Yes, you can almost always get private health insurance with a pre-existing condition; what varies is whether that particular condition is covered. Under a moratorium an excluded condition can become eligible for cover again after two trouble-free years, under full medical underwriting exclusions are fixed and known from the start, and company schemes can sometimes cover pre-existing conditions entirely through medical history disregarded underwriting.
A pre-existing condition is anything you have had symptoms of, or received treatment, medication or advice for, before your policy started. Having one does not keep you out of the market. What it does is determine the terms you are offered, and those terms differ far more between routes than most people realise.
Route one: moratorium underwriting
The standard individual route. Conditions from the five years before you join are excluded, but not necessarily forever: go two continuous years on the policy without treatment, medication, advice or symptoms for a condition, and it can become eligible for cover again. For something genuinely behind you, a resolved injury, a one-off episode, the moratorium can quietly restore full cover. For a condition needing ongoing medication or monitoring, the two year clock never completes, and the exclusion effectively stands. The mechanics, and the traps, are set out in our guide to moratorium versus full medical underwriting.
Route two: full medical underwriting
You declare your history and the insurer issues the policy with named exclusions. The advantage is certainty: you know on day one exactly where you stand, and a resolved condition may attract no exclusion at all. Some insurers will review an exclusion after a few clear years on request. The obligation on you is accuracy: under the Consumer Insurance (Disclosure and Representations) Act 2012 you must take reasonable care answering the questions, and careless answers can undermine the whole policy.
Route three: a company scheme, possibly with no exclusions at all
This is the route people with significant medical history are rarely told about. Company paid schemes can be set up on medical history disregarded terms, under which pre-existing conditions are simply covered, with no look back at anyone's history. MHD is typically available on schemes from around 20 to 25 employees upwards, though thresholds vary by insurer and smaller companies can sometimes negotiate it. Cover can also follow you out: some insurers will cover pre-existing conditions when you join them directly from a company scheme held on MHD terms. If you run a business, the company route can change what is coverable, and it changes the tax treatment too, so it needs setting up with both eyes open.
Switching insurer when you already have a condition
Having a pre-existing condition does not tie you to your current insurer, but it does change how a move has to be done. Insurers offer switch terms for people coming from another policy: continued moratorium if you are on a moratorium now, and continued personal medical exclusions (some insurers call it continued medical exclusions) if you were fully underwritten. On a proper switch the new insurer takes over your existing underwriting position rather than starting a fresh look-back, so a condition that has already completed its two trouble-free years can stay covered, and exclusions you were given at the start carry across as they are.
Three things to know before you move. First, switch terms are offered at the insurer's discretion, and after you complete its switch declaration it can add exclusions of its own, so the move has to be checked against your actual history rather than assumed. Second, the basis has to match: continued moratorium only follows a moratorium, and continued exclusions only follow full underwriting. Third, the clock on a moratorium condition carries over only if there has been no gap in cover, which is why a policy should never be cancelled before the replacement has started. A condition you have been treated for in the last two years will usually remain excluded with the new insurer exactly as it was with the old one; switching does not reset it in your favour, and done badly it can reset it against you. Our guide to switching without losing cover goes through the mechanics step by step.
What excluded actually means, and what it does not
An exclusion applies to the condition and conditions related to it, not to you. Someone with excluded type 2 diabetes is still fully covered for a knee injury, a hernia or cancer, on the policy's normal terms. Note too that chronic conditions sit behind a separate rule: even where a condition is not excluded as pre-existing, policies cover acute treatment rather than long-term management, which our guide to what PMI does not cover explains.
Practical points that change outcomes
- Insurers underwrite differently. The same history can produce a broad exclusion at one insurer and a narrow or time limited one at another. This is where advice earns its keep: we know how each of the insurers we work with tends to treat particular histories, and we place accordingly.
- Never lapse cover to shop around. A gap in cover resets the clock, and everything since you first joined becomes pre-existing again. Moves between insurers should preserve your underwriting through switch terms, as covered in our switching guide.
- Disclose fully and accurately. Non-disclosure is one of the most avoidable causes of claims problems, and cover arranged on accurate answers puts you in the strongest position at claim time.
- If one insurer declines, the market has not. Appetite varies, and a declined or heavily rated application with one provider is frequently placeable with another.
A worked example
Consider someone who had a knee arthroscopy in 2023 and takes a daily tablet for blood pressure. On a moratorium starting today, both are initially excluded. The knee, if it needs nothing further, becomes covered again after two trouble-free years on the policy; the blood pressure, because the medication is ongoing, stays excluded indefinitely, along with conditions related to it. On full medical underwriting, one insurer might exclude the knee for two years and hypertension outright, another might exclude only hypertension and related cardiovascular conditions, and an insurer comfortable with well controlled, GP managed blood pressure might apply no exclusion at all. Through a company scheme on medical history disregarded terms, both could simply be covered, where the scheme qualifies for those terms. Same person, three materially different outcomes, which is the point: the structure you buy through matters as much as the policy you buy.
This guide is general information rather than advice. Pre-existing conditions are the single area where the right structure, individual or company, moratorium or full medical underwriting or MHD, makes the largest difference, and finding that structure for your situation is a conversation we have every day.