TL;DR
Navigating the world of international private medical insurance (IPMI) can feel complex, especially when you have a past health issue. At WeCovr, where we've helped arrange over 900,000 policies, we believe that understanding the small print is the key to finding the right cover. This guide demystifies how Expatriate Group, a leading specialist IPMI provider, manages pre-existing conditions, waiting periods, and exclusions for individuals and families living abroad.
Key takeaways
- Assessment of Pre-existing Conditions: Evaluating your past medical history.
- Waiting Periods: A set time before you can claim for certain benefits.
- Policy Exclusions: Specific treatments or conditions that are not covered.
- You complete a detailed health declaration form as part of your application.
- You must disclose your full medical history and that of anyone else on your policy.
Navigating the world of international private medical insurance (IPMI) can feel complex, especially when you have a past health issue. At WeCovr, where we've helped arrange over 900,000 policies, we believe that understanding the small print is the key to finding the right cover. This guide demystifies how Expatriate Group, a leading specialist IPMI provider, manages pre-existing conditions, waiting periods, and exclusions for individuals and families living abroad.
How pre-existing conditions, waiting periods and policy exclusions work with Expatriate Groups individual international health plans
Choosing an international health plan is one of the most important decisions you'll make when moving or living abroad. The core function of this insurance is to cover the costs of new, unexpected, and treatable (acute) medical conditions that arise after your policy begins.
To manage risk and keep premiums fair for all members, insurers like Expatriate Group use three key mechanisms:
- Assessment of Pre-existing Conditions: Evaluating your past medical history.
- Waiting Periods: A set time before you can claim for certain benefits.
- Policy Exclusions: Specific treatments or conditions that are not covered.
Understanding these three pillars is crucial to ensure you have the protection you expect, exactly when you need it.
How Expatriate Group Handles Pre-Existing Conditions
A pre-existing condition is any disease, illness, or injury for which you have experienced symptoms, received medication, advice, or treatment before your insurance policy starts. This could be anything from asthma or diabetes to a historic knee injury or past anxiety.
When you apply for an Expatriate Group individual IPMI plan, your medical history is assessed in one of two ways: Full Medical Underwriting or Moratorium Underwriting.
1. Full Medical Underwriting (FMU)
Full Medical Underwriting offers complete clarity from day one. It is the most thorough assessment method.
The Process:
- You complete a detailed health declaration form as part of your application.
- You must disclose your full medical history and that of anyone else on your policy.
- Expatriate Group's underwriting team reviews your information. They may request further details from your doctor (with your permission).
Possible Outcomes:
- Cover Accepted: Your health history is considered low risk, and you are offered the policy on standard terms.
- Exclusion Applied: The policy is offered, but with a specific exclusion for your pre-existing condition(s). For example, if you have a history of back pain, your policy might exclude cover for any spinal treatment.
- Premium Loading Applied: The policy is offered, but your premium is increased to reflect the higher risk associated with your condition. This is less common than an exclusion.
- Application Declined: In rare cases, where the medical risk is considered too high, the application may be declined.
Real-Life Example: Amelia, a 52-year-old marketing consultant moving to France, declared a thyroid condition that is well-managed with medication. Under FMU, Expatriate Group offered her a policy with a specific exclusion for any treatment related to her thyroid. She accepted this, as she wanted the certainty of knowing all other new, acute conditions would be covered.
2. Moratorium Underwriting
Moratorium underwriting is a simpler, faster way to get cover, as it does not require an upfront medical declaration. However, it comes with a period of uncertainty regarding pre-existing conditions.
The Process:
- You can buy the policy without answering any health questions.
- Any pre-existing medical condition you've had in a set period (typically the 5 years before your policy start date) is automatically excluded for an initial period on the policy (typically the first 24 months).
How a Condition Becomes Eligible for Cover: A pre-existing condition may become eligible for cover if you go for a continuous 24-month period after your policy starts without needing any treatment, medication, advice, or experiencing any symptoms for that condition.
Real-Life Example: Ben, a 30-year-old software developer, moved to Dubai. He had a minor shoulder strain two years prior. He chose a moratorium policy. For the first 24 months of his cover, any treatment related to his shoulder would not be covered. If he has no shoulder issues at all during those 24 months, it could become eligible for cover from that point onwards.
FMU vs. Moratorium: Which is Right for You?
Choosing between these two options is a personal decision based on your priorities.
| Feature | Full Medical Underwriting (FMU) | Moratorium Underwriting |
|---|---|---|
| Upfront Process | Detailed health questionnaire required. | No initial health questions. |
| Clarity of Cover | High. You know exactly what is and isn't covered from day one. | Low. Initial uncertainty about pre-existing conditions. |
| Application Speed | Slower due to medical review. | Very fast to set up. |
| Best For | Individuals who want absolute certainty or who have past conditions they believe are minor and fully resolved. | Individuals in excellent health with no recent medical issues, or those needing cover in a hurry. |
| Claims Process | Simpler. The insurer already knows your history. | Can be more complex. The insurer will investigate your medical history at the point of a claim to see if it's pre-existing. |
Insider Tip: While moratorium seems simpler, the "wait and see" approach can lead to disappointment at the point of a claim. For peace of mind, many people favour FMU. A broker at WeCovr can help you decide which path is best for your circumstances.
Understanding Expatriate Group's Waiting Periods
A waiting period is a fixed amount of time after your policy starts during which you cannot claim for specific benefits. This applies to all new members, regardless of their medical history.
Waiting periods exist to protect the insurance scheme from 'anti-selection'—where someone joins purely to claim for an expensive, planned event (like childbirth) and then leaves. This helps keep premiums affordable for the entire membership base.
Here are typical waiting periods you might find on an Expatriate Group policy. Note that these can vary based on the specific plan you choose.
| Benefit Type | Typical Waiting Period | Explanation |
|---|---|---|
| Maternity Care | 10 to 12 months | You must have the policy for this duration before conception for maternity costs to be covered. |
| Routine & Major Dental | 3 to 6 months | A short wait for routine check-ups, often longer (e.g., 12 months) for major work like crowns or bridges. |
| Health & Wellness Checks | 6 to 12 months | You need to be a member for a set period before you can claim for routine health screenings. |
| Advanced Medical Imaging | 0 to 3 months | MRI, CT, and PET scans are often covered from day one if treating an eligible acute condition, but check your plan details. |
Important Distinction: A waiting period is not the same as a moratorium.
- Waiting Period: Applies to a benefit for everyone.
- Moratorium: Applies to your personal pre-existing conditions.
Switching Provider? If you are moving from another IPMI provider to Expatriate Group without any gap in cover, they may agree to waive the waiting periods for benefits you were already eligible for under your previous plan. This is known as "continuous transfer terms," and a specialist broker is invaluable in negotiating this.
What Expatriate Group Policies Typically Exclude
Every insurance policy has exclusions—specific situations, treatments, and conditions that are not covered. It's vital you read your policy documents to understand them. Exclusions fall into two categories.
1. General Exclusions
These are standard exclusions that apply to almost all international health insurance plans. They represent events and treatments that fall outside the scope of what IPMI is designed for.
Common general exclusions include:
- Chronic Conditions: IPMI is for acute (curable) conditions. The long-term management of chronic illnesses like diabetes, hypertension, and most autoimmune disorders is not covered. Your policy will cover acute flare-ups, but not the day-to-day monitoring and medication.
- Pre-existing Conditions: As discussed, unless they have been explicitly accepted by the insurer under FMU.
- Self-Inflicted Injury & Substance Abuse: Treatment for alcoholism, drug abuse, or injuries sustained while committing a crime.
- Elective Cosmetic Surgery: Procedures chosen for aesthetic reasons, like a nose job or facelift. Reconstructive surgery following an accident or illness is often covered.
- Fertility Treatment: IVF and other assisted reproduction technologies.
- Experimental Treatment: Therapies and drugs that are not yet approved by mainstream medical bodies.
- Professional Sports: Injuries sustained while participating in sport as a professional.
- War and Terrorism: Although some plans offer limited cover for unexpected acts of terrorism.
2. Specific Exclusions
These are exclusions applied specifically to your policy, based on the information you provided during Full Medical Underwriting (FMU). For example: "No cover for the investigation or treatment of the right knee."
This personalises your policy, providing transparency about what is and is not covered based on your unique medical history.
How to Choose the Right Underwriting and Plan
Making the right choice starts with honesty and a clear understanding of your priorities.
- Prioritise Honesty: The golden rule of insurance is to provide full and frank disclosure. Attempting to hide a pre-existing condition is a false economy. If discovered later, your insurer can cancel your policy, refuse your claim, and you will be liable for all medical bills.
- Decide Between Certainty and Speed: If you want absolute clarity on what's covered from day one, choose Full Medical Underwriting. If you are in perfect health and need cover quickly, a moratorium plan may be suitable.
- Seek Expert Advice: The nuances between plans and underwriting options can be confusing. An independent IPMI adviser can save you time and money. They understand the market and can advocate on your behalf to find the most suitable cover from providers like Expatriate Group.
The team at WeCovr provides this expert advice at no cost to you. We help you compare the market, complete the application, and understand your policy documents, ensuring there are no surprises down the line.
Why Choose WeCovr for Your Expatriate Group Policy?
As a leading UK health insurance specialist, WeCovr offers more than just a price comparison. We provide a comprehensive advisory service designed to give you confidence and peace of mind.
- Independent, Expert Advice: We are not tied to any single insurer. Our FCA-regulated advisers offer impartial guidance tailored to your unique needs as an expat.
- No Cost to You: Our service is completely free for you to use. We receive a standard commission from the insurer you choose, so you get expert advice without the price tag.
- Application Support: We guide you through the application process, helping you complete complex medical declarations accurately to ensure your cover is secure.
- High Customer Satisfaction: Our clients consistently rate us highly for our knowledgeable, friendly, and efficient service.
- Exclusive Benefits: When you take out a policy with us, you get complimentary access to CalorieHero, our AI-powered calorie and nutrition tracking app. Furthermore, clients who purchase private medical or life insurance often qualify for discounts on other policies.
Frequently Asked Questions (FAQs)
Do I need to declare a minor condition I had years ago?
What happens if I need treatment for an excluded condition?
Can a medical exclusion ever be removed from my policy?
Is cancer considered a pre-existing condition?
Get Your Expert IPMI Quote Today
Choosing the right international health insurance is a critical step in your expatriate journey. By understanding how pre-existing conditions, waiting periods, and exclusions work, you can select a policy that provides genuine security.
Don't navigate this complex market alone. Contact the friendly, expert team at WeCovr today for a free, no-obligation discussion about your needs. We'll compare plans from Expatriate Group and other leading providers to find the perfect cover for you and your family.
