Getting Private Medical Insurance With a Pre-Existing Condition Explained

Mark Benson

Mark Benson

Money Savings Advice Private medical insurance & pre existing conditions

Are you one of many people in the UK looking for private medical insurance which will cover a pre-existing condition? In general medical insurance companies will exclude both pre-existing conditions and chronic conditions. However, there are two options when taking out a policy, full medical underwriting or moratorium.

There seems to be a general misconception that private medical insurance will cover the cost of any medical treatment going forward. In reality, you will find that private medical insurance companies will exclude both pre-existing and chronic illnesses from their cover.

The exact details will vary from provider to provider, but it is certainly something that you need to check before taking out insurance.

Continue reading to get all the details about medical insurance with a pre-existing condition.

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What Is Classed as a Pre-Existing Condition?

If we look at BUPA for example, they have particularly strict medical insurance policies which exclude conditions where you have had advice, treatment or medication at any point during the previous seven years. They may also exclude conditions where there have been symptoms during the last seven years.

Do I Need to Undertake a Medical for Private Medical Insurance?

While there may be some exceptions to the rule, you would not normally be required to undertake a medical examination prior to taking out private medical insurance. You would need to fill out an extensive questionnaire in which you would be asked to detail any pre-existing conditions.

When calculating private medical insurance premiums, insurance companies will take into account an array of different factors as well as your medical history.

What Is a Full Medical Underwriting Health Insurance Policy?

When applying for a private medical insurance policy, the full medical underwriting option would take into account your medical history when deciding which conditions would be included and excluded. The medical history of family members on a group policy would also be taken into consideration.

What Is a Moratorium Health Insurance Policy?

If you choose a moratorium insurance policy, then you will not be covered for any pre-existing medical conditions until you have seen at least two years (up to 7 years with some insurers) without incident.

After the period you should be covered for the previous pre-existing conditions, thereby giving you full cover. This is an understandable means by which insurance companies reduce their exposure to pre-existing conditions which can be expensive to treat.

What Is Defined as a Chronic Condition?

There are numerous different definitions of chronic medical conditions across the private medical insurance industry including the need for:-

  • Long-term monitoring, consultations or treatment
  • Ongoing/long-term control of the condition or relief of symptoms
  • Rehabilitation/coping techniques
  • Continuous treatment

If a medical condition has no known cure or is likely to come back, then this would be added to the chronic condition list.

Do I Need to Disclose Any Pre-Existing Medical Conditions?

If you fail to disclose any pre-existing medical conditions on your private medical insurance application, then you risk cancellation of the policy and the removal of any health cover. It is very important that you are honest and truthful during the application process with regards to yourself and others included on your policy.

Is There Specialist Private Medical Insurance for Pre-Existing Conditions?

As the private medical insurance industry continues to grow, so we have seen the emergence of some specialist insurers. There may be opportunities to incorporate pre-existing conditions into your medical cover in the future, but at the moment, these opportunities are few and far between.

Would a Medical Insurance Policy Give Me Cover for Everything?

While the term medical insurance is all-encompassing to many people, in reality, it will provide cover if you’re injured or fall into ill health. The cover itself is more focused on short-term medical assistance as opposed to long-term “chronic” conditions.

It is very important to read the terms and conditions of any medical insurance policy before signing up. You might get a shock when you try to reclaim expenses!

What Factors Will Influence My Medical Insurance Premiums?

There are many factors to take into consideration, such as age, gender, location, medical history, hobbies and smoking habits. While you will read about different levels of medical insurance, they tend to fall into three different categories, basic, medium and comprehensive. As well as the above factors, the level of cover you choose (often dictated by your budget) will impact your premiums.

Can I Pay for Private Medical Procedures for Pre-Existing Conditions?

While the private medical industry is dominated by private insurance, you will also be able to pay for private treatment on a one-off basis. However, be warned that the cost of private medical healthcare can be fairly high!

What Are My Options for Treatment for a Pre-Existing Condition?

Even though we are focusing on private medical insurance and the subject of pre-existing conditions, there are no limitations or restrictions whatsoever when it the comes to NHS treatment.

Therefore, even if you are not able to obtain the level of private medical insurance that you require or you can’t afford one-off private medical treatment, the NHS will always be there.

Can I Get Cover if I Am in Remission?

The exact details will vary between each insurance company, but if you have had no symptoms, treatment or consultations for a previously pre-existing condition for anywhere between two and seven years, you may still be able to obtain private medical insurance cover.

This can lead to a number of complications and misunderstanding, so it is very important to research the potential cover in great detail.

Should I Take Professional Advice Before Taking Out Private Medical Insurance?

You will find that many independent and tied brokers will have contacts in the marketplace who are perhaps more flexible than they appear in public. They may be able to accommodate different budgets and arrange discounts on published rates.

When discussing your private medical insurance with a professional adviser, they will be able to highlight the most relevant options for your situation.


While some people believe that all medical costs will be covered going forward, including pre-existing conditions, this is certainly not the industry standard. On the flip side of the coin, those with pre-existing conditions often feel as though there is nothing in the medical insurance market for their situation.

However, there are some companies who will accommodate pre-existing conditions if there have been no symptoms, treatment or consultations over a set period of time. It is worth investigating!

How Can Money Savings Advice Help You With Private Medical Insurance?

Here at Money Savings Advice, we have partnered with some of the UK’s leading Private Medical Insurance companies. They have already helped thousands of people get the best PMI cover, and, they can do the same for you.

Choosing an independent adviser means they won’t recommend a policy unless they are sure it is in your best interests. Their advice is also regulated by the FCA, which gives you an additional layer of protection.

If you would like to speak to one of these brokers, then click on the below and answer the very simple questions.


Money Savings Advice Author Mark Benson

Mark Benson

Mark has been writing professionally for over ten years for the financial sector. Having started in the financial world as a stock-broker in central London and then moving to equities trader Mark is one of our senior financial writers who has a vast knowledge of multiple financial sectors.

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