Can you get health insurance with pre-existing conditions?

When you complete a health insurance application, insurers generally ask whether you have what is known as a 'pre-existing medical condition'.

This can be a medical issue you've experienced, but it doesn't automatically disqualify you from getting health insurance. It may, however, change the terms of your policy and what you could potentially claim for.

What is a pre-existing medical condition?

A pre-existing medical condition can be an illness, injury, or symptom you've previously experienced before applying for health insurance.

If you're unsure as to what's considered a medical condition, here are a few examples:

In terms of the difference between acute and chronic conditions, insurers tend to define the difference as:

• Acute conditions: Generally refers to unexpected pain, injury or illness that lasts for a short duration and resolves when the body heals.

• Chronic pain: This can be a persistent medical issue that lasts longer than 3 months, beyond the normal healing period.

Pre-existing medical conditions are not restricted to those confirmed through diagnoses. If you have had symptoms or tests for a condition but haven't been diagnosed yet, you still need to declare it in your health insurance application.

How do insurers treat pre-existing medical conditions?

Health insurance policies are designed so if you develop a medical condition during a policy, it can provide care and support. If you buy a health insurance policy, a pre-existing condition is unlikely to be covered. But that doesn't mean you won't be able to find cover.

So, how do insurers calculate the risk of insuring you? An underwriting process is used to help. There are two types of underwriting: full medical and moratorium.

A full medical underwriting process involves completing a questionnaire about your medical history. An insurer will gather all the information they can and may even consult your doctor. This helps complete a full and accurate assessment of any conditions you may have and determine what you'll be covered for in your health insurance policy.

Moratorium underwriting doesn't involve disclosing any pre-existing medical conditions initially. Instead, an insurer may review your medical history if you make a claim. When you claim, an insurer will determine whether a condition is pre-existing and if you're covered for it.

Moratorium vs full medical underwriting: Which is right for you?

Both full medical and moratorium underwriting processes have their own set of advantages and disadvantages. It's important to read through the benefits of each when deciding the best approach for you. Here's a quick comparison of both:

It's important to consider your own personal situation and weigh up the health insurance policy that suits you best. The terms and conditions of health insurance policies are likely to vary between insurers, so it's always worth comparing quotes for both price and suitability.

What about health insurance with specific pre-existing conditions?

Health insurance providers typically exclude chronic conditions and other pre-existin conditions from their cover. Bupa defines chronic conditions as 'ongoing health issues with no known cure'.

Asthma and health insurance

Asthma is a particularly common chronic illness that providers tend to highlight when discussing pre-existing conditions.

You might assume that this means conditions such as asthma are completely excluded from a health insurance policy.

However, this is essentially the same as any health insurance provider omitting pre-exisitng conditions from a policy. If you have asthma prior to buying a health insurance policy, for example, it's unlikely that you'll be able to claim for any treatment relating to the condition.

Most insurers will cover any new medical conditions you develop during your cover.

It's fairly common for health insurance policy terms and conditions to vary between providers. But when it comes to the general principles of underwriting (moratorium or full medical), there is a form of consistency across the board.

What's the process for getting a health insurance quote with medical conditions?

First of all, it's important to compare and contrast the various types of health insurance policies on offer. You'll also need to decide which underwriting process you prefer.

Once you settle on a specific policy, don't assume all insurers offer the same level of cover and exclusions. Some health insurance providers may exclude cover for certain conditions altogether, whether they were pre-existing or if you develop them during a policy.

After you've landed on a preferred policy and insurer, you'll need to complete an application. The application process will depend on whether you've chosen moratorium or full medical underwriting.

During the application, it's important to have any medical information to hand, especially if you have any ongoing conditions. You'll likely need to provide information such as diagnosis dates, treatment history and doctor details, for example.

You'll need to be honest when completing a medical questionnaire. If an insurer discovers you concealed a condition when applying, and you subsequently claimed for it during your policy, your claim will likely be rejected and your insurer may cancel your policy.

What medical conditions are not covered?

Along with various pre-existing conditions, many insurers also exclude ongoing chronic conditions from health insurance. Again, this simply means you won't be able to claim for any treatment relating to the condition if you declare it prior to buying a policy.

Some of the more common chronic conditions likely to be excluded by insurers include:

• Asthma

• Diabetes

• Chronic back pain

• Long-term mental health issues

Not all insurers exclude chronic medical conditions from health insurance policies. Others may only specify exclusions for certain chronic conditions.

Crucially, what is and isn't covered by a health insurance policy will likely vary between providers. That's why it's important to research the policy that best suits you before buying.