If you’re considering private health insurance and have a current medical condition or one you’ve been treated for in the past, you may be wondering whether you can still get cover.
The good news is that having a pre-existing condition doesn’t necessarily mean you can’t take out private health insurance. Depending on your circumstances, it may affect the cover available to you, how an insurer assesses your application and, in some cases, the cost of your policy.
Understanding how insurers approach existing conditions can make it easier to know what to look for and choose cover that feels right for you.
A pre-existing medical condition is generally an illness, injury or medical problem that you’ve experienced before taking out your health insurance.
This could include conditions such as:
Exactly what counts as pre-existing can vary between insurers and policies. This is why it’s important to answer questions about your medical history accurately when applying.
Private health insurance is generally designed to cover acute conditions (illnesses or injuries that can be treated and are expected to improve). It isn’t usually designed to cover the ongoing management of chronic conditions, which may require regular medication, monitoring or long-term treatment.
Some conditions can also be recurring, meaning symptoms can come and go over time. How these are treated by an insurer will depend on your individual circumstances and the policy terms.
When you have an existing medical condition, the way an insurer assesses your medical history can affect what your health insurance covers.
There are two common ways insurers do this: moratorium and full medical underwriting:
Moratorium - You won’t usually need to provide your full medical history when you apply. Instead, the insurer reviews your medical history if you make a claim. Existing conditions may be excluded if you’ve recently had symptoms, treatment or medical advice. Some insurers may review an exclusion if you’ve been free from these for a set period.
Full medical underwriting - You’ll usually provide details of your medical history when you apply. The insurer can then assess your circumstances and confirm any exclusions before your policy starts. This can give you more certainty about what is and isn’t covered from the outset. The right option will depend on your circumstances and medical history.
Your medical history can be one of the factors that influences the cost of private health insurance. However, having a pre-existing condition doesn’t automatically mean your payments will be higher.
Other factors that can affect the price are:
There are different ways to manage the cost without removing cover that could be important to you. For example, choosing a higher excess or a more limited outpatient allowance may reduce your payments, depending on the insurer.
It’s worth considering the overall value of the policy rather than simply choosing the policy with the lowest payments. A cheaper policy may have more restrictions or lower limits, which could affect the cover available when you need it.
Applying for private health insurance is usually straightforward. You’ll need to provide some personal details and, depending on the underwriting method, information about your medical history.
This could include details of:
It’s important to be as accurate and complete as possible. If an insurer needs more information, they may ask for further details or medical evidence from your GP.
Once your application has been assessed, you’ll receive your policy documents explaining your cover, including any exclusions, limits and excesses.
If you need eligible private treatment, your insurer will usually need to approve your claim before treatment takes place. Your policy documents will explain how to make a claim and what information you’ll need.
It’s also worth reviewing your health insurance from time to time. Your circumstances, healthcare needs and priorities can change over time, and your policy may no longer provide the most suitable balance of cover and cost for your current needs.
Private health insurance doesn’t replace the NHS. Instead, it can give you another option when you need private treatment, such as a specialist consultation, diagnostic tests or treatment in a private hospital.
Finding health cover with a pre-existing condition can feel complicated, especially when insurers assess medical history in different ways. That’s where LifeSearch can help.
Our advisers can understand your circumstances, explain your options and help you find a policy that balances the cover you need with your budget. We’ll also support you through the application process, including any medical questions or evidence an insurer may need. Get in touch today to find out more.
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