If you’ve ever explored private health insurance, you’ve likely come across the term “pre-existing condition.” It’s one of the most common sticking points for people considering cover – and understandably so.
Many assume that having a pre-existing condition means you won’t be accepted for private health insurance at all. But the reality is more nuanced.
The good news? You can often still get health insurance. The challenge is understanding how insurers handle pre-existing conditions, what options are available, and what limitations might apply.
In this guide, we’ll break it all down.
What Counts as a Pre-Existing Condition?
A pre-existing condition is any medical issue you’ve had symptoms of, received treatment for, or sought medical advice about before your health insurance policy begins.
This can include:
- Long-term conditions such as diabetes, asthma, or heart disease
- Previous injuries like back problems or joint issues
- Common issues such as high blood pressure, migraines, or anxiety
- Even seemingly minor or “historic” problems if they were recent enough to be recorded by your GP
Essentially, if it’s on your medical record, insurers are likely to take it into account when deciding your cover.
Why Insurers Exclude Pre-Existing Conditions
Private health insurance is designed to cover new and unexpected illnesses or injuries that occur after your policy starts.
If insurers were to cover all pre-existing conditions from day one, they would effectively be paying for medical problems that are already known to exist. This would push premiums up significantly across the board.
That’s why most insurers exclude pre-existing conditions—or impose a waiting period before they can be included.
Moratorium vs Full Medical Underwriting: What’s The Difference?
When you apply for health insurance, insurers use a process called underwriting to decide what’s covered. There are two main types:
1. Moratorium Underwriting
This is the most common option for individuals. Under a moratorium policy:
- You won’t have to submit your health records when you apply for the policy. If you need to claim, the insurer will look at your medical history and decide if it is covered or excluded if it was pre-existing.
- Any conditions you’ve had in the last 5 years are initially excluded.
- However, if you go for 2 continuous years (the moratorium period) without symptoms, medication, or treatment for that condition, it may then be re-included in your cover.
Example: If you had back pain in 2021 but make no claims, take no medication, and have no flare-ups for 2 years after your policy begins, you could regain cover for future back problems.
This option can work well if you’ve had conditions in the past but they’ve since resolved or stabilised.
2. Full Medical Underwriting (FMU)
With FMU, you provide a full medical history at the application stage. The insurer then confirms in writing which conditions will be excluded from cover.
- FMU gives more clarity upfront—you’ll know exactly what is and isn’t included.
- However, exclusions tend to be permanent, even if you go years without symptoms.
This route is often chosen by people who want certainty, or who have more complex medical histories.
For more information on underwriting and the different types, check out this blog next:
Will Health Insurance Cover Chronic Conditions?
It’s also important to understand the distinction between chronic and acute conditions:
- Chronic conditions (e.g. diabetes, asthma, arthritis) are long-term, ongoing conditions. These are almost always excluded from private medical insurance, as they require continuous management rather than short-term treatment. The NHS is also better set up to manage these conditions long term.
- Acute conditions (e.g. a broken leg, appendicitis, or cancer) are typically covered, as they require treatment with the aim of full recovery.
If you have a chronic condition, health insurance won’t usually cover ongoing treatment for it—but you’ll still be covered for new, unrelated acute conditions.
Are There Exceptions?
Some insurers may cover treatment for pre-existing conditions if:
- They’ve been resolved for several years (not just symptom-free, but considered “cured”).
- The condition was minor and has had no recurrence.
- You’ve had successful treatment and no further medical advice or medication was needed.
The rules vary significantly between providers, which is why it’s always worth checking before making assumptions.
Why Use A Broker For Health Insurance With Pre-Existing Conditions?
Health insurance is rarely a one-size-fits-all product. With pre-existing conditions in the mix, it becomes even more complex.
An independent broker can:
- Compare across insurers – Some are more flexible than others with certain conditions.
- Explain underwriting options – Moratorium vs FMU can have a big impact on what’s covered.
- Find the best value – Balancing affordability with the right level of cover.
- Handle negotiations – Brokers often know which insurers may be open to exceptions.
- Offer Innovative Solutions – For example, splitting up a family so members with pre-existing conditions are covered by a different insurer than the rest of the family to save money and maximise cover.
- Support you long-term – Helping at renewal time if premiums rise or your needs change.
At Lifepoint Healthcare, we see cases like this every day. No two clients are the same, and what works for one person may not suit another.
For more reasons to use a broker (perhaps we’re biased!), check out this blog next:
Final Thoughts
So, can you get health insurance with a pre-existing condition? Yes—but with limitations.
- Expect exclusions at least initially.
- Understand the difference between chronic and acute conditions.
- Be clear on the type of underwriting that works best for you.
Most importantly: don’t assume you’re ineligible. With the right advice, you may find a policy that offers far more protection than you thought possible.
At Lifepoint Healthcare, our advisers can walk you through the process, explain your options clearly, and find a policy that fits your health history and budget.
And the best part? Our service is completely free to you.
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