What is a Pre-Existing Health Condition?

When we apply for health insurance and private healthcare, we are asked to declare any pre-existing health conditions. This is because most private health insurance, whether independently sourced, found via a health insurance broker or through a company health scheme when you start a new job, will typically only cover new conditions should they arise.

A pre-existing condition however, is a condition that existed prior to applying for health or life insurance.

It is crucial to understand what a pre-existing health condition is and how it can broadly be defined as people with pre-existing conditions may otherwise find themselves caught out and left without health cover when it comes to health insurance schemes.

Some health insurance companies can help with pre-existing conditions, which need to be added to the insurance policy specifically, but understanding hat these conditions are and why they matter is important from the outset when exploring healthcare options.

What Is Classified As A Pre-Existing Condition?

A pre-existing condition is classified and generally defined as any medical condition; mental or physical, where you have had symptoms, had an appointment with a medical professional, or received treatment.

This includes acute and chronic illnesses such as cardiovascular disease, dental problems, kidney diseases, diabetes, psychological conditions (such as anxiety or depression) and any treatments you had prior to applying for insurance due to accidents or incidents.

Psychological conditions are only considered pre-existing, if you have sought and received clinical treatment for the condition in question.

Otherwise, pre-existing conditions are those seen on your medical history, both with regards to NHS treatments and private care. This includes acne, asthma, eczema, and hypertension. Usually up to five years of medical history can be investigated, though it depends on the scheme as some can extend this to seven years.

Pre-Existing Conditions in Dentistry

If you apply for private dental insurance, the same idea applies. The insurance will only cover new conditions, not anything you have had in the last five years, or for which are receiving ongoing treatment.

These you must pay for yourself. Therefore, it is essential that you apply for health and dental insurance as early as possible and certainly before any problems occur. If you think you will need private dental treatment in the future, it is generally recommended to apply for the insurance policy as soon as you can.

Why Do Health Insurance Companies Need My Medical History?

The role of insurance, both in terms of health insurance and others is to protect an individual or a company from future damages and to provide cover and compensation for this potential eventuality.

You pay into the ‘insurance pot’ in the immediate term to cover future conditions in the medium to longer term (or even in the short term). When you apply for health or life insurance, a team of specialised insurance underwriters will evaluate your case and decide on whether or not to provide you with insurance.

Underwriters will analyse how high a financial risk you are to insure and they will also look at your lifestyle based on your past medical history, job and current health and the level and type of insurance you require.

A higher-risk individual for an insurer will be someone with many past medical treatments, poor current health and a regular and heavy drinker and smoker, as with these factors, they are deemed a higher risk and more likely to require medical assistance.

These individuals will pay a higher rate for insurance and their insurance premium will be more expensive, as the insurer will have to cover the risk of financial costs of any future treatments.

Do I Have to Declare Pre-Existing Medical Conditions?

Failing to declare a full medical history, including any pre-existing conditions can invalidate your entire health and life insurance policies. Therefore, it is crucial to go through and reasonably disclose your medical records honestly and thoroughly at all times.

Every individual who applies for insurance is examined on a case-by-case basis due to the fact that no person is the same and this is what the underwriters will be assessing when you apply.

Each and every insurance policy will have its own specific clauses and conditions, which you as the applicant must investigate and decide whether or not it best suits your needs.

If you anticipate you will need medical, dental treatment or psychological treatment in the future privately, outside the NHS, it is important you apply for insurance prior to this, so the condition will not be considered pre-existing.

This can also be the case with new-borns and very young children who, because of their very young age will be less likely to have needed any treatment and will be less likely to have any underlying or pre-existing health conditions to consider.

How Do I Get Cover for Pre-Existing Conditions?

Each country will have its own insurance scheme for private health, dental and medical insurance. When you take out insurance cover for your health, you must look thoroughly at the clauses as well as the terms and conditions of the policy.

It is likely that the basic policy of most insurance providers will not cover pre-existing conditions, but that you will need to pay more for each condition you declare. Some policies let you pay extra to cover chronic conditions.

When applying for private health insurance, a sensible idea is to look first at your medical history and work out what level of insurance cover you are likely to need.

If you are young, never go to the doctor are healthy and fit with a great lifestyle and diet and have no medical conditions to declare, you may be able to acquire very basic insurance underwriting, and so will pay a lower premium.

As you age, your premium may increase as it is statistically more likely you will have worse health and more chronic, pre-existing conditions.

Price comparison websites for insurance are very useful, but it is important you disclose your full history to each insurer, to ensure you make a fair comparison.

Health insurance brokers will look at your health and financial situation and do the comparisons of various health insurance providers for you, to find the cheapest, most comprehensive and most suitable policy for your circumstances and potential health needs. They do the research to ensure you are properly covered when the time for treatment comes.

How Can GlobMed Help?

Some people are deterred from private healthcare because of the potentially high costs. However, with the NHS budget decreasing, long NHS waiting lists and increased dental costs, it may be the only option for high-quality, time-suitable care for many people.

Some treatments, such as white fillings by dentists, are also excluded from NHS services and thus, private healthcare is the only way to get this service.

Additionally, not all local NHS services have treatment available for certain conditions (such as specialised inpatient facilities, eating disorders or Alzheimer’s care) and so, private health options may be the only way to get some treatments locally.

At GlobMed, we recognise the demand for more tailored healthcare, and we work hard to find these services for our clients.

At GlobMed, we are looking to build partnerships with finance and insurance companies that can provide our clients with access to tailor-made solutions, designed to help you cover the costs of treatment without a high cost to you. We work hard to provide our clients access to the best healthcare worldwide, delivering healthcare where it is done best.