You have pre-existing conditions… What are your options?
Let’s face it… most people have pre-existing health conditions. How this would impact your future health insurance coverage is often a source of anxiety for many people.
In the following article, we’re going to take a deep dive into what exactly pre-existing health conditions are, and how you should approach getting the best possible plan set up for your requirements.
Definition of Pre-Existing Health Conditions
The below definition is from one of our insurance partners. In our opinion it best summarises how insurance companies treat and define pre-existing health conditions.
Pre-existing – any medical condition or related medical condition which has one or more of the following characteristics:
- clearly showed itself;
- you had signs or symptoms of;
- you asked for advice about;
- you received treatment for;
- to the best of your knowledge, you were aware you had.
Perhaps the key takeaway here is that you do not need to have had a diagnosis for something to be classed as pre-existing. Having symptoms is enough.
Why we need to know what your health issues are..
As an intermediary, our job is to understand your requirements and propose options which are going to meet those requirements
Transparency is key. The more we know, the better we can guide you.
Solutions available to you will depend on the specific health issues you have.
Whilst we will not underwrite your plan, we have experience of which insurers are likely to give you the best offer.
How insurance companies know about your conditions
People often wonder how exactly a health insurance company is going to find out about their pre-existing conditions?
The answer is that there are predominantly 3 routes:
Rely on your Declaration
People applying for health insurance have a legal obligation to make a full and transparent declaration. Providing the insurer with the material facts they need to make an underwriting decision is vital.
We took a deep dive into the importance of an honest declaration in a previous post.
Check your medical records
Insurers will check your medical records. This can be before the inception of the policy or it can be during the policy when claims come around.
Thailand’s PDPA laws can make this process drawn out, with record owners now needing to provide their explicit permission for hospitals to release these records to your insurer.
Ask the treating Doctor
Insurance companies will often communicate with your treating Doctor. They may ask the Doctor for their opinion on whether the condition you have is a new condition or if it is a pre-existing condition.
Coverage Routes for those with Pre-Existing Conditions
So you have pre-existing health issues. What next? What can you expect from a health insurance company?
Decline to offer
Certain medical profiles will result in an insurer not offering to cover you. They will simply decline to offer any coverage.
This can be down to:
- A specific health condition.
- A combination of health issues.
Accepted with Exclusions
This is the most common outcome here in Thailand.
You are accepted onto coverage, but specified pre-existing issues are excluded from coverage.
Loading to cover
An insurer may offer to cover certain pre-existing conditions, in return for an increase in premium (loading).
Moratoriums
These plans can offer future coverage for pre-existing health issues if they resolve.
Such options are useful for people who have had acute health issues which have since resolved and they want future coverage for.
Moratorium plans are not a solution for chronic health conditions as you will never leave the moratorium period and therefore will never be covered for those specific pre-existing health issues.
An example:
Pre-existing medical conditions or related medical conditions may be covered after you have had 24 months’ continuous cover under the plan and within that time you have not:
• experienced symptoms;
• asked for advice; or
• needed or received treatment, medication or a special diet.
Where next?
A quality intermediary or health insurance broker is worth it’s weight in gold when it comes to pre-existing health conditions. They can guide you through the process using their extensive market knowledge.
Some FAQ’s
Here are some common questions we see coming up with regards to pre-existing health conditions
