Can I get Health Insurance with a pre-existing Medical Condition?

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If you currently have a medical condition, are suffering from an injury or have a history of health issues and you decide to take out health insurance, you may find it affects both the application process and the cost of the policy.

Every insurer will have a different set of criteria and a list of conditions, which they either will or will not cover you against.? Make sure you ask for a full list of these conditions before you complete your application as failure to be completely truthful at this stage could invalidate your policy in the future. doctor-filling-medical-history-8620738Some companies will simply refuse to insure you if you have a pre-existing condition for example, BUPA have a very strict policy that excludes any condition for which you have had advice, treatment or medication during the previous seven years and this is regardless of whether or not you have had a medical diagnosis. That being said, they will allow you to take insurance out with them, but with the contractual agreement that your pre-existing condition and any treatment associated with it will be excluded from the plan.

A pre-existing condition is determined as a disease, illness or injury that someone has received medication, advice or treatment for in the five years (this may vary between insurer) prior to application. Insurance companies will also need to be informed if you have a chronic condition.

A condition is considered chronic if it has one or more of the following characteristics:

  • Ongoing or long-term treatment is required to control or manage the symptoms.
  • Rehabilitation or extra support is required.
  • The condition is likely to continue indefinitely.
  • There is no known cure.
  • Even if it is treated it is likely to return.
  • Ongoing or long-term monitoring is required for example, consultations, examinations, check-ups and tests etc.
  • Life threatening illnesses, such as cancer.
  • Examples of chronic conditions include asthma, depression, diabetes and heart disease.

Regional_One_Health_Rehabilitation_Hospital_Patient_and_Family_Guide_p2Some insurers have introduced moratorium underwriting, which if you have a condition or have suffered from an injury, for example you have had a hip replacement, and you have been completely pain free and haven’t needed treatment for two years, will cover you for anything related to your hip in future. This will need to be validated by a doctor, but it means that you will be covered for something that may genuinely be a problem again in the future.

WPA are one company who offers this, although there are still certain restrictions for example, they won’t insure you if you have had a stroke, been diagnosed with heart disease, had cancer or have a strong family history of cancer, had surgery or had an arthroscopy done to treat a joint problem or back pain. Interestingly, they will also not insure you if you are overweight, which they classify as having a Body Mass Index (BMI) higher than the healthy range of between 19 and 32.

You will be able to find a health insurance policy, even if you do have a pre-existing medical condition, but you will have to do your research to find one that best suits your individual requirements. Remember that honesty really is the best policy.

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