Can you get health insurance with pre-existing medical conditions?

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.

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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.

Will my insurer ever cover pre-existing conditions?

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:

• Diabetes
• Asthma
• Chronic fatigue
• Irritable bowel syndrome

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:

The Exeter do not exclude related conditions under their moratorium terms.”

This means that if you develop a new condition that is related to any of your pre-existing conditions, as long as you didn’t have any symptoms, treatment, medication or advice relating to the new condition, in the 5 years prior to the policy start date, this will be eligible to claim for.”*

*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

So why isn’t it on their website or in their terms?

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.

Get it in writing from someone before you buy

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.

1. Moratorium Underwriting - as explained earlier, this is the simplest option, and most new policies use this type of underwriting. The added benefit of moratorium underwriting is that if pre-existing conditions get better, and don’t cause ongoing symptoms or need treatment for two years, they’ll become covered into the future. The disadvantage is that as the initial exclusion is “Any pre-existing conditions in the past five years”, along with related conditions often being excluded too, you don’t get clarity when taking out the policy of precisely what isn’t covered, and that might only be learnt when you need to claim.
2. Full Medical Underwriting - the alternative to moratorium underwriting is Full Medical Underwriting, where you complete a detailed medical questionnaire before getting the policy, and your insurer will let you know precisely what will and won’t be covered. Again, The Exeter are strong when it comes to this type of underwriting, often excluding less related conditions than others. The main disadvantage of Full Medical Underwriting is that once you have an exclusion on your policy for a pre-existing condition, even if you go symptom-free for several years, it’s unlikely to be removed from the policy unless you go through the underwriting process again or appeal it at renewal (which is not always possible).

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.

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:

• Which type of underwriting is best for you
• Which insurer offers the most cover based on your medical history
• What are the benefits of each insurer and any disadvantages
• Which insurers are fairest when it comes to how claims affect premiums
• Which insurers have the best claims and customer service levels