Understand How Pre-existing Conditions Affect Your Insurance

In Singapore, health insurance is a key part of managing medical costs, but for those with existing medical conditions, navigating coverage can be more complex. Whether you're living with diabetes, hypertension, or recovering from a past surgery, understanding how pre-existing conditions impact insurance will help you to make more informed healthcare decisions.

In this article, we explore what pre-existing conditions are, how they impact health insurance in Singapore, and what steps you can take to ensure that you’re adequately covered.

What are pre-existing conditions and how do they affect your health?

Pre-existing conditions are any illnesses or medical issues that were diagnosed, treated, or showed symptoms before you applied for a health insurance policy. These include chronic diseases such as:

• Diabetes
• High blood pressure (hypertension)
• Asthma
• Heart disease
• Cancer
• Autoimmune disorders
• Prior surgeries or long-term treatments

These conditions may require long-term management, regular medications, or follow-up treatments. Because of the increased likelihood of future claims, insurers often consider individuals with pre-existing conditions to be higher risk.

The impact of these conditions extends beyond insurance, they also affect your treatment options, medication adherence, lifestyle, and long-term prognosis. That’s why coordinated care and early intervention are crucial.

How pre-existing conditions can affect your health insurance coverage

1. Higher premiums

Insurance providers assess the risk for each applicant. A pre-existing condition may raise your premiums because it increases the likelihood of medical claims in the future.

2. Policy exclusions

Insurers may apply temporary or permanent exclusions for your existing condition. This means treatments or hospitalisation related to that condition might not be claimable, at least initially.

3. Claims complications

It’s important to be honest about your medical history when applying for insurance. If you fail to disclose any pre-existing conditions, your claims may be rejected, or even worse, your policy may be voided. This will make future applications for health insurance policies more difficult, leaving you vulnerable. Being transparent helps avoid unnecessary stress during already challenging times.

What options do we have in Singapore?

• MediShield Life

Singapore’s basic national health insurance, MediShield Life, provides coverage for pre-existing conditions. However, if you were diagnosed with a serious pre-existing illness before enrolment, you may pay up to 30% additional premiums for 10 years.

You can also use your MediSave to help offset these costs, making it a helpful option if you do not qualify for an Integrated Shield Plan.

• Specialised health insurance plans

Some Integrated Shield Plans may exclude pre-existing conditions, while others may impose a waiting period or higher premiums. Plans vary by provider, so it’s important to check policy terms.

Some insurers offer policies or riders designed for specific conditions, such as diabetes or cancer. These may offer conditional coverage after a waiting period. Examples include:

• Income’s Complete Cancer Care
• AIA’s Diabetes Care
• Singlife’s Essential Critical Illness

Note: Each plan has its own terms, so it’s important to read the fine print or speak to a qualified adviser.

• Corporate and group insurance

If you are employed, your company’s Corporate Insurance can be a significant lifeline, especially for individuals with pre-existing conditions who may face exclusions or rejections under individual private health insurance plans.

Some Corporate Insurance may not require individual medical underwriting, meaning employees are automatically enrolled regardless of their health status. This makes it one of the few ways individuals with chronic or complex conditions can still receive coverage for hospitalisation, specialist care, and chronic disease management.

Tips for managing health insurance with a pre-existing condition

Here are steps you can take to stay on top of your health and improve your insurability in the long run:

• Stay consistent with follow-ups: Regular monitoring helps detect changes early.

• Work with one primary specialist: Continuity helps ensure coordinated care.

• Maintain a healthy lifestyle: Good diet, exercise, and sleep habits support overall well-being,

• Adhere to medications and treatment plans: Stability in your condition can make you more eligible for better insurance coverage.

• Document your progress: Medical reports showing stability may support appeals for coverage in the future.

Take charge of your long-term health

Pre-existing conditions can make insurance more complex, but with the right information, coverage, and care team, you can still access quality healthcare without added stress.