Health insurance companies sometime get a bad wrap as people believe that they will always exclude pre-existing conditions no matter what. While this can be true for some specific medical insurance providers others can take a different approach and provide cover for pre-existing conditions.
Here we will look a little deeper into how this works and the ways that medical insurers underwrite your insurance plan.
1. Full Medical Underwriting
Full Medical Underwriting is a kind of medical insurance underwriting in which health insurers ask you, as an applicant, your medical history and then they would make a decision whether you are in a position to get your pre-existing medical conditions covered or not.
If you opt for an insurance plan with full medical underwriting, you will be required to complete a full medical declaration and submit it to the insurance company you are dealing with.
The insurer will then assess the application and determine what they will cover and if any pre-existing conditions can be covered. This is one of the most common ways to check if you can get a pre-existing condition covered.
With minor conditions some insurers will simply cover these from the start of the policy. With more serious or ongoing conditions some medical insurance companies can cover pre-existing conditions by applying a premium loading. This means that they will cover the condition but may increase your premium in order to do so. This is something that you would find out prior to any policy starting and before paying any premium.
Your insurance certificate will display any special terms that need to be applied. The medical coverage will be administered by the terms and conditions and benefits of your insurance policy. With this underwriting type, you will have peace of mind in that you can have medical treatment for that medical condition. On the other hand, you will be able to know from the beginning what you are able to and unable to claim for if a condition does get excluded which is also a positive.
Another way to get conditions covered is through moratorium underwriting. This is typically a longer term approach to getting conditions covered. With this method a waiting period needs to be fulfilled by the policy holder before the insurer will cover a condition. In that waiting period time providing you are not getting treatment, having symptoms or seeking advice on a medical condition then the insurer will cover you in full.
The waiting period or the moratorium is great for some members applying who might have more serious conditions who are unable to apply via Full Medical Underwriting.
Additionally one of the other upsides of moratorium underwriting include how quick, simple and cheap it is to set up cover as there are much fewer medical questions and often plans can be set up immediately.
3. Continued Personal Medical Exclusions (CPME)
CPME underwriting involves a switch from one insurer to another. It can be effective only when you were on an insurance plan with full medical underwriting and then you were transferred to this current insurance policy.
Your personal medical exclusions for pre-existing conditions that were applied by your previous medical insurance company are applied by your current medical insurer as well.
Your insurance certificate will reveal your personal medical exclusions that the current insurer has applied to your medical coverage.
In addition, any exclusions from your previous insurance plan will continue to be effective with your current insurance as long as your medical coverage has no break. Your waiting periods that have already been served in your previous insurance policy will also be honoured with the current plan with CPME underwriting. However, always be mindful that this varies from insurer to insurer.
Essentially this means if you have a condition covered with a different insurer you can transfer to a new on and they will continue to cover it. Each insurer does have their own certain rules on how this works and not every insurer provides this option which is worth keeping in mind.
If you would like to contact our Team about any of the options listed and how we can help you please contact us at [email protected]