Can I Get Health Insurance With An Existing Medical Condition?

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13-04-2020


With Health Insurance, you pay regular premiums and in exchange the insurer covers the cost of private medical care for eligible conditions in some of the UK’s top private hospitals should you need it.

But what is an eligible condition and what happens if you’re already suffering from existing health problems at the time you take out the policy? Can you even get Health Insurance with a pre-existing condition on your medical records?

The answer is yes, in most circumstances you can get Health Insurance if you suffer from a pre-existing condition. However, whether or not this condition will be covered on the policy depends on your circumstances, the condition in question and your insurer.

What is a Pre-Existing Medical Condition?

A pre-existing condition is any medical condition you’ve suffered from in the past. Insurers aren’t typically concerned with minor conditions such as coughs and colds but are more concerned with major conditions such as cancer, heart / circulatory complaints and mental health problems.

Many people think you can’t get Health Insurance without a pristine medical history, but this isn’t actually true. There are few medical conditions that will entirely rule you out of getting Private Medical Insurance, so if you do have a health condition all hope is by no means lost.

It’s best to speak with an expert, such as one of the team here at Drewberry to ensure you’re getting the best policy for your circumstances.

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The Importance of Underwriting for Pre-Existing Health Conditions

How far back into your medical history the insurer will look for any medical conditions when deciding on your policy terms will depend on the type of underwriting you choose.

As an individual taking out a new UK Private Health Insurance policy, you have two options to choose from with your medical underwriting:

  • Full medical underwriting
  • Moratorium underwriting

Which one you opt for could have a big bearing on whether your pre-existing medical condition is covered by your Health Insurance policy, so it’s important to understand the difference between the two.

Moratorium Underwriting

Moratorium underwriting excludes most pre-existing medical conditions you’ve suffered from over a set period, usually the past 5 years. After serving a period on the policy without having any symptoms or receiving advice, medication or treatment for a particular pre-existing condition, the insurer may look to cover it at their discretion.

Moratorium underwriting is the most common type of medical underwriting for Health Insurance. It is divided into plans underwritten on a rolling moratorium or a fixed moratorium basis.

Rolling Moratorium

Here the insurer will consider any claims for medical conditions that you’ve suffered from in the 5 years before taking out the policy, providing you’ve served 2 years on the policy without any symptoms or advice, medication or treatment for that condition.

This includes both self-funded private treatment or NHS treatment.

Providing you can give the necessary medical evidence to show you’ve received no care for that problem, the insurer may remove the exclusion for that condition going forward.

Fixed Moratorium

Fixed moratorium underwriting represents a more lenient type of underwriting than rolling moratorium underwriting.

While it still excludes any medical conditions you’ve suffered from in the 5 years leading up to the policy start date, once you’ve served 2 years on the policy the insurer will then consider covering you for that condition. This is regardless of whether you’ve received treatment for that condition or not over those 2 years.

It’s important to realise that often the most serious conditions — e.g. cardiac and cancer cases — are unlikely to be eligible for fixed moratorium underwriting.

While this is a more favourable type of underwriting for clients, there’s only one insurer on the market that still uses fixed moratorium underwriting for its Private Medical Insurance.

Full Medical Underwriting

Opting for full medical underwriting means you disclose your full medical history upfront to the insurer in a health questionnaire.

It usually leads to a total exclusion of any medical condition you’ve suffered from in the past, regardless of how long ago you suffered from that condition.

This exclusion will usually be permanent, although it may be possible to get it lifted at a later date with supporting medical evidence.

For more minor conditions, however, you may be able to negotiate coverage with your insurer, particularly if that condition occurred a number of years ago.

The Best Health Underwriting for Pre-Existing Conditions

This depends entirely on your circumstances and is best discussed with your adviser. However, broadly speaking, you should consider the below guidelines for your medical history.

Serious Pre-Existing Conditions

For serious medical conditions — e.g. cancer or cardiac / cerebrovascular conditions — it may be better to opt for moratorium underwriting.

That’s because after 2 years on the policy, the insurer will reassess your health and, providing you haven’t sought any advice, medication or treatment for that condition in those 2 years, potentially look in to covering you.

A fully medically underwritten policy, on the other hand, would likely place a permanent exclusion on such a serious medical condition, one which can be very tricky to get an exclusion removed at a later date.

Minor Pre-Existing Conditions

If you’ve suffered from a minor condition in the past 5 years, then full medical underwriting may be better than moratorium underwriting.

This is because moratorium underwriting will put an exclusion on most medical conditions you’ve suffered in the past 5 years regardless of severity.

However, when an insurer examines your medical history during the full medical underwriting process they may deem the condition to be minor enough for them to offer you cover for it regardless.

Get Expert Advice on Health Insurance With Pre-Existing Conditions

Health Insurance can be complicated enough without having to worry about pre-existing conditions and whether or not they’ll be covered. For that reason, we recommend speaking to an adviser before you delve into taking out cover if you have any health problems.

Why Speak to Us…

We started Drewberry because we were tired of being treated like a number and not getting the service we all deserve when it comes to things as important as protecting our health and our finances. Below are just a few reasons why it makes sense to let us help.

  • There is no fee for our service
  • We are independent and impartial
    Drewberry isn’t tied to any insurance company, so we can provide completely impartial advice to make sure you get the most appropriate policy based solely on your needs.
  • We’ve got bargaining power on our side
    This allows us to negotiate better premiums for you than you going direct yourself.
  • You’ll speak to a dedicated expert from start to finish
    You will speak to a named expert with a direct telephone and email. No more automated machines and no more being sent from pillar to post – you’ll have someone to speak to who knows you.
  • Benefit from our 5-star service
    We pride ourselves on providing a 5-star service, as can be seen from our 2872 and growing independent client reviews rating us at 4.92 / 5.
  • Gain the protection of regulated advice
    You are protected. Where we provide a regulated advice service we are responsible for the policy we set-up for you. Doing it yourself or going direct to an insurer won’t provide this protection, so you won’t benefit from these securities.
  • Claims support when you need it the most
    You have support should you need to make a claim. The most important thing when it comes to insurance is that claims are paid and quickly. We are here to support you during the claims process and make sure it’s as smooth and stress free as possible.

I had a great experience with Drewberry, they have a lot of knowledge and expertise with life insurance and income protection and were able to advise me and arrange suitable products. Highly recommend.

Lachlan Mellings
12/08/2020
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