Private health and protection insurance expert and editor
If you currently have or have had medical conditions, you may wonder whether they’ll affect your ability to get private health insurance. In this guide, we explain how pre-existing medication conditions may affect your cover, highlighting one insurer that often covers more than others.
A pre-existing medical condition is anything you’ve experienced symptoms of, sought advice for or had treated in the past.
Pre-existing conditions don’t stop you from taking out a health insurance policy, but depending on your underwriting method they may be automatically excluded if they occurred in the past five years.
In most cases, insurers will also exclude any conditions that are related to your pre-existing condition (harsh, we know!).
The Exeter may be the best health insurance provider when it comes to how your medical history affects your cover levels. They are widely regarded among the many expert brokers we speak with as the fairest, often covering more conditions relating to pre-existing ones than others.
If you’re here and wondering if you took out a policy today, whether an insurer will cover the cost of private treatment for something you’re currently suffering with, we need to be straight with you. No, they won’t, and your best bet, if you have the financial means, would be speak to private healthcare providers about self-paying for treatment.
That said, even if you have pre-existing conditions, health insurance is still valuable and will ensure that future medical concerns can be dealt with swiftly.
Technically, a pre-existing medical condition is anything you’ve suffered from, had treatment for, or sought advice about in the past, and unless you’re something of a super-human, you’ve likely got at least a couple.
When it comes to health insurance, you usually only need to worry about those you’ve suffered from in the past five years, thanks to how Moratorium underwriting works.
Moratorium underwriting is a method insurers use to simplify getting a new policy, removing the need for a detailed medical questionnaire. With moratorium underwriting, the insurer automatically excludes pre-existing conditions that you’ve experienced in the past five years. Anything before that won’t affect your cover levels unless you’ve had symptoms, required treatment or sought advice for it!
Yes, you can get private health insurance if you have pre-existing medical conditions, but anything you’re currently suffering from or have suffered from in the last five years will likely be excluded.
After getting a private medical insurance policy with moratorium underwriting, should that condition fully resolve for two continuous years; without having symptoms, or needing medical advice or treatment for that condition, then that condition will automatically be covered should it reoccur after that clear period. So yes, if the condition goes away, it’ll likely be covered in the future.
A chronic medical condition is one that, by its nature, can’t be recovered from and instead requires life-long monitoring and management. All health insurance policies exclude chronic medical conditions, regardless of whether they start before or after you get a policy. However, some will occasionally pay for the treatment of acute flare-ups of the chronic condition but not the ongoing monitoring and management.
If you have out-patient cover, your insurer will often cover the cost of being diagnosed privately, as it could be something other than a chronic condition causing your symptoms. But, as soon as it’s established that it is chronic and not an acute medical condition, you’ll be referred to the NHS for ongoing management.
Examples of chronic medical conditions:
Again, like with pre-existing conditions, while chronic illnesses are excluded, you can still get or keep a health insurance policy, as many people do, it’s just that your chronic illness, and likely anything related to it, will be excluded from cover.
Currently, the best and fairest health insurance provider for pre-existing medical conditions is The Exeter and their Health+ policy.
Whether you opt for their Full Medical Underwriting or Moratorium Underwriting, you’ll usually find that they will cover more conditions related to pre-existing and chronic conditions than others.
Exeter will still exclude the actual pre-existing or chronic condition; it’s just that they don’t usually exclude many, if any, related conditions.
Strangely, The Exeter is somewhat shy about this unique selling point, and you won’t find anything about it on their website or in their policy documents. However, we’ve heard from numerous brokers and even The Exeter themselves that it’s true.
Indeed, in May 2024, we received a document that came from The Exeter stating:
*myTribe was given this information in May 2024. While it is our understanding when writing this article, The Exeter could change or withdraw this benefit anytime for new customers
Only The Exeter knows why this isn’t being more publically pushed, as it’s a huge selling point and a significant differentiator between them and the rest of the market. They are telling brokers but not including it in their terms or policy documentation. So, some care is needed when buying a policy.
As this USP isn’t baked into Exeter’s terms and conditions, it is possible they could change the wording of their moratorium rule in future for new customers. This article, written on June 5th, 2024, may be outdated tomorrow, so please, if you are planning on getting a policy from Exeter with the expectation that things related to pre-existing conditions will be covered, GET IT IN WRITING first.
Ask your broker, or if you’re going direct, The Exeter themselves, to put it in writing that related conditions won’t be excluded under their moratorium terms.
By doing this, you know that if this gets suddenly withdrawn, you have first-hand evidence that it’s what they agreed to when you took out the policy.
For people taking out a new health insurance policy, there are usually two choices when it comes to underwriting, which, as a reminder, is the process the insurer goes through to determine what it will and won’t cover.
There’s no categorical “best” type of underwriting, as it’ll depend on your circumstances and medical history, but it should be high on your agenda to raise with your health insurance broker, as the decision you make today can affect cover levels for many years.
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Pre-existing medical conditions don’t usually affect the cost of your health insurance. The insurer effectively removes any risk associated with the condition by excluding them, so there is no need to charge you more.
While strictly speaking, your health insurance won’t cost more, as you’ll have exclusions, you will be essentially paying the same as someone without those exclusions, so it could be argued that you’re paying the same for less.
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If you have pre-existing conditions, we strongly recommend that you consult a health insurance broker (request a quote from us to speak with one for free). They will be able to help you choose the best type of underwriting, compare leading providers, and determine which insurer is best based on your circumstances and requirements.
Tips for finding the right health insurance with pre-existing conditions:
Disclaimer: This information is general and what is best for you will depend on your personal circumstances. Please speak with a financial adviser or do your own research before making a decision.
Chris Steele is myTribe’s resident expert in private health insurance and healthcare, with over a decade of experience in the field. As a Chartered Insurance Institute (CII) qualified professional, he has helped countless consumers navigate private medical insurance. Regularly quoted by national media, Chris is a trusted voice in the UK insurance industry, with his insights featured in leading consumer finance publications.
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