You might be thinking having a term like 'pre-existing conditions' in your vocabulary will only be useful when you're playing Scrabble, but a pre-existing condition is an ailment, illness or condition that, in the opinion of a Medical Practitioner appointed by ahm, the signs or symptoms of which existed at any time in the period of six months before you became insured under or changed your level of cover with ahm. It’s good to keep in mind that a pre-existing condition may exist even if you’re not actually aware of the condition.
Our appointed Medical Practitioner decides if an ailment, illness or condition is pre-existing. In doing so, they must consider any information that was prepared by your medical practitioner (your doctor, for example) who treated the ailment, illness or condition. Once we have all the information required from your treating medical practitioner (including this PEC form), we’ll need up to 10 working days to make the decision.
Does any health insurance cover pre-existing conditions?
It's less about if and more about when your health insurance policy can actually begin helping with the bill for the treatment of any conditions you had before signing up (provided the treatments are included in your cover). You can see our range of health insurance products here.
If you've got any questions about the level of cover that you might need to assist with your pre-existing condition once you have served waiting periods, you can always get in touch with us.
How do pre-existing conditions impact waiting periods?
Pre-Existing Conditions (PEC) have a 12-month waiting period from the time you join your cover. If you’ve joined but then decide to upgrade your cover and add new services or treatments, the 12-month period applies to the new services or treatments from when you upgraded.
A waiting period is the amount of time you have to wait before we can start helping with the bill for the services or treatments included under your cover. That includes hospital admissions for when you receive treatment for your pre-existing condition.
After serving any applicable waiting periods on your health insurance policy, you can begin to claim benefits in your policy – including any related to your pre-existing condition.
Not all services are subject to the PEC waiting period, for example, hospital psychiatric services or rehabilitation – so get in touch with us and we can find the best policy to suit your needs.
You can also check your Member Guide for more information on pre-existing conditions.