Health insurance doesn’t usually cover the treatment and care of chronic or long-term conditions. These are diseases, illnesses or injuries that need ongoing monitoring, continuous
or long-term control or relief of symptoms; require rehabilitation; continue indefinitely; have no known cure or are likely to come back again. Chronic or long-term conditions often need consultations over a long period, checks on medication, long-term therapy or treatment which usually keep a condition or its symptoms under control. When this happens, treatment for the ongoing management of the condition isn’t covered because the symptoms are part of its natural progression.
Am I covered for chronic conditions?
Your policy may cover you for diagnosis some tests if you’re unwell. However, once a chronic condition is diagnosed, health insurance cover for it is usually no longer available. The NHS will provide then ongoing management, screening and monitoring of the condition. Providers don’t treat cancer as a chronic condition
What if my condition gets worse?
If your long-term condition gets worse, this may be due to an acute flare-up.
This is when there’s a sudden and unexpected change in the condition or its symptoms which can be treated quickly.
Most insurance plans cover treatment of an unexpected acute flare-up when the condition is likely to respond quickly and aims to restore you to your previous level of health immediately before the acute flare-up.
After this, you’ll need to return to the NHS for the ongoing management of your condition as health insurance cover isn’t available for this.
We recommend that you contact your insurance provider before having any consultations, tests or treatment for a chronic condition to make sure it’s covered by your policy. You should also check your policy for what is and isn’t covered. If you’re unsure, please contact us and we’ll be happy to explain
