Cover for pre-existing conditions

26 Aug 2018

Pre-existing conditions

When taking out a medical insurance plan, you may be interested to know how the insurer your are signing up with will view your pre-existing conditions. Most of us have had some sort of visit to a doctor or hospital at some point in our lives so it is important to understand this in advance to avoid any surprises at a later stage. Pre-existing conditions are any significant injuries or illnesses that you currently have, or have previously had before taking out your health insurance policy.

When taking out a policy your insurance company will ask about your medical history. Based on this information they will make a decision regarding the coverage of your pre-existing conditions and will ‘underwrite' your application.

It is vital that you tell your insurer your complete medical history as accurately as possible, because many insurers will not cover you for pre-existing conditions. If you fail to disclose a condition and later on need treatment for it, you will have to pay for the treatment yourself. Depending on the condition insurers can chose to not cover pre-existing conditions, as they represent a virtually guaranteed cost to them at some point during your policy. However, there are now several insurers and plans that can cover your pre-existing conditions in a variety of ways.

The insurance company you choose to start a policy with can take a number of options with pre-existing conditions when deciding to underwrite your application.

The ways you can be covered include:

1.       Full coverage of all pre-existing conditions from the policy inception. This does happen on occasion and is typically the case for small injuries or very minor conditions typically that have happened well before the policy starts.

2.      Coverage for your pre-existing conditions only after a moratorium waiting period has been completed. This is a wait time of usually two years. If you have had no recurrences or treatment during this two year period the insurer will reconsider including your condition in your cover.

3.      Premium loading, where you pay a higher premium to have your pre-existing condition covered on your policy. This means that your annual premium will rise by a small percent but the insurance company will agree to cover the costs of treatment for the pre-existing conditions. This practice is less common; however our consultants are happy to source an overseas health insurance company that will allow you to cover a pre-existing condition in this manner.

4.      Coverage for pre-existing conditions through a group medical plan. Group plans often disregard individuals’ pre-existing conditions because of the premium paid by the entire group. When applying for a group policy it may be possible to arrange a plan that covers all members of the group for all pre-existing conditions. This option is generally only available to large groups and companies so you would need to check if you qualify for this first.

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