Chronic Conditions & Health Insurance

The purpose of a medical insurance policy, as with all insurances, is to provide effective cover for the unexpected. It does not extend to cover conditions that require ongoing or regular treatment to maintain the stability of the condition. Such conditions, known as "chronic conditions", are therefore excluded from the policy.

What is a Chronic Condition?

A chronic condition is a disease, illness or injury which has at least one of the following characteristics:

* 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.

Freedom Healthnet's private health insurance policies cover treatment of acute conditions subject to the policy document and your certificate of insurance. An acute condition is a disease, illness or injury that is likely to respond quickly to treatment, the aim of which is to return you to the state of health you were in immediately before suffering the condition, or which leads to your full recovery.

You will usually be covered with your health insurance policy for the cost of diagnostic tests that may be necessary to diagnose your condition. If you are then diagnosed as suffering from a chronic condition we will not normally pay for further treatment. If, however, you suffer from an unexpected acute exacerbation of your chronic condition, you will usually be covered for short-term treatment necessary to stabilise the condition, provided that no other policy conditions, limits or exclusions apply.

It is important to note that if you require treatment under this health insurance policy, you must contact the Claims Helpline and obtain pre-authorisation. Failure in doing this could result in costs being incurred by you which are not covered by this private medical policy.

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