Health Insurance and Pre-existing conditions

Everything you need to know about health insurance if you have pre-existing conditions

Health insurance is meant to cover private healthcare treatment for new illnesses, injuries and conditions, rather than treat anything you already have. These are called pre-existing conditions and, because of the way health insurance is designed to work, they’re not always covered by a new insurance policy.

Whatever your situation, it is very important to be clear about pre-existing conditions so that your insurance remains valid at all times. It is also worth remembering that, in some circumstances, it is possible to find health insurance that covers pre-existing medical conditions.

What is a pre-existing condition?

A pre-existing condition is a medical condition, illness, or injury you’ve had or experienced symptoms of (even if undiagnosed) within the 5 years prior to taking out private health insurance.

What kind of pre-existing conditions do I need to declare?

If you’re unsure whether a condition should be declared, it’s always better to disclose it. Full transparency ensures that your insurer can provide the appropriate level of cover and prevent any issues with your policy later on. 

You must declare any pre-existing conditions, including but not limited to the following:

• Respiratory conditions
• Heart conditions
• Circulatory conditions (including hypertension, stroke, transient ischaemic attack)
• Cancer or cancerous condition for which you have ever been diagnosed or received treatment
• Diagnosed psychological or psychiatric disorders (including anxiety or depression) which you have suffered from or received treatment for. 
• Any other disease, illness, or injury for which you are taking prescribed medication or where you consulted a hospital specialist or needed inpatient treatment.

Disclosing all relevant medical information, even if you’re uncertain, will ensure your policy provides the correct coverage.

Does health insurance cover pre-existing conditions?

Health insurance is designed to provide cover for unforeseen medical conditions that develop after the official start date of a policy. Broadly speaking, it is a level of cover designed to give you peace of mind when it comes to newly arising medical conditions. Health insurance policies are not generally designed to cover pre-existing conditions, therefore, or secondary conditions that are related to them.

There are, however, some circumstances where it is possible that health insurance for pre-existing conditions can be made available. This is usually if the insurer believes it is no longer likely that the condition will return.

I have a pre-existing condition. What are my options?

When you apply for health insurance, you can choose how any pre-existing medical conditions you think you might have are assessed by insurers. There are two common types of health insurance underwriting - full medical underwriting and moratorium. Private health insurers will usually offer one or the other as a basis on which cover may or may not be provided. It is possible to secure health insurance for pre-existing conditions through either route, but in different ways as outlined below.

Full Medical Underwriting

When you choose Full Medical Underwriting, you’ll be asked to complete a Medical History Declaration. This involves answering detailed questions about your health and medical history, including any pre-existing conditions. In some cases, your insurer may contact your doctor for additional information to gain a full understanding of your health background.

Once your insurer has reviewed your medical details, they will determine what will and won’t be covered by your policy. Pre-existing conditions, along with any conditions related to them, are typically excluded. However, having a clear understanding of exclusions from the start can provide certainty about your coverage. Additionally, there may be an opportunity in the future to have certain exclusions reviewed by your insurer, which could lead to coverage for a pre-existing condition depending on the circumstances.

Moratorium

Moratorium underwriting is another common option for private health insurance. Unlike Full Medical Underwriting, you won’t need to provide a detailed Medical History Declaration, which can simplify the initial application process.

Under this method, the insurer automatically excludes any pre-existing conditions for which you have received treatment, advice, or experienced symptoms within the five years prior to the policy start date. However, if you go without treatment, symptoms, medication, or advice for two consecutive years after your policy begins, your insurer may consider reinstating cover for those conditions.

It’s important not to delay or avoid treatment for any condition in the hopes of securing future cover. As with Full Medical Underwriting, any new conditions that arise after your policy begins will typically be covered, and pre-existing conditions may be reconsidered after the initial waiting period.

What are General Medical Exclusions in health insurance?

There are also certain conditions which will never be covered by an insurance policy. Each insurer will have its own set of "General Medical Exclusions" defined by them, so the onus is on you as the customer to check these before you apply.

General Medical Exclusions may include, but are not limited to, chronic conditions, cosmetic surgery, sexually transmitted diseases, normal pregnancy and maternity requirements, and GP and accident and emergency services.

Our Partners

I’m not sure what health insurance option to choose. What should I do?

If you’re still not sure which option to pick when seeking out private medical insurance with pre-existing conditions in mind, then talking it over with one of our experts at ActiveQuote could help.

They will listen to your concerns and take a basic medical history from you before using their experience and expertise to recommend which form of medical underwriting is most suitable for you.

How do I buy health insurance with pre-existing conditions?

The best way to make sure you are getting the right policy for your individual needs is to compare health insurance quotes from a number of providers. As the leading health insurance comparison website in the UK, ActiveQuote partners with MoneySuperMarket, GoCompare, and more to bring our customers the best cover at the right price.

When you compare private health insurance quotes with ActiveQuote, you will be asked a few simple questions including your name and address, your date of birth, whether you smoke, your monthly health insurance budget and any pre-existing conditions you might have.

Different policies offer different benefits, especially where pre-existing medical conditions are concerned. ActiveQuote can help you make sure that the level of cover you take out suits your needs.

Why compare health insurance that covers pre-existing conditions with ActiveQuote.com?

Buying private health insurance knowing you have pre-existing conditions in place can be daunting and we know how important it is for you to feel confident that you have the cover that’s right for you and your family in place regardless. The majority of our policies are straightforward and can be bought online. We pride ourselves on our excellent customer care, with a highly trained team ready to take your call and answer any queries you have and we’re more than happy to talk you through health insurance policies.

If you still have questions about private medical insurance, you can also compare health insurance policies online now, or call one of our advisors for free on 0800 862 0373.

Do you already have health insurance?

Sometimes you’ll already have health insurance through your place of work but it’s worth making sure that you have the level of cover you need. It’s also worth reviewing your policy each year to make sure it still meets your needs, and budget. .

Health insurance pre-existing condition FAQs

How far back do pre-existing conditions go?

The way pre-existing conditions are considered depends on the type of underwriting you choose. 

• For Moratorium Underwriting, insurers will automatically exclude any condition you’ve experienced, sought advice for, received treatment or medication for, or had symptoms of in the 5 years prior to your policy starting. While you are not required to provide a detailed medical history upfront, it’s important to be aware that insurers may still consult your medical records, so it’s always best to be transparent about your health. 
• For Full Medical Underwriting, you will need to disclose all relevant medical history, including any diseases, illnesses, or injuries you’ve had, no matter how far back they go. This means completing a detailed Medical History Declaration, where you may be asked about your entire health history, not just the past 5 years. The insurer may also contact your doctor to verify the information. 

By fully disclosing any relevant conditions, you can ensure that your policy reflects your needs accurately and avoid any complications later. 

Does a condition need to be diagnosed to be pre-existing?

No, a pre-existing condition includes symptoms, tests and advice, even if you haven’t had a diagnosis.

How do insurers know about pre-existing medical conditions?

Insurers learn about pre-existing medical conditions primarily through the application process. During underwriting (the process of evaluating the risks involved when insuring people), you’ll either complete a detailed medical history questionnaire, if opting for Full Medical Underwriting, or be assessed under Moratorium underwriting, where any conditions you’ve had in the last five years are automatically excluded from being covered on your policy.

Do you have to declare a pre-existing condition?

Yes, you should declare all pre-existing conditions before taking out health insurance. Sometimes during the underwriting process, the insurance company will check with your doctor to make sure they have all the information, and if at some point during your policy a pre-existing condition is found to be undisclosed, your policy can become invalid.

What happens if I don't declare a pre-existing medical condition?

If you do not declare a pre-existing medical condition, it can lead to serious consequences. Insurers may reject any claims related to that condition, invalidate your policy, or even cancel your coverage entirely. It’s important to be honest and provide full details about your health when applying for insurance. This transparency helps ensure that your policy remains valid and that you are not caught out by unexpected exclusions or claim rejections later on.

What is the exclusion period for pre-existing conditions?

The exclusion period for pre-existing conditions varies depending on the type of underwriting you choose. Under a Moratorium policy, pre-existing conditions are usually excluded if you’ve had symptoms, treatment, medication, or medical advice in the five years prior to the policy start date and will remain excluded until you have had no further symptoms, treatment, medication or advice for a full two years after the policy starts. With Full Medical Underwriting, the insurer will decide whether to exclude the condition permanently or for a fixed period of time based on your medical history, and this decision will be outlined in your policy documents. If your condition was excluded for a fixed period of time, you will need to apply to the insurer to have the exclusion removed.

How can I get treatment for a pre-existing condition if it is not covered on my health insurance?

If your health insurance policy does not cover a pre-existing condition, you can still receive treatment through the NHS or pay for private treatment.