Key takeaways: Can I get health insurance if I’m disabled?

If you’re disabled, you can get health insurance for new medical conditions that start after your plan starts, as long as they aren’t related to your disability. You won’t usually be able to claim for conditions you had symptoms of when your plan started, and that includes conditions related to your disability. If you’re not covered for a condition, your health insurer may still be able to support you in other ways.

The way health insurers cover conditions related to disabilities will vary depending on the insurer and your plan. However, most health insurers don’t usually cover existing conditions or conditions they count as chronic conditions, and many disabilities will fall into these categories.  

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Can I claim for treatment for a disability I had before my plan started?

If you already have a diagnosis or symptoms of a disability when your health insurance starts – whether you’ve seen a doctor or not – you won’t usually be covered for that condition. Your insurer may also ask your GP for information about when your symptoms started.

Find out more about how health insurers cover pre-existing conditions in our guide: Can I get health insurance to cover a pre-existing condition?

Example case

Chris already has multiple sclerosis (MS) when their plan starts, so he’s not covered for any treatment related to MS. When Chris develops arthritis in his shoulder, he can claim treatment for this because it’s an unexpected condition unrelated to his MS. 

Can I claim for treatment for a disability I develop after my plan starts?

If you didn’t have any signs or symptoms of your disability before you started your health insurance, you may be able to claim for the tests or scans to diagnose the condition, and your initial specialist consultations. However, once the disability is diagnosed, most health insurers consider disabilities to be chronic conditions and won’t cover them. Some health insurers may cover short-term treatment if your chronic condition flares up or gets worse unexpectedly. 

Health insurers usually count a condition as chronic where any of these apply:

·         It needs ongoing or long-term monitoring through checkups, tests, examinations or consultations.

·         It needs long-term control or relief of symptoms.

·         It needs you to have long-term rehabilitation or special training to cope with the illness.

·         It continues indefinitely.

·         It has no known cure.

·         It comes back or is likely to come back.

Individual insurers might have a different definition, so it’s worth checking your membership documents for their definition of a chronic medical condition.

Example case

Stevie doesn’t have signs or symptoms of any medical conditions when she starts her plan. After she’s been with her health insurer for a few years, she notices a tremor in her hand. Her health insurance pays for her to see a specialist and have some diagnostic tests, and she’s diagnosed with Parkinsons disease. As this is a chronic condition, her insurance may not cover any more treatment for Parkinsons after her diagnosis. 

How can my health insurer support me if they don’t cover my disability?

Most health insurers give you access to additional services with your general health insurance to support your health and wellbeing. For example, with AXA Health, you’ll get:

  • A 24/7 health support line for any health information you need.
  • A 24/7 mental health support line where you can talk to a mental health professional.
  • Access to our online GP service – you can have an appointment in the convenience and privacy of your own home, or anywhere else that suits you, subject to appointment availability. There are usually slots available around the clock, including in the evenings and weekends.

Do I need to tell my health insurer if I have a disability?

It's important to tell health insurers everything about symptoms linked to your disability, whether you're diagnosed or not. If your disability affects how your insurer gives you information – for example, it affects your eyesight or hearing – let them know, as they may be able to communicate in a way that suits you better, or may have other ways to support you. 

If you claim for any condition, your insurer will be able to see whether it’s linked to a disability from the information you provide, or from your referral. They will then let you know what they can or can’t cover.

You may want to check how your insurer defines a disability. At AXA Health we define it by statute, specifically the Equality Act 2010.

Will having a disability affect my health insurance premium?

When you apply for health insurance, whether you are disabled or not, you will need to answer some questions which will affect the price you pay. It's important to tell health insurers everything about symptoms linked to your disability, whether you're diagnosed or not. If you need to declare your disability the insurer will apply exclusions.

If you develop a disability after joining, your health insurer shouldn’t make any premium changes to your plan because you have a disability. Your premiums should stay the same until your plan is due for renewal, when your insurer will review your price as normal.

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