Alyssa Lane
Private medical insurance is intended to cover the costs of private healthcare for unexpected acute conditions, and most policies do not cover pre-existing conditions. However, some insurers offer the option to add cover for certain pre-existing conditions, and moratorium underwriting policies may cover pre-existing conditions after a set period.
| Characteristics | Values |
|---|---|
| Definition of pre-existing condition | Any medical problem experienced before applying for cover |
| Definition of chronic condition | Ongoing medical problem with no known cure |
| Cover for pre-existing conditions | Most private medical insurance products do not cover pre-existing conditions |
| Cover for chronic conditions | Most private medical insurance products do not cover chronic conditions |
| Underwriting types | Full medical underwriting, moratorium underwriting |
| Full medical underwriting | Requires full disclosure of medical history, covers pre-existing conditions if agreed upon |
| Moratorium underwriting | Does not require full disclosure of medical history, pre-existing conditions are excluded for a set period |
| Exceptions | Some insurers may cover pre-existing conditions after being symptom and treatment-free for 2 years |
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What You'll Learn
- Private medical insurance is designed for new or unexpected medical issues
- Pre-existing conditions are any medical issues experienced before applying for cover
- Full medical underwriting requires a full medical history declaration
- Moratorium underwriting doesn't require a full medical history declaration
- Pre-existing conditions may be covered after a moratorium period
Private medical insurance is designed for new or unexpected medical issues
Private medical insurance is designed to cover new or unexpected medical issues. It is intended to provide access to private healthcare and help cover the costs of treatment for unforeseen events. When applying for private health insurance, individuals are required to disclose their health and lifestyle details, including any pre-existing medical conditions and issues. This allows insurers to assess the risk and determine the appropriate coverage and cost of the policy.
Pre-existing conditions are generally defined as diseases, illnesses, or injuries for which an individual has received medication, treatment, advice, or exhibited symptoms prior to the start of their insurance coverage. These conditions are often excluded from private medical insurance policies, as they are considered known risks. However, it is important to note that not all pre-existing conditions are permanent or chronic, and some insurers may offer coverage for specific pre-existing conditions or provide the option to add them to the policy later.
There are two main types of underwriting for private medical insurance: Moratorium and Full Medical Underwriting. With Moratorium Underwriting, individuals are not required to disclose their full medical history during the application process. Instead, pre-existing conditions from the previous five years are automatically excluded from coverage for a set period, typically two years. After this moratorium period, the insurance company may agree to cover the pre-existing condition if it has remained symptom-free and untreated during the exclusion period.
On the other hand, Full Medical Underwriting requires individuals to complete a medical questionnaire and disclose their medical history, including pre-existing conditions. The insurer then decides whether to cover these conditions and at what cost. While this approach provides clarity at the outset, it may result in higher premiums or exclusions for pre-existing conditions.
It is important to carefully review the terms and conditions of private medical insurance policies to understand what is covered and what is excluded. Individuals should also be aware that private medical insurance is not meant to replace the care provided by national healthcare services but rather to offer additional coverage and access to private healthcare options.
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Pre-existing conditions are any medical issues experienced before applying for cover
Pre-existing conditions are any medical issues experienced before applying for private health insurance cover. This includes any disease, illness, or injury for which you have received medication, treatment, advice, or symptoms before the start of your cover, whether or not you have sought advice from a medical professional. For example, conditions like high blood pressure, asthma, diabetes, arthritis, depression, anxiety, broken bones, migraines, back pain, and knee pain are all considered pre-existing conditions.
When you apply for private health insurance, the insurer will ask about your health and lifestyle, and you are required to disclose any pre-existing conditions. This can be done through a medical questionnaire or by giving the insurer access to your medical records. Your medical history is one of the factors that affect the cost of your health insurance and helps the insurer make an informed decision about the type of cover you can have.
There are two main types of underwriting that determine how pre-existing conditions are covered: Moratorium Underwriting and Full Medical Underwriting. With Moratorium Underwriting, you don't have to disclose your full medical history when applying for cover, but all pre-existing conditions from the previous five years are excluded for a set period, typically two years. After this moratorium period, cover for the pre-existing conditions may be included in the policy, provided there has been no recurrence of the condition during the exclusion period.
On the other hand, with Full Medical Underwriting, you will need to complete a medical declaration and disclose any pre-existing conditions. The insurer will then decide whether to cover these conditions or exclude them from the policy. While this approach provides clarity from the start, it may result in higher premiums or difficulty in obtaining coverage for certain pre-existing conditions.
It is important to note that even with a pre-existing condition, you can still obtain private health insurance. However, the specific condition may not be covered under the policy, and you may need to explore alternative options or enhancements to include such conditions.
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Full medical underwriting requires a full medical history declaration
Private health insurance is designed to cover the costs of short-term, acute medical treatment for unexpected new events that arise after the start of the cover. It is not meant to cover pre-existing conditions, which are defined as any disease, illness, or injury for which an individual has received medication, advice, treatment, or had symptoms before the start of their cover. However, some private health insurance policies can offer cover for certain pre-existing conditions.
Full medical underwriting is one of the two main types of underwriting for private health insurance, the other being moratorium underwriting. With full medical underwriting, you will need to provide a full medical history declaration and fill out a questionnaire about your past health, including any pre-existing conditions. The insurer may also need to speak to your doctor and review your medical records. This allows the insurer to determine whether any pre-existing conditions will be covered or excluded from the start of the policy. Choosing full medical underwriting provides clarity from the outset and can speed up the claims process since the insurer already knows about your medical history.
The medical history declaration and questionnaire will ask about any symptoms, tests, treatments, medications, or advice you have received for any disease, illness, or injury before applying for private health cover. This includes chronic conditions like diabetes, asthma, and arthritis, as well as one-off symptoms like knee pain or a broken bone. It is important to be transparent and provide full disclosure to the insurer so that they can make an informed decision about the type of cover you can have.
While full medical underwriting requires disclosing your full medical history, it provides clarity on what is covered from the start of the policy. With moratorium underwriting, you don't need to disclose your full medical history when applying, but any pre-existing conditions from the previous five years will be excluded from coverage for a set period, typically two years. After this moratorium period, the insurer may agree to cover pre-existing conditions if they have remained symptom-free and untreated during the exclusion period.
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Moratorium underwriting doesn't require a full medical history declaration
When applying for health insurance, you will likely be given the option of moratorium underwriting or full medical underwriting. With moratorium underwriting, you are not required to disclose your full medical history at the start of your cover. Instead, your insurer will only ask about your medical history when you make a claim.
Moratorium underwriting is a good option for those with pre-existing conditions that are well-managed by NHS services or if treatment for a pre-existing condition is not needed. It is also a good option if you have a complicated or unusual medical history, as it may take a long time to complete full medical underwriting.
With moratorium underwriting, you may be covered for pre-existing conditions, depending on when you last experienced symptoms or received treatment. If you have not had treatment, medication, or advice for a condition for at least two years, you may be covered for it. However, moratorium underwriting does not cover any conditions you have had in the five years before taking out insurance.
Full medical underwriting involves answering questions about your medical history and may involve giving your insurer access to your medical records. This type of underwriting provides clarity on what is covered before the policy begins and can speed up the claims process.
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Pre-existing conditions may be covered after a moratorium period
When applying for private health insurance, any pre-existing medical conditions and health issues you’ve had in the past could potentially affect your coverage. Most private medical insurance products exclude both pre-existing and chronic conditions. This is done to keep insurance affordable. If these conditions were not excluded, there would be a higher number of claims, making health insurance much more expensive.
However, some insurers may cover pre-existing conditions after a moratorium period. A moratorium is a period of time during which an individual’s pre-existing medical conditions are not covered under their insurance policy. After the moratorium period has ended, cover for the pre-existing conditions will typically be included in the policy, subject to terms and conditions. This is called moratorium underwriting. With this type of underwriting, you don’t need to disclose your full medical history at the start, but all pre-existing conditions from the previous five years are excluded for a set period, usually two years. After this period, if you have not had any symptoms, tests, treatment or medication for your pre-existing condition, the moratorium may be lifted and the condition may be covered.
Full medical underwriting is the other common type of underwriting. With this option, it is clear from the start if any pre-existing medical conditions are covered or not. When you apply for cover, you’ll need to fill in a questionnaire about your medical history and your insurer might also need to speak to your doctor. Once they’ve gathered all the information, they’ll decide what symptoms and conditions they can or can’t cover and let you know. Choosing full medical underwriting can help speed up the claims process, because your insurer already knows about your medical history.
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Frequently asked questions
A pre-existing condition is a disease, illness, or injury for which you have received medication, treatment, advice, or symptoms before the start of your cover.
Private medical insurance is intended to cover the cost of unexpected acute conditions and, therefore, does not usually cover pre-existing conditions. However, some insurers may offer cover for pre-existing conditions after a moratorium period of two years during which the condition does not reoccur.
Acute pre-existing conditions are short-term illnesses, injuries, or medical conditions that have a clear end date, such as a broken bone that will heal in a few weeks. Chronic conditions are ongoing and have no known cure, such as asthma, arthritis, and diabetes.
There are two main types of underwriting: moratorium and full medical. Moratorium underwriting does not require you to disclose your full medical history, but all pre-existing conditions from the previous five years are excluded for a set period, usually two years. Full medical underwriting requires you to complete a medical questionnaire and may involve providing access to your medical records. Any pre-existing conditions will be excluded unless the insurer agrees to accept them.
