Should I delay buying health insurance

DubLad69

Hi guys,

We are looking to buy health insurance after a long enough stint without any. The only problem is the waiting periods.

I know that preexisting conditions aren't covered if they were present at any stage in the 6 months prior to purchase. My question is, if I had an issue 2 months ago that I would like to be covered should it occur again, should I wait an extra 4 months to buy the insurance? Or will I be covered if I have the insurance and don't have the issue for 6 months but it develops again in 9 months time?

Also, what exactly isn't covered as a pre existing condition? Say for example you had a toe chopped off, it's a pretty existing condition now, but If a while later rate missing toe caused you to develop some problem with your foot, would that be pre existing? (I don't have a missing toe, I'm just curious)

DubLad69

DubLad69 wrote: »

Hi guys,

We are looking to buy health insurance after a long enough stint without any. The only problem is the waiting periods.

I know that preexisting conditions aren't covered if they were present at any stage in the 6 months prior to purchase. My question is, if I had an issue 2 months ago that I would like to be covered should it occur again, should I wait an extra 4 months to buy the insurance? Or will I be covered if I have the insurance and don't have the issue for 6 months but it develops again in 9 months time?

Also, what exactly isn't covered as a pre existing condition? Say for example you had a toe chopped off, it's a pretty existing condition now, but If a while later rate missing toe caused you to develop some problem with your foot, would that be pre existing? (I don't have a missing toe, I'm just curious)

When you take out insurance for the first time or after a gap of more than 13 weeks you will not be covered for "new" conditions for a period of six months. If you ask nicely the insurer will waive this waiting period, especially so if you are under 45.

You will not be covered for a "pre-existing" condition for a period of 5 years. Pre-existing is usually defined by insurers based on medical evidence such as an estimated date of onset provided by your consultant.

In your example of something that happened 2 months ago happening again, this entirely depends on the nature of the illness. If it is an ongoing condition you will not be covered for 5 years. I will use diverticulitis as an example. You were hospitalized two months ago, recovered well and it flares up again next year. This is a pre-existing condition. If the incident two months ago was of a "one-off" nature, and you are unlucky and it happens again, this is a condition which has occurred entirely independently of what happened before and is not connected. This would be a new condition and would be covered after six months (or less if the waiting period was waived). So basically, it depends on the nature of the illness and what your doctor writes down.

In your toe example, probably (indeed likely) it would be pre-existing but again it depends on the exact nature. It is hard to say, if a previous illness increases the likeliness of a different separate illness it does not necessarily mean they are directly connected. It really depends!

Jim2007

DubLad69 wrote: »

Hi guys,

We are looking to buy health insurance after a long enough stint without any. The only problem is the waiting periods.

I know that preexisting conditions aren't covered if they were present at any stage in the 6 months prior to purchase. My question is, if I had an issue 2 months ago that I would like to be covered should it occur again, should I wait an extra 4 months to buy the insurance? Or will I be covered if I have the insurance and don't have the issue for 6 months but it develops again in 9 months time?

Also, what exactly isn't covered as a pre existing condition? Say for example you had a toe chopped off, it's a pretty existing condition now, but If a while later rate missing toe caused you to develop some problem with your foot, would that be pre existing? (I don't have a missing toe, I'm just curious)

Insurance does not work that way. An insurance contract is what the lawyers call a contract of the utmost good faith. That means that you must disclose all relevant information, even if not asked. A failure to do so, allows the insurance company to walk away without paying.


So you can't really manipulate the dates as you suggest. If you fail to disclose something that has a potential to come up in the future, then you leave yourself open to a disappointment.

DubLad69

Jim2007 wrote: »

Insurance does not work that way. An insurance contract is what the lawyers call a contract of the utmost good faith. That means that you must disclose all relevant information, even if not asked. A failure to do so, allows the insurance company to walk away without paying.


So you can't really manipulate the dates as you suggest. If you fail to disclose something that has a potential to come up in the future, then you leave yourself open to a disappointment.

I'm not really trying to manipulate the dates. It's more so that this thing happened once. I was told it was a once off.

I'm more so trying to make sure that it's not considered a pre existing condition if it is something that happens again a few years down the line and they try not to pay out.

The question for me really is, if you have something that is a "pre existing condition" and you buy a policy. Does it stop being a pre existing condition once its gone for 6 months..

Jim2007

Jim2007 wrote: »

Insurance does not work that way. An insurance contract is what the lawyers call a contract of the utmost good faith. That means that you must disclose all relevant information, even if not asked. A failure to do so, allows the insurance company to walk away without paying.


So you can't really manipulate the dates as you suggest. If you fail to disclose something that has a potential to come up in the future, then you leave yourself open to a disappointment.

Just to be clear here, failure to disclose a pre-existing condition does not somehow give the health insurer a "get-out" card from paying if it arises again in the future. You are not obliged to inform your health insurer of any previous illnesses or conditions. It is advisable to do so, so they can recommend a suitable level of cover.

While they may refuse to pay out because it is deemed a pre-existing condition and you have not yet satisfied the 5 year waiting period, they cannot turn around and refuse to pay out because you did not tell them about this condition when you took out the policy.

OP, I think your next step is clear. Take out the insurance and start the clock ticking on the five years and hope it doesn't crop up again until the 5 years is over.

DubLad69

Casey Purring Shortstop wrote: »

Just to be clear here, failure to disclose a pre-existing condition does not somehow give the health insurer a "get-out" card from paying if it arises again in the future. You are not obliged to inform your health insurer of any previous illnesses or conditions. It is advisable to do so, so they can recommend a suitable level of cover.

While they may refuse to pay out because it is deemed a pre-existing condition and you have not yet satisfied the 5 year waiting period, they cannot turn around and refuse to pay out because you did not tell them about this condition when you took out the policy.

OP, I think your next step is clear. Take out the insurance and start the clock ticking on the five years and hope it doesn't crop up again until the 5 years is over.

Thanks,

I actually just read through the policy terms, and it seems as though the waiting period only really effects hospital/inpatient cover.

And not Day to day cover. So I'm not too worried about it now anyway.