Navigating Health Insurance: Getting Cover for Pre-existing Medical Conditions

best guide for finance

Past severe injuries and illnesses can affect what health insurance covers. Typically, any major medical event in the last three years may result in an exclusion from a health insurer. Significant events like surgery, cancer, or heart attacks may lead to permanent exclusions.

Some exclusions can be lifted after a certain period if the insured remains symptom and treatment free. The review time depends on the severity of the medical issue. For instance, a minor back strain might only require a 12-month symptom-free period for review. At the same time, a past breast cancer diagnosis resulting in an exclusion may never be eligible for review.

Fortunately, there are two insurers offering coverage for existing or past health issues:

Nib Easy Health

This is ideal if your medical conditions doesn't fall under one of these specific categories:

  • Cardiovascular conditions
  • Cancer
  • Hip or knee conditions
  • Back conditions
  • Transplant surgery
  • Reconstructive or reparative procedures or surgery

Southern Cross UltraCare

Unlike Nib's Easy Health, this covers any pre-existing medical condition after three years. However, it initially comes with a higher-than-average cost. After three years, the policy owner can switch to the more affordable Wellbeing One or Two plan. While this would be considered a product downgrade, the life assured would still have coverage for their pre-existing conditions.

Having placed hundreds of health insurance policies over the last decade, we're well-versed in identifying the most suitable insurance product for each scenario, including considering the plans mentioned earlier. We also provide a start-to-finish claim support service.

The links to the key product brochures can be found below:

Please send us a few details here if you’re currently exploring your health insurance and would like some obligation free professional guidance.

This article is for informational purposes only and should not be considered as financial advice. It is always recommended to consult with a qualified financial professional before making any financial decisions based on your individual circumstances.


Crafting Success: The Tradie's Guide to Self-Employment
Health Insurance 101 with Paul


Certified, efficient, and empowering Kiwis to make better financial decisions.