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Pre-Existing
Conditions

Private health insurance policies, also referred to as private medical insurance, work as a supplement to the provisions available from the NHS.

While the NHS provides excellent care to the public, stress on these services can lead to long-waiting times and inconvenience to individuals in terms of when and where they may be treated.

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Private Health Insurance Pre-Existing Conditions

One of the most common questions people have when taking out

a private health insurance policy is: are pre-existing conditions included?

Insurance allows people to get diagnosed and treated more quickly and with the option to choose where they are seen, at a time and location that fits around their life.

For individuals who already have a health problem such as diabetes or a skin condition, it can be challenging to find a health insurance policy that enables them to experience the same peace of mind as others. In this guide, we’ll examine whether private health insurance providers cater for those with pre-existing conditions and how this might affect their policy as a whole.

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Does Private Healthcare Cover Pre-Existing Health Conditions?

Private health insurance plans are designed to cover medical or health complaints which develop once the policy is already in place, as opposed to medical conditions which already exist. But for those who have a pre-existing condition, there are still options for private health cover and in many cases, an insurance provider will accept the application.

However, it’s important to note that the policy may include a waiver for the condition you’re receiving treatment for or there may be exclusions in place that wouldn’t be otherwise. Some insurance for health providers cover pre-existing medical conditions if it is deemed to be a minor ailment or if there isn’t any further treatment planned for a specific amount of time, which is typically five years. However, the timescale for this can vary between providers and policies, so it's important that you check the details outlined in the terms and conditions of each contract.

Can You Get Health Insurance
With A Pre-Existing Condition In The UK?

Most providers in the UK will allow you to take out health cover but it’s likely that any pre-existing conditions you have will not be covered as part of your policy. Some may include temporary or general exclusions as part of your policy, but most will not cover pre-existing or chronic conditions – this is so that cover can remain affordable and accessible to the majority of people. If pre-existing conditions were not excluded, there would be a far higher number of claims made to health insurance providers which would make medical insurance far more expensive.

It's important to remember that health insurance is designed to deliver cover for unforeseen medical conditions, rather than helping with conditions that you already have received a diagnosis for. Medical insurance policies are not designed to cover conditions that you’re already dealing with, but some circumstances may make it possible for your pre-existing condition to be covered if the insurance provider believes that it is no longer likely that the condition will come back.

What Is Classed As
A Pre-Existing Condition?

The definition of what constitutes a pre existing condition varies depending on who the policy is with. But in most cases, the term refers to conditions which require regular treatment or where symptoms have been diagnoses in the previous five years.

Some of the conditions which fall into these categories include heart disease, high blood pressure, cancer, asthma, diabetes and stroke. Similarly, it could include conditions for which the individual has had extensive surgery in the past or a regular ailment that occurs often, such as back pain.

In most cases, an insurance policy provider will look at your medical history from the last five years, although some may look as far back as seven and others might only consider ailments from the previous three years.

What About Conditions That No Longer Require Treatment?

It is possible to find cover for pre existing medical conditions that no longer require treatment.

There are usually two options for this type of cover, which depends on how the policy is underwritten. Full medical underwriting involves the completion of a full medical history declaration, which usually includes information from your GP.

As part of this, any pre-existing conditions are identified within your history and are excluded from the cover you will receive for the duration of your policy. Moratorium underwriting does not require a full medical declaration, but you are expected to declare all of your pre existing conditions from the past five years.

Your provider will then act on the information by excluding the conditions outlined in your declaration in accordance with the terms of your policy agreement.

But, if a condition you’ve declared within your full medical information becomes symptom-free for two continuous years or you stop needing treatment for it after the policy starts, you could have cover reinstated for that condition, at the discretion of the provider.

Does Bupa Cover Pre-Existing Conditions?

Bupa is one of the most popular providers of health insurance, but typically their policies do not include pre existing medical conditions. If the individual applying has never had a health insurance policy before, then Bupa will base their decision on the past seven years of medical history. The type of insurance taken out will also affect their decision. For example, if the individual is joining Bupa with Moratorium underwriting, then they don’t need to complete the medical history declaration as part of their application, but with the understanding that there will be no immediate protection for conditions that have existed for the past five years.

If the individual is switching from another provider to a Bupa policy, there may be the opportunity for a continuation of their current underwriting terms – so, if pre existing conditions were excluded as part of their previous policy, they would continue to be excluded with the new cover.

Which Companies Offer Insurance
For Pre-Existing Conditions?

There are many health insurance firms in the UK to choose between, from Bupa and Axa to Vitality. These leading companies provide comprehensive cover and can often tailor the policies they offer to include or exclude specific health problems to tailor your cover to your needs, such as chronic conditions.

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What Pre-Existing Conditions
Will Be Covered?

Typically, a pre-existing health condition will not be covered as this will affect the cost of health cover overall. Many of these problems are defined by the fact that they are long-term or incurable, such as epilepsy or asthma. The type of treatment and medication required for these types of condition are focused on helping individuals with these health issues to live with their illness as easily and painlessly as possible.

But while the list of pre existing conditions covered is slim, many providers are willing to offer additions to their policies for levels of cover for chronic conditions – this might come at an extra cost but will provide additional peace of mind. A chronic medical condition needs ongoing treatment in order for you to manage it effectively, such as diabetes, high blood pressure, hay fever, skin conditions like eczema, psoriasis or acne, and glaucoma. Some policies may pay for a one-off cost associated with these conditions, such as a hospital stay, but won’t cover the medication or regular follow-up appointments.

There are some conditions and health issues which will never be covered by an insurance policy, which are known as general exclusions. These vary from provider to provider, but they should be checked before you take out a policy. General exclusions usually include cosmetic surgery, dental work, eye care, and sexually transmitted diseases, as well as some chronic conditions, although the specific list of exclusions will vary depending on who you choose your insurance with. Some providers may offer the option to add 'bolt-ons' to the policy to provide protection against costs for these types of exclusions, but this needs to be discussed with the provider as not all companies allow this.

The Importance Of Insurance

If you suffer from a pre-existing medical condition and need affordable private health cover, it can be difficult finding a high

quality provider of health insurances.

The good news is that the terms and policies available vary depending on the provider and the type of health insurance you’re taking out. It’s well worth researching your options in order to compare providers and find the right type of policy for your specific needs, as there are often opportunities to tailor your policy to suit your requirements.

Insurance comparisons can be a great way of assessing whether a medical condition is or is not covered with different policies, so you can narrow down your options and find the right protection for your needs.