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

  • Insurance

| 28/07/2025

Man smiling and patting his golden labrador symbolising care, trust, and the personalised support Finsol provides when navigating health insurance and pre-existing medical conditions

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-free 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 render one ineligible 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 don’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.

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