Health insurance exclusions
Every policy is different, but most share the same main exclusions. Take a look at our guide to what’s not covered by health insurance.
Edited by Darren Siddle, health
insurance expert at Bupa
Last updated 12 June 2026
3 minute read
What's not covered by health insurance?
All policies are slightly different, so exactly what isn’t covered will depend on your insurer and the level of cover you choose. Most policies share the same main exclusions though
Not covered by most health insurance
- Chronic conditions – These are ongoing health issues with no known cure. For example, asthma or diabetes.
- Pre-existing conditions – These are conditions or injuries you had before your policy started.
- Cosmetic treatments
- Allergies and food intolerances.
- Life events like pregnancy, menopause, or ageing.
To find what is and isn’t covered on Bupa health insurance policies, you can compare our cover options.
What are pre-existing conditions?
These are conditions you had before your health insurance policy started. Most insurers won’t cover pre-existing conditions.
Health insurance covers new conditions or injuries that begin after your cover starts. It doesn’t cover conditions or symptoms you have after your policy starts, that are related to illnesses or injuries from before you took out the policy.
For example, imagine you had a slipped disc before your policy started and it wasn’t covered. Later, you develop nerve pain such as sciatica that’s caused by that same slipped disc. Because it’s linked to the original condition, your insurance wouldn’t cover treatment for the sciatica either.
When you take out health insurance, your provider will ask you to give a medical history. They’ll then let you know what they won’t cover you for.
What are chronic conditions?
These are ongoing health issues with no known cure, such as arthritis, diabetes, or asthma. Most health insurance policies won’t cover treatment for long-term conditions.
Make sure you understand what is and isn’t covered before you buy a health insurance policy.
Chronic conditions
- Conditions that need ongoing or long-term monitoring, check-ups, or tests.
- Conditions that need ongoing or long-term control or relief for symptoms.
- A condition that needs rehabilitation or for you to be specifically trained to cope with it. For example, a stroke that affects your ability to walk or talk.
- A condition that is likely to last for the rest of your life or a very long time.
- A condition that has no known cure.
- A condition that comes back or is likely to come back.
Some policies do cover flare-ups of long-term conditions. There are sometimes other exceptions to these rules. For example, Bupa health insurance may cover ongoing care for mental health or cancer.
What counts as cosmetic surgery?
Most policies won’t cover treatments or surgery used to change your appearance.
This is because most health insurance covers treatment for injuries and illness. But cosmetic surgery could be considered a choice.
Most insurers will pay for surgery to restore your appearance if there is a medical reason. For example, after an accident or cancer surgery.
Other health insurance exclusions
Most health insurance policies have these exclusions.
Not covered by health insurance
- Accident and emergency treatment
- Allergies or food intolerances
- Birth control
- Fertility treatment
- Gender dysphoria or gender affirmation
- Deafness
- Dialysis
- Treatment to correct eyesight
- Intensive care
- Learning difficulties, or behavioural and developmental conditions
- Overseas treatment
- Pregnancy or childbirth
- Puberty, menopause or ageing
- Sleep problems and disorders
- Speech disorders
- Varicose veins
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