The level of cover that you receive from your health insurance policy depends upon what level of cover you choose, and how much you are prepared to pay. A basic policy will cover the cost of the majority of in-patient treatments, including surgery and tests, and day-care surgery, whilst other, more expensive policies will pay for out-patient visits to see consultants, and may pay you a small amount for each night you have to stay in hospital.
If you apply for a health insurance policy you will most probably discover that any health conditions you have suffered in the past will affect your application. Some prior illnesses will have a temporary effect on your policy, whilst others could be permanent. In general, the majority of insurance providers exclude cover for both chronic and pre-existing conditions. This actually serves a quite useful purpose as it ensures that premiums are kept to a minimum; if all pre-existing conditions were covered then there would be far more claims submitted by customers thus making health insurance much more costly.
The definition of a chronic condition is one that requires continuous or long-term treatment to manage the symptoms, and has no known cure. A chronic condition will continue indefinitely, is likely to return and requires that you are trained in some way to manage the effects of the illness. You are expected to require regular monitoring via consultations, examinations and tests.
A pre-existing condition, on the other hand, is one for which you have received treatment in the form of advice and/or medication at some point during the past five years prior to applying for health insurance, or one for which you have experienced symptoms, even if the disease has not been formally diagnosed.
Some health insurance policies are underwritten on a moratorium basis, which technically means a temporary prohibition of an activity. In the case of health insurance it means that any medical condition that took place at some point during the five years prior to taking out the policy will be excluded for the first two years that the policy is in place. Any cover that is excluded by the moratorium could be later reinstated if the medical condition does not reoccur for a continuous period of two years since the date that it was treated last.
It can be confusing when you are looking to take out a life insurance policy if you do suffer from any pre-existing medical conditions, and a common question is whether a pre-existing condition results in health insurance becoming more expensive. In general, the answer is ‘no’ as most insurers simply exclude the condition, on a permanent or temporary basis, rather that include it and increase your premiums.
Having a pre-existing medical condition does not necessarily mean that you are unable to take out health insurance. When you submit your initial application you will be asked to complete a detailed medical questionnaire. Your insurer will use the information you provide in this questionnaire to put together a picture of your medical history and, depending on the results, they will decide whether any exclusions will be applied to your policy, either temporary or permanent, for certain areas of your body, or certain medical conditions.
If your insurance provider decides to impose a temporary restriction due to an existing medical condition it could be included in the policy at a later date. In general, if the condition you have is likely to require specialist care or future treatment it is likely to be excluded from your policy on a permanent basis. However, exclusions can be made on a temporary basis for a set period of time. If, during this pre-determined time, you are able to provide evidence from a registered practitioner that you have been entirely free of symptoms then the insurer may agree to remove the exclusion.
Chronic conditions are defined as having no recognised cure and are not covered by most insurance policies. But what happens if you are diagnosed with a chronic condition after you take out your health insurance policy? Well, the majority of policies will not cover the day-to-day management of the condition, but they may pay out if you experience acute episodes of the condition which require treatment, including surgery.
Although the majority of private health insurance policies do not cover pre-existing conditions they still offer consumers a number of benefits. Some offer private casualty insurance for minor injuries, including fractures and sprains, giving you the benefit of avoiding long waits in busy Accident and Emergency Departments, and being treated within the, often luxurious settings, of a private hospital. In addition, you do not need to be referred by your GP to a specialist, which can often be a long and frustrating process, your claim will be looked at immediately and an appointment will be made with appropriate specialists in the field. Private health insurance ensures that you get speedy access to consultants, and that you receive any tests, scans, therapies and surgery, if you need it, as soon as possible. This can go a long way to alleviating many of the stresses and anxieties that come hand in hand with an episode of ill health, allowing you to recover more quickly, and giving your friends and family extra peace of mind.