Health insurance and Autism

housebuyer143

After many years deliberating I finally decided to get private health insurance for myself and my family. No problems really apart from my 6-year-old son is autistic.

As a condition of health insurance pre-existing conditions or chronic conditions are not covered. While I expected this, I want to understand what degree this would impact on my son. I appreciate I would not be eligible for things like speech therapy, occupational therapy, and therapies to treat autism, but would this rule him out for any health related treatments?

Following on from this My husband has generalised Raynaud's condition which he takes medication for. It's not expected to get worse and I appreciate this also isn't covered but he takes heart medication for it. Would taking heart medication for this condition mean he would not be covered for heart-related issues in future?

Any help is appreciated as I find the private health insurance a little bamboozling and don't want them to weasel out of the claim.

DullGreyGuy

Private medical insurance will typically exclude any pre-existing conditions and anything related to them. So for example if you have diabetes it is likely to exclude loss of eyesight due to a detached retina as this is a long term consequence of the condition but wouldnt exclude other eye conditions. 

If you are unsure then it may be worth speaking to an advisory broker who can advise you on the best policy for your needs. Dealing directly with the insurers will be a non-advised sale where they can simply tell you the terms and you are responsible for deciding what's best for you.

It may also be worth checking any work options for PMI as corporate policies can sometimes cover pre-existing conditions... they still wont cover the maintenance of chronic conditions but will cover an acute episode related to them. Added to that prices are often much more reasonable than personal lines (one sale gets them thousands on cover whereas personal lines each policy has to be sold and managed independently). 

housebuyer143

DullGreyGuy said:

Private medical insurance will typically exclude any pre-existing conditions and anything related to them. So for example if you have diabetes it is likely to exclude loss of eyesight due to a detached retina as this is a long term consequence of the condition but wouldnt exclude other eye conditions. 

If you are unsure then it may be worth speaking to an advisory broker who can advise you on the best policy for your needs. Dealing directly with the insurers will be a non-advised sale where they can simply tell you the terms and you are responsible for deciding what's best for you.

It may also be worth checking any work options for PMI as corporate policies can sometimes cover pre-existing conditions... they still wont cover the maintenance of chronic conditions but will cover an acute episode related to them. Added to that prices are often much more reasonable than personal lines (one sale gets them thousands on cover whereas personal lines each policy has to be sold and managed independently). 

Thank you, I will contact a broker. When I ask about the autism the response I get from the insurer is " we would not cover any treatments or conditions related to the autism". It's super vague, especially as autism isn't treatable 🤔 and they won't or they're not able to go into more detail about this. Hopefully a broker can advise better. 

My works policy isn't that great so have decided this is the best route.

DullGreyGuy

Afraid its a medical condition I know very little about but to the best of my knowledge it wont develop into something else... I've not heard of those with autism having a higher rate of cancer or heart failure etc. I guess one question could be about physical injury related to outbursts or reckless behaviour etc

Alderbank

DullGreyGuy said:

Afraid its a medical condition I know very little about but to the best of my knowledge it wont develop into something else... I've not heard of those with autism having a higher rate of cancer or heart failure etc. I guess one question could be about physical injury related to outbursts or reckless behaviour etc

I don't know much about it either but the support charity Thinking Autism
 https://www.thinkingautism.org.uk/ says:

It is an undeniable and sad fact that individuals with autism suffer much poorer health and shorter lifespan than their peers without autism. Multiple studies have shown this including one published in 2018, an important investigation of over 27,000 Swedish people diagnosed with ASD which revealed that the average life expectancy among the people studied with severe autism is 39.5 years, rising to only 58 years for those with high-functioning autism, or Asperger syndrome.

To me those are shocking and unexpected figures.

housebuyer143

Alderbank said:

DullGreyGuy said:

Afraid its a medical condition I know very little about but to the best of my knowledge it wont develop into something else... I've not heard of those with autism having a higher rate of cancer or heart failure etc. I guess one question could be about physical injury related to outbursts or reckless behaviour etc

I don't know much about it either but the support charity Thinking Autism
 https://www.thinkingautism.org.uk/ says:

It is an undeniable and sad fact that individuals with autism suffer much poorer health and shorter lifespan than their peers without autism. Multiple studies have shown this including one published in 2018, an important investigation of over 27,000 Swedish people diagnosed with ASD which revealed that the average life expectancy among the people studied with severe autism is 39.5 years, rising to only 58 years for those with high-functioning autism, or Asperger syndrome.

To me those are shocking and unexpected figures.

I can believe it. It's likely down to them being  unable to explain their symptoms to others when they are ill. 
Someone who can't speak, how would they say they have found a lump, their stomach hurts, they are getting worse. It's probably too late to help them when they eventually make it to the right people. 

6 in 10 of all covid death were from those with learning disabilities ☹️

housebuyer143

In case anyone is looking at this in future, the response eventually was, Autism is classed as a behavioural issue and not a clinical one, so therefore most clinical issues will be covered. There are very few clinical issues associated or as a result of autism therefore most things would be covered apart from therapies and drugs to manage the behaviour etc.