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Health insurance and pre-existing medical conditions

Health insurance and pre-existing medical conditions

If you have a long-term medical condition or have been ill in the past, you may be under the misconception that you aren’t eligible for private medical cover. Yet many insurers are happy to offer tailored health insurance to people with existing or previous medical conditions - read on!

It’s often the unexpected onset of symptoms or having a diagnosis that can prompt us to start looking into health insurance in the first place. According to our research, nearly three quarters (73%) of people living in the UK don’t have private medical cover, largely due to the myth it’s too expensive. Added to this is the commonly-held belief that you will be uninsurable if you already have a chronic health condition or past medical issues.

The good news is that not only is affordable cover available, but there are many tailored options for you. Some existing medical conditions won’t be included, but getting cover for other health problems you may be worried about having in the future will provide essential peace of mind. 

What does health insurance cover?

Health insurance is designed to make life easier if you become ill or suffer an injury, helping you get a diagnosis faster or starting treatment that might otherwise involve a long waiting list on the NHS.

Even if you have an existing medical condition or one that you’ve experienced in the past five years, you can still take out health insurance. Usually, the condition in question will be excluded, although some policies might provide a certain level of cover but with restrictions as to what they will pay out for treatment in relation to it.

What is a pre-existing condition?

It counts as a pre-existing condition if you’ve had medical care, including consultations and medication, for any illness, injury or disease within five years prior to buying a policy. An insurance provider will have a list of what they consider to be pre-existing conditions, which could include things like joint and bone conditions, high blood pressure, cancer, high cholesterol, gastrointestinal conditions and heart disease.

Although most insurers won’t cover a health condition you’ve had within the past five years, some providers are more flexible. The effect that your previous condition has on your cover will depend on the type of condition, when you were last affected by it and what type of cover you are seeking. For example, some policies will cover you for certain conditions, such as cancer, if you haven’t had to take any medicine or required any check-ups for three years.

Even if you have suffered from a relatively minor condition in the past, it’s a good idea to complete a full medical underwriting questionnaire from your insurer. This provides full transparency and your insurer can clearly tell you what conditions you will be covered for. If you don’t disclose information that later comes to light, your policy might be invalid and any benefits cancelled.

What is a chronic condition?

A chronic condition is defined by the Association of British Insurers (ABI) as a disease, illness or injury that comes back, is likely to continue for a while or is long term. Chronic conditions include things such as MS, diabetes, Crohn’s disease, Parkinson’s, cancer and heart disease and can be harder to get cover for. It can be a complex area when it comes to insurance, and our comprehensive guide to chronic conditions is useful to read if this applies to you.

Although chronic illnesses and their associated ongoing management are generally not covered, there are some instances where you may receive payment towards some of the treatment costs, such as if a new treatment option becomes available that is aimed at curing the disease rather than managing it.

Moratorium underwriting and medical conditions

Covering an existing condition will increase the cost of your policy. To counteract this, a popular and affordable method of insurance is moratorium health insurance. This is where all pre-existing conditions from the past five years are excluded for a set period. Typically, if no symptoms emerge in the two-year period after the cover begins and you receive no treatment or medical advice for them, these conditions can then be included on your policy and will be covered from that point forwards.

Life insurance and pre-existing conditions

Life insurance provides your family or dependents with a lump sum in the event of your death. Cancer patients, people with diabetes, those with heart problems and others who are living with serious health conditions will undoubtedly be aware of the value of having life insurance. Thankfully, if you have a pre-existing condition some providers do still offer life cover options.

In some instances it is also possible to get life insurance without any exclusions. This means that, were you to die from a previously declared pre-existing condition, your policy would still provide a payout.

Often, the cost of covering pre-existing illnesses will be higher to reflect the increased risk, therefore you won’t be able to receive the cheapest life insurance premiums. However, you may feel that it’s a price worth paying to take some of the worry away from your loved ones. It’s never an easy conversation to have, but our guide to talking to your family about death can help you get started.

Critical illness and pre-existing conditions

Like private medical cover and life insurance, critical illness cover - which provides a tax-free lump sum on diagnosis of a listed condition -  can be more difficult to take out if you have a pre-existing illness but, again, options are available. Each insurer defines ‘pre-existing conditions’ differently and assesses each application individually. We work with a number of leading critical illness insurance providers to find the right policy depending on your circumstances.

As with any type of insurance, it’s important to take time to compare quotes, read policy documents and note any exclusions. You can also get helpful advice and support from our impartial experts on specialist health insurance for pre-existing conditions by calling ActiveQuote free on 0800 862 0373.