Your medical history is personal. It can include everything from previous hospital stays and ongoing conditions to medication you’ve taken or treatment you received years ago.
So, when you take out health insurance and are asked questions about your health, you might wonder why your insurer needs to know all of this.
The simple answer? Your medical history can affect how your cover applies.
Being open and accurate about your health when applying for insurance helps your insurer assess your application correctly and can help prevent problems when you need to claim later.
Why do health insurers ask about your medical history?
When you apply for health insurance, you may be asked about previous illnesses, injuries, diagnoses, treatments, medication or hospital admissions.
This information helps the insurer understand the health risks that existed before your policy started and determine how the terms of your cover apply.
Depending on the policy and your circumstances, certain conditions may be subject to waiting periods, exclusions or other policy terms.
That doesn’t mean having a medical history automatically prevents you from getting health insurance. It means your insurer needs accurate information to assess your cover correctly.
What happens if you don’t disclose your medical history?
Leaving out important medical information when applying for health insurance can cause complications later, particularly when you submit a claim.
If information relevant to your application wasn’t disclosed, your insurer may investigate the circumstances and assess the claim according to the terms and conditions of your policy.
Depending on the circumstances and policy terms, non-disclosure or incorrect information could affect whether a claim is covered.
And that can become a serious problem if you’ve already received medical treatment and were expecting your insurance to cover eligible costs.
Understand your health insurance terms.
What should you tell your health insurer?
The safest approach is simple: answer the questions on your application fully and accurately.
This may include information about:
- Previous or existing medical conditions
- Operations or hospital admissions
- Ongoing or previous treatment
- Prescription medication
- Injuries
- Tests, investigations or diagnoses
- Symptoms or conditions you’ve received medical advice for
If you’re unsure whether something is relevant, rather ask than leave it out.
Your insurer can then determine whether it affects your cover.
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What about pre-existing conditions?
A pre-existing condition generally refers to a medical condition that existed before your health insurance cover began, subject to the definitions and terms of your specific policy.
This is one of the reasons providing an accurate medical history is so important.
Depending on your policy, a pre-existing condition may have specific waiting periods, exclusions or other conditions attached to it.
Make sure you understand these before your cover begins so you know what you can and cannot claim for.
Why do waiting periods exist?
Waiting periods are a standard feature of many insurance products.
A waiting period is a set amount of time after your policy starts during which certain benefits or conditions may not yet be covered.
They help insurers manage risk and prevent situations where someone only takes out insurance after discovering they need immediate medical treatment.
Your waiting periods will depend on your policy, so always check your policy documents rather than assuming you’re covered from day one.
Understand what exclusions and waiting periods are.
Here’s a simple example
Imagine you were previously diagnosed with high blood pressure and received treatment for it.
A few years later, you apply for health insurance.
If you’re asked about previous medical conditions, this is information you should disclose, even if you’re feeling healthy now or no longer taking the same medication.
If you later submit a claim relating to your cardiovascular health, your previous medical history could be relevant when the insurer assesses your claim.
Providing accurate information from the start means your insurer can apply the correct policy terms upfront rather than discovering important information only when a claim is submitted.
Honesty makes your cover clearer
Nobody wants uncertainty when they need medical care.
Being open about your medical history helps you understand how your health insurance will work before you need to use it.
Before taking out a policy:
- Answer all health questions accurately
- Ask if you’re unsure what needs to be disclosed
- Read your policy documents
- Check your waiting periods
- Understand any exclusions that apply to your cover
- Know how and when you can claim
It might not be the most exciting part of taking out health insurance, but it is an important one.
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Know your cover before you need it
At Oneplan, we believe understanding your cover should be simple.
Take the time to understand your policy, waiting periods, exclusions and benefits so you know what to expect when you need to claim.
And when you’re applying for Health Insurance, don’t leave your medical history to guesswork. Give accurate information, ask questions when you’re unsure and make sure you understand the cover you’re taking out.
Because when it comes to your health and your insurance, being upfront from the start can save a lot of confusion later.
Your health insurance family,
