Blog  |  April 17th, 2015

How pre-existing medical conditions affect Private Health Insurance

We often get asked questions around pre-existing medical conditions and the impact they might have on taking out a health insurance plan.  There is usually a lot of confusion around whether private medical insurance is even an option for those with pre-existing conditions and if so, will it be significantly more expensive?

Jim Livingstone from H3 Health Insurance answers some of the most common questions about pre-existing health conditions and insurance to provide clarity over some of the issues involved.

What is categorised as a chronic health condition?

This is generally categorised as an illness, injury or disease that requires ongoing treatment, including rehabilitation or training, to manage the symptoms. In most cases the condition will have no known cure and require long-term assessment.

What about pre-existing health conditions?

These are generally categorised as an illness, injury or disease that requires medication, advice or treatment in the five years building prior to you seeking a health insurance policy. This also includes any symptoms you may have experienced, regardless of whether the condition has been diagnosed.

Can you take out health insurance if you have a pre-existing condition?

Yes. When applying for cover with H3 you will complete a short medical questionnaire as part of the application itself and depending on your medical history we may apply temporary or permanent exclusions for certain conditions or parts of the body. However, you may still be eligible to take out the cover itself as the exclusions may be limited.

Can this condition ever be covered under your policy?

It depends on the nature of the condition. Generally, if there is a risk of the condition needing future treatment or specialist led care then it is likely to be excluded under the policy. However, it may be appropriate that a temporary exclusion is placed on the policy for a pre-determined time period. We may remove the exclusion if the member can provide medical evidence to confirm that they have been free of symptoms or treatment for that pre-determined time period.

Do pre-existing conditions make your policy a lot more expensive?

No. At H3 we do not increase costs based on pre-existing medical conditions. Instead we either temporarily or permanently exclude the condition.

What about chronic conditions?

Chronic conditions by their definition are often diagnosed as not having a recognised cure and are not covered under an H3 policy. If a member is diagnosed with a chronic condition AFTER their policy has started, then whilst we will not cover the general management of the chronic condition itself, we may cover acute flair ups of the condition which may need treatment or surgery.

What are the benefits of taking out private medical insurance?

While your pre-existing conditions may be excluded from your policy either temporarily or for the duration of your cover, there are benefits of having H3 Health Insurance for illnesses that are not associated with pre-existing conditions.

• Unique Private Casualty cover for minor injuries, i.e. sprains and fractures. Avoid busy A&E departments and be seen within minutes at the 5 star luxury surroundings of Kingsbridge Private Hospital, Belfast.
• No need to wait to be referred by your GP, we start progressing your claim right away, booking you appointments with the best specialists.
• Claims managed by our local team in Belfast.
• High speed access to consultants, tests and scans, therapies and surgery.

Get a quote for H3 Health Insurance or call us on 028 9046 9990

photo credit: Stethoscope and piggy Bank via photopin (license)