Private Medical Insurance Full Medical Underwriting
What is Full Medical Underwriting?
Full Medical Underwriting (FMU health insurance) is a process in which you get to fill out a medical declaration and understand exactly which medical conditions you get coverage for and which ones are not excluded. It is one of the two key underwriting choices offered by most insurers for expats. The other underwriting option is moratorium.
How does Full Medical Underwriting work?
If you take the option of full medical underwriting for your medical insurance policy, you will need to give out the details of your medical history to the insurer before the policy will start.
Depending on your medical history your physician or healthcare facility may be asked for additional relevant information or you may need to supply recent reports. Always keep in mind that the information you put in the declaration is as precise and thorough as possible or else your future claim may not be in the cover and your whole insurance policy may be deemed invalid.
Once an insurer has all of the relevant information you will be informed about which medical conditions get excluded for your medical insurance policy or are covered with a premium loading.
Exclusions – refer to conditions, situations or events which are not eligible for reimbursement under an international medical insurance policy. These usually include things like war, self-harm, terrorism, HIV/AIDS, cosmetic surgery, injuries arising from dangerous hobbies and usually, pre-existing conditions treated in the past two years. For example, as an expat living abroad, you declare that you have asthma. You are also eager that you condition be covered but the range of insurance plans have all shown that pre-existing asthma is excluded from the medical insurance policy. The outcome is that you are unhappy and may decide to look elsewhere for asthma cover.
Premium loading (also known as loading) – refers to the amount that an insurance company adds to the basic premium to cover those that are applying. Sometimes premium loading is applied during the application process if you would like to cover pre-existing conditions. For instance, with a premium loading applied, you will be able to include some common pre-existing conditions such as asthma, type 2 diabetes and high blood pressure on cover by making an additional payment on top of your basic premium.
Your health insurer’s underwriting team will review each application on a case by case basis and decide if a loading option be applied based on the condition and the case history. There is no guarantee that any of these conditions mentioned above will be loaded.
Exclusions are reviewed under some specific circumstances.
You will have the choice: either pay a little extra to have the condition covered or keep the price the same by excluding the condition.
Real-life Examples of How Full Medical Underwriting Works
John underwent an operation on his arm. Then he takes part in an ABC healthcare program. The question is will he get coverage for any further medical treatment after his operation such as medical check-ups or physiotherapy?
If John opted for full medical underwriting, then the coverage for any further treatment related to the operation of his arm would not be included because he was aware of the condition when he initially signed up.
Three weeks following Kathy’s enrollment of DEF healthcare scheme, she visits the physician and discovers that she is diagnosed with a pulmonary condition. As her pulmonary abnormality must have progressed prior to her enrollment, would she get coverage for treatment of this medical condition?
If Kathy was being treated for the pulmonary condition prior to her enrollment and then had a diagnosis of the condition she would not get coverage for any of this medical condition. If however Kathy was not aware of the said condition then she would be covered in full.