Health insurance when you already have a condition

Many people who look at private health insurance already live with a health condition. They want to know what a policy could still do for them.

A policy can still cover problems that are not related to a condition you already have. This page explains how insurers treat conditions you already have, so you can read a policy with the right questions in mind.

What a policy can cover

Private medical insurance pays for private treatment, such as seeing a specialist, tests and hospital stays. Many policies also include extras such as a virtual GP service, mental health support or physiotherapy.

A condition you had before the policy started is called a pre-existing condition. It is usually excluded, at least at first. Claims that are not related to it can still be covered.

Two ways insurers look at your health

With full medical underwriting, you give the insurer your full medical history. It uses this to decide whether to insure you and on what terms. You know from the first day which conditions are covered and which are not.

With a moratorium policy, you give only limited information at the start. Some moratorium policies exclude a condition at first and then begin to cover it after a waiting period, often two years, if you have had no symptoms or treatment for it in that time. The details depend on the insurer and on what you agreed.

Long-term conditions

Most long-term conditions that need ongoing care, such as diabetes or asthma, are not covered as standard. Cancer is a notable exception to that rule.

The NHS also gives you choices. If a GP refers you for treatment, in most cases you have a legal right to choose the hospital or service. That can include many private hospitals that provide services to the NHS.

Cover through work

Health insurance from an employer is usually cheaper and more generous than a policy you buy yourself. Some workplace schemes cover pre-existing conditions, so it is worth checking yours.

If you later leave a workplace scheme or switch insurer, ask whether conditions that were covered will stay covered. A new insurer may exclude them. Switching at renewal usually avoids a fee for leaving early.

Answering health questions

When an insurer asks about your health, the law expects you to take reasonable care to answer accurately.

Before you arrange private treatment, call the insurer to check it is covered. Stay in touch with them at each stage.

Travel insurance with a medical condition

Travel insurers must point people to a directory of firms that cover more serious medical conditions. They must do this when they decline you because of a medical condition, or offer cover only with an exclusion you cannot remove or a medical premium above a set level. The FCA lists these directories on its website.