A pre-existing condition is any condition you suffer from prior to taking out the policy. It will typically be excluded either for a set period or indefinitely from your policy.
How pre-existing conditions are treated when it comes to Private Health Insurance and whether or not they’ll be covered depends on the type of underwriting you choose.
Moratorium underwriting excludes most pre-existing medical conditions you’ve suffered from over a set period, usually the past 5 years.
Moratorium underwriting is the most common type of medical underwriting for Health Insurance is divided into plans underwritten on a rolling moratorium or a fixed moratorium basis.
Rolling Moratorium Medical Underwriting
The vast majority of Health Insurance is written on a rolling moratorium basis.
Rolling moratorium underwriting means 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 advice, medication or treatment for that condition.
This includes both self-funded private treatment or NHS treatment.
Fixed Moratorium Medical Underwriting
Fixed moratorium underwriting is a more lenient type of underwriting that rolling moratorium underwriting.
It still excludes any medical conditions you’ve suffered from in the 5 years leading up to the policy start date.
However, once you’ve served 2 years on the policy, the insurer will then consider covering you for that condition, 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 — such as cardiac and cancer cases — are unlikely to be eligible for fixed moratorium underwriting.
Only one insurer still uses fixed moratorium underwriting for its Medical Insurance, however.
Full Medical Underwriting Health Insurance
Buying fully medically underwritten Health Insurance means you disclose your entire medical history to the insurer from the start.
This lets your insurer take your health into consideration when deciding how to provide you with cover.
You provide your medical history through a health declaration form, which will ask a set of questions about your health and previous medical conditions.
Depending on what comes up on the form, the insurer might write to your GP for further evidence of your medical history to back up the underwriting.
Any disclosures on the health declaration form or that later come up if the insurer decides to write out for your medical history will result in an exclusion for that condition.
With full medical underwriting, any serious condition you’ve suffered from in the past will likely be excluded, even if it occurred more than 5 years ago.
This exclusion will usually be permanent, although it may be possible to get it lifted at a later date with medical evidence from your GP.
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.