Private Health Insurance UK: Job Change Guide

Protecting Your Private Health Insurance: Navigating Continuity and Portability When You Change Jobs in the UK.

Navigating Private Health Insurance When Changing Jobs: Understanding Continuity and Portability in the UK

In today's dynamic job market, changing roles is increasingly common. While a new job brings exciting opportunities, it also presents a crucial challenge: what happens to your private health insurance? For many, private medical insurance (PMI) is a significant and valued employee benefit, offering peace of mind through faster access to specialist care and a wider choice of hospitals. However, the transition from an employer-sponsored scheme to a new arrangement can be a minefield, fraught with the risk of losing valuable coverage, particularly for conditions that have emerged while you were insured.

This comprehensive guide will demystify the complexities of continuity and portability in UK private health insurance, equipping you with the knowledge to make informed decisions when you embark on a new career path. We'll explore the critical concepts that protect your health cover, illuminate the different underwriting methods, and provide practical steps to ensure your well-being remains a priority, no matter where your professional journey takes you.

The UK's Private Health Insurance Landscape

The National Health Service (NHS) remains the cornerstone of healthcare in the UK, providing comprehensive medical services to all residents. However, growing waiting lists, limitations on choice, and the desire for more personalised care have led many individuals and employers to embrace Private Medical Insurance.

PMI in the UK typically offers:

• Faster Access: Reduced waiting times for consultations, diagnostic tests, and treatments.
• Choice of Specialist: The ability to choose your consultant and often the hospital where you receive treatment.
• Comfort and Privacy: Access to private rooms and facilities during hospital stays.
• Flexible Appointments: Greater flexibility in scheduling appointments around your work and life commitments.

For most working professionals, PMI is often provided as a benefit through an employer's group health scheme. These schemes typically offer competitive rates and often require little to no individual medical underwriting, making them a highly attractive perk. However, when you leave that employer, your coverage under their group scheme ceases, leaving you to navigate the private health insurance market independently. This is where understanding continuity and portability becomes paramount.

Understanding Continuity of Cover

Continuity of cover is arguably the most critical concept to grasp when transitioning between private health insurance policies, especially when changing jobs. It directly impacts your ability to maintain coverage for conditions that developed or were treated while you were on a previous policy.

What is Continuity of Cover?

In essence, continuity of cover refers to the ability to transition from one private health insurance policy to another without having to undergo a completely new assessment of your medical history, particularly concerning conditions that arose or were treated during your previous period of cover. Its primary purpose is to protect you from new exclusions being applied to your policy simply because you changed jobs or insurers.

Why is it Important When Changing Jobs?

When you apply for a new individual health insurance policy, insurers will typically assess your medical history to determine what conditions, if any, they will cover. Conditions that you've had symptoms of, sought advice for, or received treatment for prior to the start of your new policy are generally classified as 'pre-existing conditions' and are usually excluded from cover. This is a fundamental principle of private health insurance in the UK.

However, if you can demonstrate continuity of cover, certain insurers may be willing to honour the terms of your previous policy regarding pre-existing conditions that arose during that policy's term. Without continuity, a condition you were previously covered for (e.g., a knee problem that developed while you were insured with your old employer's scheme) could suddenly become an 'uncovered pre-existing condition' under a new policy, leaving you to fund treatment yourself.

Types of Underwriting Explained

To truly appreciate the value of continuity, it's essential to understand the different methods insurers use to underwrite policies. The underwriting method applied to your new policy will directly dictate how pre-existing conditions are handled.

1. Full Medical Underwriting (FMU):

   • How it works: This is the most detailed form of underwriting. When you apply for a new policy, you complete a comprehensive medical questionnaire, often requiring your GP's details for further information if necessary. The insurer will assess your full medical history from birth to determine any conditions they will permanently exclude from your policy.
   • Implications for pre-existing conditions: Any condition you've had in the past (even years ago) could be permanently excluded. This is the least favourable option if you have a medical history you want covered.

2. Moratorium Underwriting (Mor):

   • How it works: This is the most common underwriting method for individual policies due to its simplicity. You don't need to provide a full medical history upfront. Instead, the insurer applies a 'moratorium' period (typically 2 years) from the start date of your new policy. During this time, any condition you've had symptoms of, sought advice for, or received treatment for in the 5 years prior to the policy start date will be excluded.
   • Implications for pre-existing conditions: A pre-existing condition may become covered after the 2-year moratorium period if you have had no symptoms, treatment, medication, or advice for it for a continuous period of 2 years after the policy start date. If the condition recurs or you need treatment within that 2-year period, the moratorium effectively restarts for that condition. This can be problematic if you have ongoing or recurring issues.

3. Continued Personal Medical Exclusions (CPME):

   • How it works: This is the 'gold standard' for continuity of cover and is often the most desirable outcome when transitioning from a group scheme. With CPME, the new insurer agrees to carry over the underwriting terms and exclusions from your previous health insurance policy. This means that if a condition was covered under your old policy, it will continue to be covered under the new one, subject to the same terms and conditions. The new insurer essentially adopts the underwriting history of your previous policy.
   • Implications for pre-existing conditions: This method is specifically designed to prevent conditions that arose and were covered during your previous period of insurance from becoming new exclusions. If your old policy had specific exclusions, these would typically be carried over. However, if your old group policy had no individual exclusions (as is common with large group schemes), then this is highly advantageous as it means your new policy will also have no individual exclusions for conditions that developed under the old scheme.
   • Crucial Note: CPME is usually offered only when you transfer directly from a group scheme to an individual policy with the same insurer, or in some cases, between very specific group schemes or if an insurer explicitly offers this facility based on a 'Certificate of Previous Cover' from your old insurer.

4. Group Schemes (Medical History Disregarded - MHD):

   • How it works: Larger employer-sponsored health insurance schemes often use a 'Medical History Disregarded' (MHD) underwriting basis. This means that the insurer agrees to cover all eligible conditions for all employees, regardless of their past medical history, with no individual exclusions. This is the most generous form of underwriting.
   • Implications for pre-existing conditions: Under MHD, even existing conditions are covered, provided they are acute and not chronic (see section 7). However, when you leave such a scheme, this 'medical history disregarded' status is lost, and you will typically revert to FMU, Moratorium, or CPME (if offered by the insurer) for any new individual policy.

Understanding these underwriting methods is fundamental because the method applied to your new policy will dictate whether a pre-existing condition (which was covered under your old policy) will continue to be covered or will be excluded.

Understanding Portability of Cover

While closely related to continuity, portability refers to a slightly broader concept: the ability to move your existing health insurance coverage from one policy or provider to another.

What is Portability of Cover?

Portability of cover is the capacity for your health insurance benefits and underwriting terms to be transferred or 'ported' when you change jobs, switch from a group scheme to an individual policy, or even move between insurers. It's about maintaining a comparable level of cover without significant disruption or loss of benefits.

When is Portability Relevant?

Portability comes into play in several scenarios:

• From Employer Group Scheme to Individual Policy: This is the most common scenario when changing jobs. You need to 'port' your benefits from the group scheme to your own policy.
• Changing Insurers for an Individual Policy: If you have an existing individual policy and want to switch to a different insurer (perhaps for better pricing or different benefits), you'll assess portability.
• Moving from One Employer Scheme to Another: Less common, but sometimes a new employer's scheme might offer to port your existing underwriting terms from a previous large group scheme.

Key Considerations for Portability

When considering portability, you'll need to weigh up several factors:

• Underwriting Method: As discussed, the underwriting method of the new policy (FMU, Mor, or CPME) is the most critical factor influencing true portability, especially concerning pre-existing conditions.
• Comparing Benefits and Exclusions: A new policy, even if offering continuity, might have different overall benefits, excesses, or general exclusions. It's vital to compare the 'like-for-like' aspects.
• Impact on Premiums: Porting your cover may come with a different premium, which could be higher or lower depending on your age, location, and the specific plan chosen.
• Timeline: Most insurers have strict time limits (e.g., 30 or 60 days) after leaving an employer's scheme within which you must apply for a personal policy to qualify for continuity benefits.

Practical Scenarios and Solutions When Changing Jobs

Let's explore the common scenarios you might face when changing jobs and the best strategies for each.

Scenario 1: Moving from an Employer Scheme to an Individual Policy with the SAME Insurer

This is often the most straightforward path to maintaining continuity.

• The Process: Most major UK health insurers (e.g., Bupa, AXA Health, Vitality, Aviva, WPA) offer a 'conversion option' or 'transfer option' for individuals leaving an employer group scheme. They will typically allow you to convert your group cover to an individual policy on a Continued Personal Medical Exclusions (CPME) basis. This means they will largely honour the underwriting terms you had under the group scheme, ensuring conditions covered previously remain covered.
• Key Advantage: This path offers the highest degree of continuity for pre-existing conditions, as the insurer already holds your medical history (or a record of the group's underwriting basis) and knows what was previously covered.
• Action Steps:
  1. Contact your current insurer (or your employer's HR/benefits department) as soon as you know your leaving date. Inquire about their individual conversion options.
  2. Understand the conversion terms: Ask about the specific plan options available, the premium, any changes to benefits or excesses, and confirm that CPME terms will apply.
  3. Adhere to time limits: You typically have a limited window (e.g., 30 or 60 days) from your cessation of employment to apply for the conversion. Missing this deadline could mean you lose the CPME option and have to apply for a new policy under Moratorium or Full Medical Underwriting.

Scenario 2: Moving from an Employer Scheme to an Individual Policy with a DIFFERENT Insurer

This is a common desire, perhaps to find a more competitive premium or a plan with different benefits. However, it presents a greater challenge for continuity.

• The Challenge: A new insurer generally has no obligation to honour the underwriting terms of your previous insurer. They will typically require you to start a new policy under their standard Moratorium (Mori) or Full Medical Underwriting (FMU) terms. This could mean that conditions covered under your previous group scheme might now be excluded.
• The 'Certificate of Previous Cover' (or Continuity Letter): This document is your most valuable asset in this scenario. When you leave your employer, request a 'Certificate of Previous Cover' or 'Continuity Letter' from your old health insurer (or your employer's HR department if they manage this). This letter details:
  • The period you were covered under the group scheme.
  • The underwriting basis of the group scheme (e.g., Medical History Disregarded).
  • Any specific exclusions applied to you personally (rare on large MHD schemes).
  • Claims history (sometimes included, but often not necessary for new underwriting).
• How it Helps: While a new insurer won't automatically grant CPME, this certificate provides them with crucial information. Some forward-thinking insurers, or those working with an expert broker, may be willing to offer more favourable terms (e.g., accepting some form of modified Moratorium or even a version of CPME) if they can verify a long period of uninterrupted cover under a comprehensive scheme. They might, for example, waive the 5-year look-back for Moratorium, or reduce the moratorium period for certain conditions.
• Action Steps:
  1. Immediately request your 'Certificate of Previous Cover' from your outgoing insurer/employer.
  2. Contact a specialist health insurance broker like WeCovr. This is where their expertise truly shines. WeCovr can approach all the major UK insurers on your behalf, presenting your Certificate of Previous Cover and advocating for the best possible underwriting terms. They understand which insurers are more flexible and how to present your case to maximise your chances of achieving continuity, even when switching providers. Crucially, their service is entirely free to you, as they are remunerated by the insurers.
  3. Be prepared for Moratorium or FMU: Understand that while a broker can help, you may still end up with Moratorium or FMU underwriting, meaning some previously covered conditions could now be excluded. Weigh the benefits of switching insurers (e.g., premium, specific benefits) against potential loss of continuity.

Scenario 3: Moving from One Employer Scheme to Another Employer Scheme

This scenario means your new employer also offers private health insurance.

• The Usual Case: Your new employer's scheme will likely have its own underwriting basis (often Medical History Disregarded for larger schemes). You will simply join their scheme, and the benefits and underwriting terms of that scheme will apply. Your cover from your previous employer's scheme ceases and does not usually 'port' directly to the new employer's scheme's underwriting.
• Exceptions (Rare but Valuable): In some instances, particularly if you're moving between large organisations with long-standing health insurance schemes, the new employer's insurer might agree to honour some level of continuity from your previous large group scheme, especially if it was also Medical History Disregarded. This would be negotiated at the corporate level.
• Action Steps:
  1. Check with your new employer's HR/benefits team. Understand the details of their health insurance scheme: which insurer, what level of cover, and critically, the underwriting method.
  2. Inquire about continuity: Ask if they have any provisions for individuals joining from another PMI scheme, especially concerning pre-existing conditions.
  3. Consider a bridging individual policy: If there's a gap between leaving your old job and starting cover with your new employer, you might consider a short-term individual policy to maintain continuous cover. A broker like WeCovr can help you assess if this is cost-effective and necessary.

Scenario 4: From Individual Policy to Employer Scheme / New Individual Policy

While less common, this scenario is still relevant.

• Joining an Employer Scheme: If you have an individual policy and join a new employer offering a group scheme (especially MHD), your individual policy can often be cancelled, as the employer's scheme will typically cover existing conditions (as it's MHD). However, confirm this with your new employer's HR.
• Moving from One Individual Policy to Another: If you're switching from one individual policy to another (either with the same or a different insurer), your current underwriting terms will be key. If you're on a CPME policy, moving to a new insurer will almost certainly mean new Moratorium or FMU terms. If you're on a Moratorium policy, conditions that were still 'under moratorium' might restart their 2-year clock with a new insurer. This is where a broker like WeCovr can help you weigh the pros and cons of switching versus staying put.

The Critical Role of Pre-Existing Conditions

Let's reiterate and expand on the crucial point about pre-existing conditions. This is where many individuals face significant challenges when transitioning policies.

Definition: A 'pre-existing condition' is generally defined by insurers as any illness, injury, or disease for which you have experienced symptoms, received treatment, taken medication, or sought advice during a specific period before the start date of your new health insurance policy. This period is typically 5 years for Moratorium underwriting.

The Golden Rule: Most new private health insurance policies in the UK will exclude pre-existing conditions. This is a standard practice across the industry. Insurers are in the business of covering future, unforeseen medical events, not addressing past or ongoing issues that you already know about.

Why Continuity is Your Only Hope for Pre-Existing Conditions:

• Acute Conditions that Developed While Insured: If you developed an acute (curable, short-term) condition, such as a specific back pain requiring surgery, or a particular heart rhythm disturbance, while you were covered by your previous employer's group scheme, and that condition was treated and covered under that policy, then:

  • With CPME (same insurer): This condition should continue to be covered under your new individual policy, as the insurer is honouring your previous underwriting terms.
  • Without CPME (new insurer/Mor/FMU): This condition would very likely be considered 'pre-existing' by a new insurer and would be excluded, or subject to a new moratorium period. You would then have to fund any further treatment for this condition yourself.

• Chronic Conditions: It is absolutely vital to understand that Private Medical Insurance typically covers acute conditions – those that are sudden in onset, have a definable cause, and can be cured or managed to lead to a full recovery. PMI generally does not cover chronic conditions – those that are long-term, incurable, or require ongoing management. Examples include:

  • Diabetes (Type 1 or Type 2)
  • Asthma (requiring ongoing medication)
  • Hypertension (high blood pressure)
  • Most auto-immune diseases (e.g., Crohn's disease, rheumatoid arthritis)
  • Long-standing, degenerative conditions (e.g., severe osteoarthritis requiring ongoing management rather than a single acute intervention)

  Even with continuity, these chronic conditions are generally NOT covered by PMI, as they fall outside the scope of what private medical insurance is designed to cover. Continuity protects you from new exclusions on acute conditions that developed and were treated under your previous policy. It does not magically make a chronic, incurable condition insurable if it falls outside the typical scope of PMI.

• The Nuance of CPME: CPME is about carrying over existing terms and exclusions. If your previous group policy, despite being MHD, had a general exclusion for chronic conditions (which almost all PMI policies do), then your new CPME policy will also have that general exclusion. CPME is primarily beneficial for acute conditions that arose during your previous cover and were paid for, ensuring they don't become new exclusions simply because you've changed policies.

Always disclose your full medical history truthfully. Failure to do so can invalidate your policy, leaving you uninsured when you need it most.

Steps to Take When Changing Jobs

Being proactive is key to a smooth transition of your health insurance. Follow these steps:

Before You Leave Your Old Job:

1. Understand Your Current Scheme: Get a copy of your current health insurance policy terms or speak to your HR/benefits department. Understand what's covered, your excess, and any specific exclusions.
2. Identify Your Leaving Date: This is crucial, as deadlines for conversion options are typically linked to this date.
3. Request a 'Certificate of Previous Cover': Contact your current health insurer or employer's HR department well in advance. Explain you are leaving and need a document confirming your period of cover, the underwriting basis (e.g., Medical History Disregarded), and if possible, confirmation that no personal exclusions were applied to you.
4. Research New Employer Benefits: If you're moving to a new job, ask about their benefits package. Does it include PMI? If so, which insurer, what level of cover, and what is the underwriting basis?

During the Transition Period (After Leaving Old Job, Before Starting New):

1. Contact Your Previous Insurer (for Conversion): If you wish to convert your existing group cover to an individual policy with the same insurer, contact them promptly after your leaving date. Be mindful of their application deadlines.
2. Explore Options with a Broker: If you're considering switching insurers, or if your previous insurer's conversion option doesn't meet your needs, this is the ideal time to engage a specialist health insurance broker like WeCovr.
   • WeCovr's Role: Provide them with your 'Certificate of Previous Cover'. WeCovr will then assess your specific situation, your medical history (always be transparent!), and your coverage needs. They will then approach all the leading UK health insurers (Bupa, AXA Health, Vitality, Aviva, WPA, etc.) on your behalf, comparing their offerings, underwriting terms (especially regarding continuity), and pricing.
   • Cost-Free Service: WeCovr's service is completely free to you. They are compensated by the insurer if you decide to take out a policy through them. This means you get expert, unbiased advice and comprehensive market comparison without any upfront cost.
3. Understand Underwriting Terms: Whichever path you choose, make sure you fully understand the underwriting terms that will apply to your new policy (CPME, Moratorium, or FMU) and how they will impact any existing conditions.

After Starting New Job:

1. Activate New Employer's PMI (If Applicable): If your new employer provides PMI, ensure you complete all necessary enrolment forms. Understand its start date and how it affects any individual policy you might have.
2. Finalise Individual Policy: If your new employer doesn't offer PMI, or you've opted for a separate individual policy, ensure all paperwork is completed and your policy is active.

Key Questions to Ask:

Don't be afraid to ask these critical questions to your old insurer, new employer, or potential new insurer/broker:

• To my old insurer/HR:
  • What are my options for converting my group cover to a personal policy?
  • What underwriting terms (e.g., CPME, Moratorium, FMU) will apply if I convert?
  • What is the deadline for applying for a conversion policy?
  • Can I get a 'Certificate of Previous Cover' or 'Continuity Letter' detailing my period of cover and underwriting basis?
• To my new employer/HR:
  • Do you offer Private Medical Insurance as a benefit?
  • Which insurer is it with, and what are the main benefits?
  • What is the underwriting basis of the group scheme (e.g., Medical History Disregarded, Moratorium)?
  • Is there any provision for continuity of cover for employees joining from another PMI scheme?
  • When does cover start, and what is the enrolment process?
• To a new insurer/broker (like WeCovr):
  • Given my 'Certificate of Previous Cover', what are my best options for maintaining continuity?
  • What are the premium differences between insurers offering the most favourable continuity terms?
  • Can you explain how each underwriting method will impact my specific medical history?
  • What are the benefits and exclusions of the proposed plans?

The Value of a Specialist Health Insurance Broker

Navigating the intricacies of private health insurance, especially around continuity and portability, can be daunting. This is where the expertise of a specialist health insurance broker becomes invaluable.

Why Use a Broker?

• Independent Advice: Brokers are not tied to a single insurer. They work for you, offering impartial advice tailored to your specific circumstances and needs.
• Access to the Whole Market: A good broker, like WeCovr, has access to all the major UK health insurance providers (Bupa, AXA Health, Vitality, Aviva, WPA, etc.) and knows their specific underwriting rules, particularly concerning continuity. This means they can find you the best fit, not just the easiest option.
• Understanding Complex Underwriting: The nuances of FMU, Moratorium, and CPME are complex. A broker can explain these clearly and advise on how they apply to your personal medical history. They know which insurers are more flexible with continuity requests, even when moving providers.
• Negotiating on Your Behalf: Brokers can often negotiate better terms or highlight specific benefits that you might miss. They act as your advocate.
• Saving Time and Effort: Instead of spending hours researching different insurers, comparing policies, and understanding jargon, you can rely on a broker to do the heavy lifting for you.
• Expert Knowledge of Continuity & Portability: This is their bread and butter. They understand how to leverage your 'Certificate of Previous Cover' to secure the most advantageous terms possible, helping you avoid exclusions on conditions that were previously covered.

WeCovr's Advantage:

WeCovr stands out as a modern UK health insurance broker committed to client satisfaction. They provide expert, unbiased advice, helping individuals and businesses find the right health insurance solutions. Their key value propositions include:

• Free Service: As mentioned, WeCovr's service is entirely free for clients. You pay nothing for their advice, research, and application support.
• Whole-of-Market Access: They compare plans from all leading UK health insurers to ensure you get the most comprehensive and cost-effective cover.
• Simplified Process: They streamline the application process, handling the paperwork and liaising with insurers on your behalf.
• Personalised Advice: They take the time to understand your unique health needs and financial situation, offering bespoke recommendations.

When facing a job change, reaching out to a broker like WeCovr should be one of your first steps. Their expertise can be the difference between maintaining comprehensive health cover and finding yourself with unexpected exclusions.

Common Pitfalls to Avoid

Navigating a job change alongside health insurance can be tricky. Be aware of these common mistakes:

1. Assuming Automatic Continuity: Never assume your cover will simply transfer automatically. It won't. You must proactively manage the process.
2. Letting Cover Lapse: A gap in cover can be highly detrimental. If you have an acute condition that surfaces during a lapse, it will almost certainly be considered pre-existing by any new policy. Aim for continuous cover where possible, even if it means a short-term individual policy.
3. Not Disclosing Pre-Existing Conditions: Always be 100% honest and transparent about your medical history, even if you know a condition will be excluded. Non-disclosure, even accidental, can lead to your policy being invalidated, leaving you with no cover at all when you need it most.
4. Focusing Solely on Premium: While cost is a factor, don't sacrifice essential benefits or favourable underwriting terms (like CPME) just to save a few pounds. The cheapest policy might be the most expensive in the long run if it excludes conditions you rely on.
5. Not Getting a 'Certificate of Previous Cover': This document is invaluable. Without it, new insurers have less reason to offer any flexibility on their standard underwriting terms.
6. Misunderstanding Underwriting Terms: Ensure you fully grasp the implications of FMU, Moratorium, and especially CPME for your personal circumstances. If in doubt, ask your broker.

Beyond Continuity and Portability – Other Considerations

While continuity and portability are paramount when changing jobs, remember to assess the overall suitability of any new policy. Consider:

• Level of Cover: Does the policy include outpatient treatment, therapies (physiotherapy, chiropractic), mental health support, and complementary treatments? Some basic policies only cover inpatient care.
• Excess Options: A higher excess can significantly reduce your premium, but ensure you're comfortable paying that amount upfront if you need to claim.
• Hospital Network: Does the policy give you access to your preferred hospitals or specialists? Some policies have restricted hospital lists.
• Additional Benefits: Does the policy offer any value-added services like virtual GP appointments, health assessments, or discounts on health-related products?
• Geographic Scope: Are you covered for treatment only in the UK, or also abroad (e.g., for emergencies while travelling)?
• Policy Limits: Understand any annual limits on claims for specific conditions or overall.

Conclusion

Changing jobs is an exciting chapter, but it shouldn't come at the cost of your health security. Navigating the nuances of private health insurance continuity and portability is crucial to ensuring you maintain valuable coverage, especially for conditions that have emerged while you've been insured.

Remember that pre-existing conditions are generally excluded from new policies, and true continuity through Continued Personal Medical Exclusions (CPME) is your best defence against losing coverage for acute conditions previously paid for. While chronic conditions typically remain outside the scope of PMI, proactive planning and expert advice can make a world of difference for acute issues.

Don't leave your health to chance. Plan ahead, understand your options, and always seek professional advice. A specialist health insurance broker like WeCovr offers an invaluable service, at no cost to you, by expertly guiding you through the complexities of the UK market. They can help you compare options from all major insurers, secure the best possible terms for continuity, and ensure your private medical insurance truly offers you peace of mind, no matter where your career journey leads. Secure your health, secure your future.