I've been told I'll need minor surgery down the line (next year probably) but I've no

wherearewe45

So I got a sports injury a few months back and went for an MRI after a referral from my physio. She thinks it looks like I may need keyhole surgery but for the time being I am getting rehab on it and it has been improving (surgery may be needed before it's 100% but right now that's not a big deal).

I'm 27 and have always put off health insurance as I've seen myself as being young and healthy. Am I right in saying that if I got health insurance now, I would have to disclose my knee issue and then I wouldn't be covered n the event that I do eventually require surgery.

Sorry if this is an idiotic question - I'm a newbie to health insurance - and yes I know now I probably should have gotten insurance as soon as I was no longer covered under my parents.

thebiglad

You are correct, you would have to disclose any current medical issues and would be excluded from your policy for 5 years after you take it out - known as waiting period.

Anything else which is not related or pre-existing is covered.

MouseTail

As it is a preexisting injury/condition, there would be a waiting time before it is covered, with VHI for example its 5 years

wherearewe45

And as a follow up, not disclosing this in applying for insurance is insurance fraud ya?

thebiglad

If you did not declare it, yes its fraud but with Health Insurance more than any other policy they will see when you go for treatment that the condition pre-existed the policy date and was known (your medical records).

OP did not say he wouldn't declare, simply asking would it be covered.

Rocket19

Hi OP, it's not a case of "declaring" a pre-existing condition to the insurance company. There is no need to mention it to them upon purchasing a policy because it will not influence your premium in any way.

However, if you have treatment for your pre-existing condition, and a claim is submitted to your insurer, it is only at point of claim that it will come to light that the relevant waiting periods have not been served. When you have any hospital treatment, you and your treating consultant will have to complete the insurer's hospital claim form. This includes detailed information about the history of your condition and the duration of symptoms. It will ask whether the treatment is as a result of an injury, and when the injury occurred.

Even if you were to hypothetically lie on the claim form, I doubt your doctor would. If the insurer is unhappy/unsure about the details outlined in the form, they are entitled to seek further information by requesting your GP referral letter or your medical records of up to 5 years.

FYI, you will have to 26 weeks for any new conditions to be covered (anything that starts after taking out the policy), and 5 years for anything pre-existing. Accident/injuries where you seek immediate treatment should be covered straight away. Because you are young, try to have the insurer waive your initial (26 week) waiting period.