Understanding Pre-Existing Conditions and Health Insurance

By Lifepoint Healthcare

When clients come to us looking to take out health insurance for the first time, one of the most common concerns we hear is: “Will my pre-existing condition affect my cover?” If you’re in the same boat, you’re not alone. Pre-existing conditions can seem like a confusing hurdle — but with the right advice, they don’t have to be a barrier to getting the protection you need.

In this blog, we’ll walk you through:

What counts as a pre-existing condition
How insurers treat them
Your options if you have a pre-existing condition
Tips for finding the right policy

Let’s get started!

What is a Pre-Existing Condition?

In simple terms, a pre-existing condition is any medical issue you had symptoms of, received treatment for, or sought advice about before taking out your health insurance policy.

Different insurers may define the exact timeframe slightly differently, but most commonly, they’ll ask about conditions in the past five years.
Common examples include:

Asthma
Diabetes
High blood pressure
Mental health conditions like anxiety or depression
Back pain
Heart conditions
Cancer

Even if the condition is well managed, or hasn’t caused problems for a while, it’s still considered pre-existing if it falls within the specified period.

How Do Pre-Existing Conditions Affect Health Insurance?

The way a pre-existing condition affects your health insurance largely depends on how insurers underwrite your policy.

In the UK, there are two main types of underwriting for private medical insurance:

1. Moratorium Underwriting

This is one of the most common options, especially if you want a quick and easy application process.

You don’t have to declare your full medical history upfront.
Instead, if you need to claim, the insurer checks your medical history at that point.
Conditions you had treatment, symptoms, or advice for in the five years before the policy starts are excluded automatically.
If you go two consecutive years without any symptoms, treatment, or advice for that condition after the policy begins, it may become covered again. This time period depends on the insurer.

Good to know:

If your pre-existing condition is mild, stable, and not chronic, and you don’t seek any treatment or advice for two years, you could potentially have it covered in the future.

2. Full Medical Underwriting (FMU)

This is a more thorough process.

You complete a full medical questionnaire when you apply.
The insurer assesses your entire health history and decides exactly what will and won’t be covered.
They may exclude specific conditions permanently, offer cover with certain limitations, or (less commonly) offer full cover.

Good to know:
If you prefer certainty about what’s covered right from the start, full medical underwriting might be the better choice.

3. Medical History Disregarded (MHD)

Medical History Disregarded (MHD) underwriting is the least common type of underwriting and is only applicable to company policies. There is a minimum membership number required to set up an MHD scheme.

It allows for pre-existing conditions to be covered without medical exclusions, but it is still subject to the terms and conditions of the policy. As a result of this, it is usually more expensive than FMU and moratorium underwriting.

In A Nutshell:

MHD covers most pre-existing conditions but is more expensive and only accessible to those on larger company schemes.

If you want to learn more about the different types of underwriting, read this blog next!

What About Chronic Conditions?

A chronic condition is an illness that cannot be cured but can usually be managed with ongoing treatment — like diabetes, arthritis, or hypertension.

Almost all UK health insurance policies exclude cover for the ongoing management of chronic conditions.
This means they won’t pay for:

Routine check-ups
Regular medication
Monitoring or maintenance treatment

However, your policy may cover acute flare-ups of a chronic condition — for example, a hospital stay due to an asthma attack — depending on the insurer and the policy wording.

For the majority of chronic conditions, most of the treatment will be down to the NHS, who are better equipped to deal with patients over a number of years. To read more about how the NHS and private healthcare work together, click HERE.

Can You Get Health Insurance If You Have a Pre-Existing Condition?

Yes, absolutely — but there are some things to be aware of.

You can still take out a policy even if you have one or several pre-existing conditions. However:

The insurer might place exclusions on your policy for those conditions.
You may not be able to claim for treatment related to your specific condition immediately (or at all, depending on underwriting).
You may still benefit from cover for other, unrelated health issues.

For example:
If you have a history of back pain, the insurer might exclude treatment for any musculoskeletal issues.

But you would still be fully covered for unrelated issues, like cancer care, heart treatment, or private GP appointments.

Tips for Getting Health Insurance with Pre-Existing Conditions

Here’s how to put yourself in the best position:

1. Be Honest on Your Application

It’s crucial to disclose your medical history truthfully when asked — even if it feels tempting to leave something out.
Failure to disclose any relevant information can lead to a rejected claim later, which no one wants when they’re unwell. It’s better to include more information than less, so if you’re not sure – include it!

2. Work with a Specialist Health Insurance Broker

A good broker (like us!) can:

Help you understand how different insurers approach pre-existing conditions
Recommend insurers who are more lenient with particular conditions
Talk you through underwriting options
Negotiate the best terms for your situation

Every insurer has slightly different rules, and we know which ones are more understanding about specific issues.

3. Consider Moratorium Underwriting

If your condition is well managed and you haven’t needed treatment recently, moratorium underwriting could be a strategic choice — you may eventually have that condition re-covered if you remain symptom-free.

4. Understand What’s Excluded

Make sure you know exactly what is and isn’t covered under your policy. Ask your broker or insurer to explain any exclusions clearly.

5. Review Your Policy Regularly

Your health situation can change — and so can insurance options.
Set a reminder to review your cover each year to make sure it’s still the best fit for you.

The Bigger Picture: Why Health Insurance Is Still Valuable

Even if your pre-existing condition is excluded, health insurance can still be hugely valuable. It can provide:

Faster access to specialists and diagnostics
Private hospital care
Mental health support
Cancer cover
Physiotherapy and rehabilitation services
24/7 GP services (included in many modern policies)

Think of it as an investment in your future health — and peace of mind that, whatever happens next, you’ll have support in place.

And if you do have a pre-existing or chronic condition – you’ll know better than most how valuable good health is.

Conclusion

Pre-existing conditions can affect your health insurance cover, but they don’t have to stand in the way of getting the protection you deserve.

With the right advice, clear information, and a well-chosen policy, you can still enjoy many of the key benefits of private health insurance — quicker care, greater choice, and more control over your healthcare journey.

If you’re unsure where to start, we’re here to help.
As experienced health insurance brokers, we’ll listen to your situation, explain your options clearly, and guide you to a policy that fits your needs — now and in the future.

Get in touch with us today to chat about your options.