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 28 May 2024
3 minute read
What's not covered by health insurance?
Exactly what isn’t covered will depend on the insurer you choose and the level of cover you select. Although most policies share the same main exclusions.
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.
For example, if you took out health insurance in March 2024, it wouldn't cover an injury you got in January 2024. You wouldn’t be able to claim for any treatment related to that injury.
For example, imagine you had injured your shoulder in January. You then took our health insurance in March. Then, imagine your shoulder injury started to affect your back. If you then needed physio for your back, your insurance wouldn't cover this.
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 specially trained to cope with it.
- A condition that continues indefinitely.
- 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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Bupa health insurance is provided by Bupa Insurance Limited. Registered in England and Wales with registration number 3956433. Bupa Insurance Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Arranged and administered by Bupa Insurance Services Limited, which is authorised and regulated by the Financial Conduct Authority. Registered in England and Wales with registration number 3829851. Registered office: 1 Angel Court, London, EC2R 7HJ.
