Chronic and Acute Conditions

Medical insurance is designed to cover people for short term unexpected illnesses and medical conditions. The term for this is acute. Conditions which are ongoing and require long term medical treatment are known as chronic conditions and are generally not covered by private medical insurance.

The Association of British Insurers (ABI), who represents the interests of the UK insurance companies has set up definitions for chronic and acute conditions.

An acute condition:
A disease, illness or injury that is likely to respond quickly to treatment which aims to return you to the state of health you were in immediately before suffering the disease, illness or injury, or which leads to your full recovery

A chronic condition
-A disease, illness or injury which has at least one of the following circumstances:
-It continues indefinitely and has no known cure
-It comes back or is likely to come back
-It is permanent
-You need to be rehabilitated or specially trained to cope with it
-It needs long-term monitoring, consultations, check ups, examinations or tests.

Examples of chronic conditions may include: asthma, long term disability, dialysis for kidney failure, multiple sclerosis.

As reported in Health Insurance News UK, cancer presents a particular problem. When a cancer is still considered curable then your condition can be said to be acute. However if you become terminally ill then you may not be covered under the terms of your policy. Insurance companies can reclassify your illness from acute to terminal during your treatment.

AXA PPP Healthcare, for example, will not pay for maintenance treatment of cancer, for example where hormone treatment is needed for several months or years to help prevent the return of cancer.

Getting health cover for psychiatric conditions can also be an issue as mental health probelms are often long term and therefore do not come under the cover of 'acute.' Some policies however do cover psychiatric illness under extensions of their policy.

Most policies will pay for the cost of diagnostic tests that may be needed in order to diagnose your chronic condition but will not normally pay for any further treatment. Generally speaking, a policy will cover you for an acute attack of your chronic condition until you are stable again but will not further treat the chronic condition itself.

Chronic conditions which involve relapses and times of improvement, for example, multiple sclerosis, are not included as the relapses are considered to be part of the chronic nature of the condition rather than acute and unexpected complications of the disease.

You should always receive written notice if your cover is to be withdrawn when a condition is considered to be chronic.

Above all, it is important to always compare private medical insurance policies and be armed with an idea of what you want before you shop around.