Looking For Health Insurance? Let’s Go Through the Pre-Existing Conditions Rules

Let’s be honest, insurance can often feel a bit overwhelming when going through the fine print! Whether you’re joining a new policy or transferring from an old one, knowing how medical underwriting works can save you time, stress, and surprises. Understanding how your health cover deals with pre-existing conditions doesn’t have to be complicated.

One way members are assessed is through Full Medical Underwriting (FMU). Think of it as being completely upfront with your insurer. If you have a pre-existing condition, you need to declare it when you join. Any exclusions we apply will be shown on your policy schedule, and some conditions – especially chronic ones – can’t be removed later. FMU is all about making sure your cover is accurate and personalised from day one.

If you’re moving from another fully underwritten policy, you might be covered under Continued Personal Medical Exclusions (CPME). This essentially carries your old exclusions forward. Any condition excluded on your previous policy stays excluded here, and we’ll need your old insurance certificate to make it official. It’s a smooth way to transfer coverage without redoing the whole underwriting process.

Another option is the Moratorium (MORI) or Continued Moratorium (CMORI). These work a bit like a waiting game. Pre-existing conditions aren’t covered if you had symptoms, treatment, medication, tests, or advice in the five years before joining. But after a continuous two-year symptom-free period, those conditions can be covered. CMORI applies the same rules if you’re transferring from a previous moratorium policy, keeping your cover consistent.

Finally, there’s Medical History Disregarded (MHD) – the “fresh start” option. With MHD, no personal medical exclusions are applied for eligible members, making it perfect for groups that want broad coverage. If you’re transferring from another policy, you may be asked for your old certificate, but otherwise, it’s a clean slate.

The main takeaway? Different types of medical underwriting exist to strike a balance between fair coverage and realistic risk. FMU is upfront and personalised, CME carries exclusions forward, MORI/CMORI uses a waiting period, and MHD gives you a fresh start. Always check your policy schedule and provide old certificates if required. It keeps everything simple and clear.

Ready to get your cover sorted? Contact us today for friendly, expert advice and make sure your group health insurance works for you – not the other way around.