Health insurance for pre-existing conditions

What is a pre-existing medical condition?

A pre-existing condition is defined as any illness, injury or disease for which you've had symptoms, medication, advice, treatment or tests in the five years before taking out a policy. That's the definition most UK insurers use, though it can vary slightly between providers.

It's worth understanding the difference between two types of condition, as insurers treat them differently:

• Acute conditions are illnesses or injuries that can be treated and resolved – for instance, a broken bone, a chest infection or a kidney stone. Private health insurance is primarily designed to cover these: conditions that arise after your policy starts and can be treated to a conclusion.
• Chronic conditions are long-term health issues with no known cure that require ongoing management. Common examples include asthma, diabetes, arthritis, Crohn's disease and Alzheimer's disease. Chronic conditions are typically excluded from standard private health insurance policies, regardless of when they first developed.

That being said, there might be ways to get assistance with some chronic conditions, as we'll explain below.

Can I get health insurance with a pre-existing medical condition?

Yes – but the condition itself is likely to be excluded from your cover, at least initially. What private health insurance can still do is cover any new, unrelated acute conditions that develop after your policy starts. So even if – say – your asthma isn't covered, a new condition that emerges later could be.

The key is understanding how insurers assess your medical history before they offer you a policy. In the UK, there are two main approaches – and the one you choose is likely to have a significant impact on your cover and your premium.

What is moratorium underwriting?

With moratorium underwriting, you don't need to disclose your full medical history when you apply. Instead, the insurer automatically excludes any conditions you've had symptoms, treatment, medication or advice for in the five years before your policy starts.

The important detail here is the two-year rule: if you go two continuous years from your policy start date without any symptoms, treatment or medication for a previously excluded condition, the insurer might agree to cover it from that point onwards.

The pros and cons:

• Pros: Quick, straightforward application – no lengthy health questionnaire
• Cons: You won't know exactly what's covered until you claim, as your medical history is reviewed at that point rather than upfront

Moratorium underwriting tends to suit people with minor or older conditions that are unlikely to recur or those who want a simple application process.

What is full medical underwriting (FMU)?

With full medical underwriting, you complete a detailed health questionnaire at the application stage, and the insurer may request access to your GP records. In return, they give you a clear decision before the policy starts – typically a list of specific exclusions (for example, ‘no cover for the right knee’ or ‘cardiac conditions excluded’).

The pros and cons:

• Pros: Complete clarity from day one; no surprises at claim time. FMU could also result in lower premiums, as the insurer has a precise picture of the risk rather than applying broad exclusions
• Cons: Longer, more detailed application process; exclusions tend to be permanent rather than subject to review

FMU is generally the better option for people with a more complex medical history who want certainty about what they're covered for.

What about Medical History Disregarded (MHD)?

A third option exists, called Medical History Disregarded, where the insurer covers you regardless of any pre-existing conditions. However, this is generally only available through large corporate or group schemes arranged by employers – it's not something you can typically access as an individual buying a personal policy.

What if my pre-existing condition is permanently excluded?

Even if a specific condition is excluded from your policy, private health insurance still has real value. Your policy will cover any new acute conditions that develop after your start date. This means you're still protected against the unexpected.

It's also worth remembering the NHS safety net. The NHS will continue to provide ongoing management for chronic conditions and emergency treatment, and this is regardless of whether you have private cover. Many people use private insurance to complement NHS care, rather than replace it entirely.

There's also a middle-ground option worth knowing about: self-pay. Even without insurance cover for a particular condition, you can often pay privately for individual consultations or diagnostic tests. For example, you could choose to pay for an MRI scan. This can help speed up diagnosis or get a second opinion before returning to the NHS for ongoing treatment.

Tips for finding health insurance with a pre-existing condition

Our most important tip is to be honest about everything when you apply. If you fail to disclose a relevant condition when applying for health insurance – whether through moratorium or full medical underwriting – your insurer could refuse a claim or even cancel your policy entirely. And this applies even if the non-disclosure was accidental.

When in doubt, disclose. It's far better to have a condition listed as an exclusion than to find out at claim time that your policy is invalid.

Here are a few more tips for arranging care when you have a medical history to consider:

• Always compare policies. Different insurers might take different approaches to the same conditions. This is why you should compare a range of policies, as this should improve the chances of finding terms that work for you.
• Apply sooner rather than later. The older you get, the more likely you are to develop conditions that could affect your cover or increase your premium. Taking out a policy while you're in good health should mean fewer exclusions, and hopefully lower premiums.
• Review your cover regularly. If you took out a policy some time ago, it's worth checking whether conditions that were previously excluded might now qualify for cover. This is especially the case if you've been symptom-free for two years or more under a moratorium policy.

Want to know more? Read our health insurance guides for plenty of useful info and pointers.