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Health Insurance for Chronic Conditions

There are several illnesses that most health plans can cover. They are called acute or curable diseases. This is understood to mean treatable diseases, injuries, or conditions that are short-term. If you have a chronic illness, you will see that your insurance provider may be reluctant to cover for the treatment of your condition.

This does not necessarily mean that your plan won’t cover for anything as it will be possible to take insurance for other unrelated and acute conditions that may come up.

Read on to explore the conditions considered chronic and consequently have no cover from your health insurance plan. Learn also why it may still be possible for you to claim treatments that are associated with these conditions.

What are chronic medical conditions?

Chronic disease is that which is persistent over a long period. It lasts for three months or even more. It is not possible to prevent chronic disease by using vaccination or cure them by using medication.

Examples of Chronic Diseases include the following:

  • Diabetes
  • Arthritis
  • Heart disease
  • Multiple sclerosis
  • Lupus
  • kidney disease

The objective of treating these illnesses is to help the patient learn to live with the conditions, and not curing it. These medical problems can be managed through dieting and physical exercise and also taking certain medications.

The treatment’s end is, in most cases, unspecified. Even with the medical technology in existence, most of these conditions cannot be cured, and the likelihood of their recurrence is high.

There exists a lot of checkups and consultations that are necessary for monitoring the illness. Nowadays, cancer cover has been included in many health plans even though, in every way, it falls in the chronic condition category.

Generally, most health insurance providers don’t cover chronic illnesses or illnesses you had before your policy term began. This is because the condition was not part of the policy agreement when the contract started. Moreover, if they had to cover any chronic conditions that came up later, then the insurance coverage would be costly due to higher claims.

How Health Insurers deal with Pre-existing Chronic Conditions


This is the typical way for most insurance givers to handle pre-existing chronic conditions. In this plan, your insurer will exclude your condition’s treatment and its related symptoms from coverage. You will, therefore, access treatment for other medical issues that are not related to your chronic illness but won’t get indemnification for all the medical costs that are associated with the treatment of your pre-existing condition.


Placing a moratorium on the condition’s coverage is the second option for most insurers. This is a grace period of around twenty-four months. During this period, the policy cannot cover chronic conditions. If the moratorium period is over without the policyholder needing medication, treatment, or checkups, the insurer may put into consideration providing cover under the terms laid out in the policy.

Coverage with loading

In this case, the insurer will provide cover for the condition. Consequently, you will have to part with a higher premium. What’s important to note is the fact that not all insurers will offer this option. It’s a much more expensive alternative, but if you can afford the monthly or annual premiums, why not go for it?

The Aspects of Chronic Illnesses covered

Your insurance provider may not include the required treatments for your chronic illnesses but will consider some of the chronic illnesses’ aspects.

These are some of the conditions under which your insurance provider will cover for chronic conditions:

  • When there is an attempt to cure or diagnose the illness in the first place. Once the efforts are exhausted, the treatment is passed onto the maintenance phase, which is meant to control and manage the illness or cure it.
  • If there is the availability of a new option in the treatment

Instead of merely managing your condition, the latest development’s objective will be to cure the disease completely.


Before you sign up for any insurance policy, make sure you have read and understood its terms and agreements to know what you will be paying for. It’s also wise to shop around before settling on an insurer. This will help you explore other options that may be offered by some insurance companies.

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