurance policy, there are usually two choices when it comes to coverage, which, as a reminder, is the process an insurer goes through to determine what it will and won’t cover.
- Warranty moratorium – as explained earlier, this is the simplest option, and most new policies use this type of insurance. An added benefit of taking the moratorium is that if pre-existing conditions improve and do not cause permanent symptoms or require treatment for two years, they will be covered in the future. The downside is that the initial exclusion is “Any pre-existing conditions within the past five years”, along with associated conditions that are often excluded, you don’t get clarity when taking out a policy as to what exactly isn’t covered, and this may only be learned when you need to ask.
- Full medical guarantee – an alternative to moratorium insurance is Full Medical Underwriting, where you fill out a detailed medical questionnaire before getting a policy, and your insurer will inform you exactly what will and will not be covered. Again, Exeter is strong when it comes to this type of guarantee, often excluding less related conditions than others. The main disadvantage of a full medical guarantee is that once you have an exclusion on your policy for a pre-existing condition, even if you are symptom-free for a few years, it is unlikely to be removed from the policy unless you go through the insurance process again or appeal at renewal (which is not always possible).
There is no categorical “best” type of cover, as this will depend on your circumstances and medical history, but it should be high on your agenda for discussion with your health insurance broker, as the decision you make today can affect your coverage levels for many years.
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Do pre-existing conditions make health insurance more expensive?
Pre-existing health conditions usually do not affect the cost of your health insurance. The insurer effectively removes all the risks associated with the condition by excluding them, so there is no need to charge you more.
While strictly speaking your health insurance won’t cost more, since you’ll have exclusions, you’ll essentially be paying the same as someone without those exclusions, so it could be argued that you’re paying the same for less.
How to compare health insurance for pre-existing conditions
If you have pre-existing conditions, we strongly recommend that you consult with a health insurance broker (request a quote from us to speak to them for free). They will be able to help you choose the best type of insurance, compare leading providers and determine which insurer is best based on your circumstances and requirements.
Tips for finding the right health insurance with pre-existing conditions:
- What type of insurance is best for you
- Which insurer offers the most coverage based on your medical history
- What are the advantages and disadvantages of each insurer
- Which insurers are fairest when it comes to how claims affect premiums
- Which insurers have the best claims and level of customer service
Waiver: This information is general and what is best for you will depend on your personal circumstances. Talk to a financial advisor or do your own research before making a decision.
