You can get a policy. You usually cannot get that condition covered, and the two are constantly confused.
What the policy documents actually say
Insurers do not refuse applicants for having a history; they exclude the history. Bupa states that any conditions, special conditions, pre-existing conditions, moratorium conditions, symptoms, illnesses or injuries you had before the policy started are not usually covered, and that where a special condition applies it is confirmed to the member in writing. Freedom Private Health Insurance is the most specific of the documents we hold, naming a five-year look-back: it will not cover a condition, or a related condition, you had within the five years before cover started unless it has agreed to.
The phrase doing the work there is 'or a related condition'. A shoulder problem declared at application can carry an exclusion that later catches a different shoulder complaint, because the insurer assesses relatedness at claim time rather than at purchase.
AXA Health sets out four underwriting routes, and the choice between them is what actually determines your position: full medical underwriting, continuing medical exclusions, medical history disregarded, and moratorium. Only the third ignores your history, and it is generally reserved for employer schemes.
WPA adds a separate trap for the newly insured — a 14-day deferment period covering anything arising in the first fortnight, whether diagnosed or not, unless declared and accepted in writing.
The practical answer for most people with a history is a moratorium policy, cover for everything unrelated from day one, and a realistic expectation that the known problem stays outside the policy for a defined period or permanently.
Questions to put to the insurer or broker
- Would this specific condition be excluded, and for how long?
- What counts as 'related' to it?
- Which underwriting basis am I being quoted on?
Related questions
- Is company-paid private health insurance taxed as a benefit in kind?
- Does private health insurance cover A&E or an emergency?
- Will private health insurance pay for cosmetic surgery?
- Does private health insurance cover dental treatment and glasses?
Sources
- Source: AXA Health — Personal Health membership handbook, October 2024, read 4 September 2026.
- Source: Bupa policy guide — Bupa By You health insurance (BINS 14718) (2024), read 4 September 2026.
- Source: WPA — Private Medical Insurance — Insurance Product Information Document (Complete Health) (2025-11), read 4 September 2026.
The limit behind every answer here
None of this reaches a condition you already have. Cover is written for problems that arise after it starts, so anything you have symptoms of when you apply is excluded — permanently under full medical underwriting, or until a symptom-free period has passed under a moratorium. Chronic conditions are excluded by every insurer whose wording we hold. Figures quoted come from current policy documents and change at renewal, so check the document you are actually offered.
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