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Health insurance can often be something of a minefield and one area in which it is particularly confusing is cover for pre-existing condition. What is a pre-existing condition? Why do most insurers not cover them?
It is estimated that around half of all people who are looking for a medical insurance policy have a pre-existing condition. Some of these are conditions that are relatively minor and do not impact at all on daily life now, but for others there are serious health conditions that should be taken into consideration such as a heart condition. This usually means ongoing treatment.
In recent years there has been an increase in the number of people who have a pre-existing condition and who want to obtain health insurance. Developments in medical science mean that more people are now able to manage serious conditions and live with them for a number of years quite easily. However, this does still create a problem for insurance companies as it means that insuring people with a pre-existing condition could be more costly.
This can be a worry for those who have had health issues in the past but it does not mean that there will be a problem getting health insurance. A growing number of insurers are now able to offer policies that suit those who have ongoing health concerns, partly because more and more conditions can be easily managed.
Pre-existing condition
A condition that an insurer will categorize a condition as pre-existing if you have already undergone treatment for it or you are already showing the symptoms. You need to be aware that a health issue can be considered to be pre-existing even if you do not have a formal diagnosis at the time of applying for the health insurance. A simple injury like a torn ligament or a respiratory problem such as asthma should be declared as a pre-existing condition. Insurers are reluctant to offer insurance knowing that claims are definitely going to be made against the policy but at the same time there is a growing awareness that policy holders are going to need help with these problems more than any others.
What will the insurer do?
The first step for the insurer is to look at the medical records of the client and possibly have a health check carried out. This will accurately assess the situation and then the insurer has a number of options:
- They may choose to offer an insurance policy that includes the pre-existing conditions. This option doesn’t have any exclusions or premium loading.
- A policy might be offered that covers the pre-existing conditions but includes premium loading.
- Cover could be offered but there may be an exclusion period applied to the policy.
- Cover could be limited to conditions that are not considered to be pre-existing.
- Health cover could be denied. However it should be noted that this only happens in rare cases and would normally only be applied to those who have a lot of health problems and could prove to be expensive to insure.
It used to be standard practice for insurance companies to refuse any type of cover for a pre-existing condition. The reason for this is that they knew that they would have to make a payment at some point.
Exclusion plans
Exclusion plans have become commonplace in the health insurance industry. You can then get cover for any health condition that you have not suffered from before. If you are offered an exclusion plan you need to check if it also excludes any related conditions. For example, a person who suffers from high blood pressure might find that they are not able to get cover for a condition like high levels of cholesterol as the two can be connected. So if you are diagnosed with a connected condition while you are living and working abroad you will need to make sure that you have the funds to cover the cost of treatment yourself.
Another issue is that as we get older we are more likely to develop conditions that are linked to lifestyle. We are also more likely to develop chronic conditions. For this reason the earlier you put your health insurance into place the better as you have more chance of getting full cover. Insurers could deny full coverage if you wait unnecessarily, but this is slowly changing as insurers change their processes to meet current demand.
Common conditions including asthma are now more likely to be covered by insurers but it is worth doing a little research in advance before you purchase a policy. If you are in any doubt ask your advisor about the type of conditions that might be excluded. For conditions such as diabetes, heart conditions and some types of cancer there could be limited cover on offer but the insurer will assess each applicant individually and will offer cover accordingly. It may be that they want to know when your last ‘episode’ with the condition took place or what treatment you are undergoing at the moment. It is also common for an assessment to be carried out on general health and lifestyle to determine if this will have a detrimental effect on the condition.
At Health Asia there is a team of advisors on hand to guide you through the process of finding the right health insurance policy for you and we are no strangers to sorting out the issues that surround pre-existing conditions. We work with a variety of insurance providers so we know that we have a wide range of policies to offer and that there is a policy out there to suit everyone! To find out more pick up the phone and speak to a member of the Health Asia team.
