Eligibility for PMI After Major Operations

Hi all,

A common question I see here and elsewhere is about getting private medical insurance after a major operation like heart surgery, cancer treatment, or a joint replacement. It's a valid concern, and the landscape can seem confusing, so I wanted to share a summary of the key things to know.

The short answer is yes, it's often possible to get a new PMI policy after major surgery. The main goal in this situation is usually to get cover for new, unforeseen, and unrelated health issues that might come up in the future.

The fundamental thing to remember about PMI is that it's designed to cover new, acute conditions that arise after your policy begins. It generally does not cover pre-existing or chronic conditions. The major operation you had, and the condition that caused it, will be considered a pre-existing condition. This means it will almost certainly be excluded from your new policy, at least for a set period.

When you apply, insurers use a process called underwriting to assess your application. The two main types are:

• Full Medical Underwriting (FMU): You provide a detailed medical history upfront. The insurer then gives you a clear list of what is and isn't covered from the start. It offers certainty but takes longer.

• Moratorium Underwriting: This is quicker as you don't fill out a detailed health form. Instead, the policy automatically excludes any condition you've had symptoms or treatment for in the last 5 years.

For example, if you've had heart surgery, an insurer will typically want to see a stable period of recovery (e.g., 6 months to 2+ years) and evidence from your GP or specialist that your condition is well-managed. They're assessing the risk for future, unrelated problems, not looking to re-cover your heart condition.

The key takeaway is that while your past major surgery will be excluded, you can still secure valuable cover for a wide range of other potential acute conditions, from hernias and cataracts to joint pain or diagnostic tests for new symptoms.

Full disclosure: these insights are from a guide I work on.

For those who've been through this process of applying after a significant medical event, did you opt for full medical underwriting to get clarity on exclusions from day one, or did you go with a moratorium policy? I'm curious to hear about your experiences and reasoning.

https://wecovr.com/guides/eligibility-for-pmi-after-major-operations?utm_source=reddit&utm_medium=social&utm_campaign=rd-community