If you have a medical condition before applying for health insurance — like diabetes, asthma, hypertension, or cancer — you might wonder: Can you still get medical insurance? The short answer is yes, but it depends on the insurer, underwriting method, and specific condition.This article explains what a pre-existing condition is, how insurers treat them, and what options might be available if you’re in this situation.
What is a pre-existing condition?
A pre-existing condition refers to any health issue, symptom, diagnosis, treatment, or medical history that already existed before you apply for medical insurance. This could be chronic diseases (like diabetes or heart disease) or conditions that required medical care in the past few years.
In insurance terms, it usually includes illnesses diagnosed or treated within a certain period (sometimes up to several years) before your policy’s start date. How long this look-back period is — and whether the condition will be covered — varies by insurer and policy.
How does your insurer check out if you suffer from any pre-existing conditions?
The simple reality is:
Most Standard Medical Cards Exclude Them
Most medical insurance policies in Malaysia do not cover pre-existing conditions automatically. That means treatments related to conditions you already have before buying the policy may not be covered while the exclusion applies.
Some Insurers May Offer Coverage Under Conditions
Some health insurers use underwriting methods that may eventually cover pre-existing conditions, but only with specific conditions such as:
- Waiting Period Before Coverage – you may need to keep your policy active for a set time (often 12–24 months) before those conditions become eligible for claims.
- Premium Loading or Higher Premiums – insurers may accept you but charge more to cover the higher risk.
- Exclusions Still Apply – even with premium loading, the policy might still exclude claims for that condition if very high risk.
There is no guarantee — each insurer’s underwriting criteria and risk appetite differ by company and product.
How Do Insurers Assess Pre-Existing Conditions?
When you apply for a medical card, insurers typically go through a process called medical underwriting:
Health Questions and Records Review
You’ll answer questions about your health history, surgeries, medications, and treatments, and the insurer may access your medical records.
Medical Examination (Sometimes Required)
In some cases, the insurer may require a medical check-up to get clearer insights into your health before issuing a policy.
Based on this assessment, the insurer decides whether to:
- Accept you with full coverage (rare for most conditions)
- Accept you with higher premiums
- Apply a waiting period before covering the condition
- Exclude the condition completely
- Decline the application altogether
Here is what you need to know about medical insurance policies for pre-existing diseases.
What Is a Waiting Period?
A waiting period is a time after your policy starts during which claims for specific conditions are NOT covered. For pre-existing conditions, this waiting period is usually longer than the standard general waiting period applied to new conditions.
For example:
- General waiting period (for new non-pre-existing illnesses): ~30 days
- Pre-existing condition waiting period: often 12–24 months (varies by insurer)
During this time, any treatment for your pre-existing condition is usually not claimable — but if you outlive the waiting period and meet the policy conditions, coverage may start afterward.
Premium Loading
Premium Loading is applied when an insurance company is dealing with a high-risk candidate. This includes medical history, dangerous jobs, and risky pastimes. The insurance company will include the pre-existing condition but for a higher premium.
The amount is added to the premium to provide cover for the individual that is already affected by the pre-existing disease.
Waiting Period + Premium Loading
The insurance company may have decided to load the premium as well as apply the waiting period for some critical cases.
What Happens If You Don’t Declare a Pre-Existing Condition?
Never hide or under-report your medical history. Full disclosure is a legal and contractual requirement when applying for insurance.
If you fail to disclose a relevant pre-existing condition:
- Claims may be denied
- The policy could be rescinded or canceled
- The insurer may take legal action in severe cases
Honesty ensures your coverage remains valid when you need it most.
Tips If You Have a Pre-Existing Condition
- Apply early and while healthy if possible — insurers are more likely to accept applicants at younger ages with fewer conditions.
- Discuss underwriting options with an expert — some plans use different underwriting criteria that may help with coverage eligibility.
- Compare plans carefully — some insurers offer specific products or riders for chronic conditions or older applicants.
- Understand waiting periods and exclusions — always read policy terms thoroughly to know what’s covered and when.
Conclusion
Yes — you can still get medical insurance with pre-existing conditions, but it depends on the insurer and product. Many plans exclude such conditions, require long waiting periods, charge higher premiums, or may not offer coverage at all. Knowing how underwriting works and disclosing your health history honestly helps you secure the best outcome possible.
If you want tailored guidance based on your specific condition and budget, BJAK’s insurance advisors can help you explore suitable medical card options for 2026.
