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Pre-existing Medical Conditions:  Help me find health insurance

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Pre-existing medical conditions on health insurance is probably the largest area of discussion for health insurance companies and will probably be debated for years and decades to come.

Let's face it, insurance companies generally don't want to cover pre-existing medical conditions whereas their customers do want them covered.  The reason for both parties is the same; and that is that a pre-existing medical condition is more likely to be claimed for so the claim ratio is higher, and the management of them is more costly so the claim value is higher.

Within health insurance, you are going to find four different kinds of policy.  These include:

Medical History Disregarded (MHD)

These are medical plans where the insurer will accept pre-existing medical conditions subject to the standard terms and as the title says, they will generally disregard an insured's previous medical history when making a claim.  Within the concept of health insurance, this type of medical cover is the most open and customer friendly as it will allow most pre-existing if not all medical conditions through.

With this type of medical plan being so generous with the cover, the health insurance company will want something in return and that expectation will be a financial value and a risk transfer.  Therefore, MHD policies are usually only made available to larger corporate groups of say 30 employees or more.

Full Medical Underwriting (FMU)

Fully underwritten medical plans mean that each individual pre-existing medical condition is identified and analysed on its own basis and the health insurance underwriter makes a judgement on the potential financial risk that the medical condition will pose to the insurer.

Once an analysis has taken place, the insurer will either cover the condition with a loading, cover the condition at the standard price, exclude cover for claims relating to the pre-existing medical condition or even exclude the potential insured person from any cover with the health insurance company.

Moratorium

Moratorium health insurance plans mean that pre-existing medical conditions will not be covered unless certain standard terms can be met usually set within a period of time.  An example of a moratorium clause is that claims for conditions that you have not suffered the syptoms of, received treatment or medication for or sought medical advice in a two year period after inception of the policy will be eligible for payment.

If you are taking a health insurance policy with a moratorium clause, you must be careful as this type of medical coverage can be confusing and is oftened not explained well by insurance advisors and brokers.

Pre-existing exclusions

Pre-existing exclusion policies are simple to understand and state that you will not be covered for any claim directly or indirectly relating to a pre-existing medical condition.  This within the medical coverage is a blanket exclusion and will not allow you to ever receive medical insurance coverage for those conditions.

Conclusion

A Health insurance company's position on pre-existing medical conditions is one of the most important elements of the cover to understand.  If you have a condition here is the best advice:  Get written confirmation from the health insurance company directly on how they will treat your medical condition.

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