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We Have Plans That Can Include Some Pre-existing Medical Conditions
This could potentially lead to very wide ranging exclusions for a condition that seemed quite insignificant (see below for further information).
However, in the last 12 months or so, several plan providers have approached underwriting from a different angle. We now have plans that will look at your medical history and your pre-existing medical conditions and will try and include them in cover, albeit with a potential premium loading if they do.
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Until recently it was a fact that most private medical insurance plans would exclude pre-existing conditions from cover.Pre-existing Medical Conditions
Perhaps the most revolutionary aspect of medical insurance in the last 10 years, is pre-existing medical conditions.
In the past pre-existing medical conditions have been excluded from cover, along with all related conditions. This is true even if the condition was under control with medication. Therefore, for instance, someone suffering from high blood pressure, would find themselves faced with a whole host of exclusions on their policy, such as Angina, Aneurysm, Heart Attacks, Stroke, Thrombosis, Phlebitis etc. The potential cost of someone having to pay their own medical bills following a heart attack is astronomical. In more costly countries even the ambulance alone can be much as $1,500.00, with a heart bypass being as much as $140,000.00.
The only way of getting a pre-existing medical condition covered previously, was through a moratorium plan. This means that an insurer will accept someone immediately, without asking for any medical history but excluding any cover for pre-existing conditions. Then after a period of 2 years, providing no medication has been taken, no medical advice sought and no symptoms suffered in relation to the conditions, they will then become eligible for coverage.
Whilst this may be fine for older non-current conditions, anything that requires ongoing medications or check-ups will never become eligible for cover. High blood pressure is a very common condition which we see a lot. From a clients point of view their blood pressure is now normal as they take medication to bring it under control. Unfortunately, this is not how insurers view things. Even a cured condition which requires no medication, but maybe requires an annual check up just to make sure everything is still OK, would never become eligible for coverage. Clients need to be aware of this, as they will receive a certificate of insurance, not listing any specific exclusions, so may not realise there are any, until they come to claim by which point it’s too late.
The industry as a whole has always had this same tunnel vision approach. However, who is the safer risk – someone with diagnosed blood pressure who now has this under control with medication or someone with undiagnosed high blood pressure, unaware, but all the time putting more strain on their heart? With the demand from customers growing, the insurers needed to take action.
We are now delighted to work together with a handful of insurers who will seek to cover pre-existing conditions and all related conditions, from day one. They will ask for medical history upfront and a medical professional will assess all the details given. We have already seen conditions like high blood pressure/cholesterol, diabetes, previous cancers, allergies, asthma etc covered. There may be an additional premium percentage added by the insurers for this. This loading can sometimes be reviewed in the future, with a view to reducing or removing it. There is nothing stopping a customer applying to more than one insurer to see who offers the better terms.
Through experience, we know which insurers may decline cover for certain conditions and would therefore not waste the customers time by applying to them. We are also sometimes able to get percentages reduced in certain circumstances. This is where the help of a broker becomes invaluable. We are here to work with our customers to find the best plan for their needs.
We are not paid by commission, so we have absolutely no benefit of recommending one plan over another. Therefore we can truly work on behalf of our customers.
Erika Glew
International Sales Adviser