As an FCA-authorised expert insurance broker that has helped over 750,000 UK customers, WeCovr specialises in navigating the complexities of private medical insurance. This guide explains how we help individuals with pre-existing conditions find the best possible private health cover, a task where many others fall short.
Private medical insurance (PMI) offers a powerful alternative to long NHS waiting lists, providing prompt access to specialist consultations, diagnostic tests, and high-quality private treatment. However, for the millions of people in the UK with a pre-existing medical condition, securing a policy can feel like an impossible challenge.
The fundamental truth of the UK private health insurance market is that policies are designed to cover new, acute conditions that arise after your policy begins. They are not designed to cover pre-existing or chronic conditions.
This is where the expertise of a specialist PMI broker becomes invaluable. While the rules are firm, the application and underwriting process has nuances. WeCovr’s deep understanding of the market allows us to find pathways to comprehensive cover for our clients, even those with complex medical histories. We know which insurers take a more nuanced view of certain conditions and how to present your application to achieve the most favourable outcome.
Private health cover acts as a complementary service to the National Health Service (NHS). It is not a replacement. Its primary purpose is to bypass the waiting times for eligible, acute medical treatments, giving you choice, speed, and comfort when you need it most.
This is the core driver for the 4 million+ people in the UK who have some form of private medical cover (LaingBuisson, 2024).
What Private Medical Insurance Typically Covers:
What Private Medical Insurance Critically Excludes:
The key takeaway is that PMI is for unforeseen, curable health issues. The challenge, and where we excel, is in managing how insurers view your past health history when you apply.
The definition is crucial. An insurer will typically define a pre-existing condition as any disease, illness, or injury for which you have experienced:
This applies to a set period before your policy starts, usually the last five years, but this can vary.
Condition Category | Specific Examples |
---|---|
Musculoskeletal | Past knee or back pain, arthritis, sciatica, joint replacement, sports injuries. |
Cardiovascular | High blood pressure, high cholesterol, heart murmurs, angina. |
Mental Health | Anxiety, depression, stress, eating disorders, PTSD. |
Gastrointestinal | Irritable Bowel Syndrome (IBS), acid reflux (GORD), gallstones. |
Respiratory | Asthma, sleep apnoea. |
Dermatological | Eczema, psoriasis, acne. |
Major Illnesses | A history of cancer, stroke, or heart attack. |
It's vital to be honest and thorough. Non-disclosure of a past condition can invalidate your entire policy when you come to make a claim.
"Underwriting" is the process an insurer uses to assess your risk and decide the terms of your policy. For pre-existing conditions, this is the most critical stage. There are two primary methods in the UK.
This is the most common and straightforward method. You do not need to disclose your full medical history upfront.
This method requires a more detailed application process but provides complete clarity from day one.
Feature | Moratorium Underwriting | Full Medical Underwriting |
---|---|---|
Application Process | Fast and simple. No health forms. | Detailed health questionnaire. May need GP records. |
Initial Exclusions | Automatically excludes conditions from the last 5 years. | Exclusions are decided based on your specific history. |
Clarity of Cover | Ambiguous. You only know for sure at the point of a claim. | Crystal clear from day one. You receive a list of any exclusions. |
Future Cover | Pre-existing conditions can become eligible after 2 years symptom-free. | Exclusions are typically permanent. |
Best For... | People with minor past ailments who want a quick start. | People who want certainty, especially with a known medical history. |
A direct online application might lead to an automatic decline or overly broad exclusions if you have a medical history. This is because automated systems lack nuance. Our role as a specialist PMI broker is to be your expert advocate, navigating the system to find the best possible terms.
Here’s our proven approach:
In-Depth Personalised Assessment: We don't just ask for your name and date of birth. We take the time to understand your specific medical history, the nature of your past conditions, when you last had symptoms, and what treatment you received. This detail is crucial.
Unmatched Insurer Knowledge: We work with a wide panel of leading UK private medical insurance providers, including AXA Health, Bupa, Aviva, and Vitality. We have an in-depth, working knowledge of their underwriting philosophies.
Strategic Application Management: Based on your history, we recommend the best underwriting path. For some, a moratorium policy is the smartest choice. For others, FMU provides necessary peace of mind. We can even "pre-vet" your case with underwriters informally to gauge the likely outcome before a formal application is submitted, saving you time and preventing a formal decline on your record.
Negotiating on Your Behalf: For FMU applications, our relationship with underwriting teams allows us to provide context and clarification. We can help argue for a narrow, specific exclusion (e.g., "degenerative wear and tear in the right hip") rather than a blanket exclusion (e.g., "all hip-related conditions"). This ensures you have maximum cover for any new, unrelated issues.
By acting as your expert intermediary, WeCovr transforms a process fraught with uncertainty into a clear, strategic path towards the best private health cover available to you.
Theory is helpful, but real-world examples illustrate the value of expert guidance.
It is essential to be direct about this: standard UK private medical insurance does not cover the long-term management of chronic conditions.
A chronic condition is an illness that cannot be cured and requires ongoing monitoring and management, such as:
PMI's role is to diagnose a condition and provide initial treatment to stabilise it. For instance, if you develop symptoms that lead to a diagnosis of Crohn's disease, your PMI policy would cover the initial consultations and diagnostic tests. It might even cover the first stage of treatment to bring the flare-up under control. However, once the condition is diagnosed as chronic, long-term care, medication, and management will revert to the NHS.
While all insurers exclude pre-existing conditions, their flexibility and processes differ. A specialist broker can guide you to the one best suited to your history.
Provider | Typical Underwriting Approach | WeCovr's Expert Insight |
---|---|---|
AXA Health | Offers flexible Moratorium and Full Medical Underwriting (FMU) options. | Often highly pragmatic with minor or historic conditions on FMU applications. Their modular policies allow for precise customisation. |
Bupa | A market leader with robust and well-defined Moratorium and FMU processes. | Renowned for their comprehensive cancer care and extensive hospital network. Their underwriting is thorough but fair and transparent. |
Vitality | Provides both Moratorium and FMU, with a unique focus on wellness and rewards. | Can be favourable to applicants who demonstrate a healthy lifestyle. Their wellness programme may positively influence underwriting decisions for certain managed conditions. |
Aviva | A major player offering standard Moratorium and FMU across a wide range of policy options. | A great all-rounder with competitive pricing. Their underwriting criteria are clear and well-understood by our expert advisors, allowing us to predict outcomes with high accuracy. |
This table provides a general overview. The final decision always rests with the insurer's underwriting team and is based on individual circumstances.
We believe in providing holistic support to our clients. When you arrange a Private Medical Insurance or Life Insurance policy through WeCovr, you receive more than just expert advice.
Here are answers to some of the most common questions we receive.
Yes, it is often possible to get private health insurance after cancer. The underwriting approach is critical. Most insurers will require you to be cancer-free for a set period (typically 5 years) and will use Full Medical Underwriting (FMU) to apply a specific exclusion for cancer. This means you would be covered for new, unrelated conditions like heart issues or joint replacements, but not for a recurrence of the cancer. An expert broker can help navigate this sensitive application.
Not necessarily. With Moratorium underwriting, the condition is simply excluded, so it usually doesn't affect the premium. With Full Medical Underwriting, if the insurer agrees to cover the condition (which is rare) or sees you as a higher risk, they might apply a "premium loading" or increase the price. More commonly, they will exclude the condition at the standard premium, meaning you pay the same as someone without that condition but have a specific gap in your cover.
Failing to declare a known pre-existing condition on a Full Medical Underwriting application is known as "non-disclosure" and is a serious issue. If the insurer discovers this when you make a claim, they are within their rights to void your entire policy from the start and refuse to pay for your treatment. This would mean you lose all the premiums you have paid. Honesty and transparency are always the best policy.
Yes. If you have developed conditions while on your current policy, you can switch to a new provider using Continued Personal Medical Exclusions (CPME) underwriting. This ensures that conditions covered by your old policy continue to be covered by your new one. Any exclusions on your original policy will also be carried over. This is a specialist process where broker guidance is essential to ensure no loss of cover.
Navigating the world of private medical insurance with a pre-existing condition requires specialist knowledge and expert guidance. Don't risk a decline or an overly restrictive policy by going direct.
Let WeCovr be your expert advocate. Our advisors will assess your unique situation, compare the entire market, and find you the most comprehensive cover at the best possible price—at no cost to you.
Contact WeCovr today for a free, no-obligation quote and discover the private health insurance options you didn't think were possible.