What Are Pre-Existing Conditions?
A pre-existing condition is any health issue that existed before your insurance coverage began. This includes chronic illnesses, ongoing treatments, and previously diagnosed conditions such as:
- Diabetes (Type 1 or Type 2)
- Asthma
- Depression or anxiety disorders
- Epilepsy
- Heart conditions
- Autoimmune diseases
- Allergies requiring ongoing treatment
- Previous surgeries with follow-up needs
- ADHD
- Thyroid disorders
For international students, pre-existing conditions create one of the biggest health insurance challenges. Many private insurance plans exclude or limit coverage for conditions you already have, potentially leaving you without coverage for the treatment you need most.
How Pre-Existing Conditions Affect Your Insurance
Insurance companies view pre-existing conditions as higher risk. Depending on the country and plan, they may:
- Exclude the condition entirely: Your plan covers everything except treatment related to your pre-existing condition
- Apply a waiting period: Coverage for the condition begins only after 6–24 months
- Charge higher premiums: You pay more for the same plan
- Deny coverage altogether: The insurer refuses to cover you (rare in regulated markets)
- Cover with limitations: Partial coverage, annual caps, or higher co-payments
Pre-Existing Condition Rules by Country
Germany
GKV (Public Insurance), Best option for pre-existing conditions:
- ✅ All pre-existing conditions covered: no exclusions, no waiting periods
- ✅ Same premium regardless of health status (~€146/month for students)
- ✅ Full access to all necessary treatments
- ✅ Prescription medications included
- This is why switching to GKV is often recommended for students with chronic conditions
PKV (Private Insurance):
- ❌ May exclude pre-existing conditions
- ❌ May charge risk surcharges
- ❌ Must disclose all conditions (Gesundheitsfragen)
- ⚠️ Failure to disclose can void your entire policy
Recommendation: If you have pre-existing conditions and study in Germany, choose GKV whenever possible. See our Germany insurance guide.
United States
- University SHIPs: Most now cover pre-existing conditions thanks to ACA regulations affecting university plans. However, some plans still have limitations.
- Private international student plans: Coverage varies widely. Always check the policy’s pre-existing condition clause.
- ACA marketplace plans: Cover pre-existing conditions, but F-1 students are generally not eligible.
Australia
- OSHC: Must cover pre-existing conditions with some exceptions. A 12-month waiting period applies for pre-existing conditions, meaning you’ll need to pay out of pocket for the first year.
- Exception: Psychiatric conditions, pregnancy, and some chronic conditions may have specific rules.
United Kingdom
- NHS: Covers all conditions for eligible students: no exclusions. Access requires paying the Immigration Health Surcharge (IHS).
- Private insurance: May exclude pre-existing conditions or apply waiting periods.
Spain
- Public system: Covers all conditions for registered residents.
- Private insurance: Varies: many Spanish insurers exclude pre-existing conditions or apply waiting periods. This can be problematic for visa applications.
Tips for Students with Pre-Existing Conditions
1. Always Disclose Your Conditions
Never hide a pre-existing condition from your insurer. Non-disclosure can:
- Void your entire policy retroactively
- Result in denied claims when you need care most
- Create legal problems
Be honest on all health questionnaires. It’s better to pay a higher premium than to be uninsured when you need help.
2. Choose Public Insurance When Possible
In countries with public health insurance options (Germany, UK, Spain), public insurance almost always provides better coverage for pre-existing conditions than private plans.
3. Bring Sufficient Medication
Bring enough medication to cover your first few months abroad. This gives you time to:
- Register with a local doctor
- Get new prescriptions
- Handle the local pharmacy system
4. Get Medical Records Translated
Have your medical records and prescriptions translated into the language of your host country (or English). Include:
- Diagnosis history
- Current medications (use generic/scientific names)
- Treatment plans
- Allergies
5. Research Specialists Before You Go
Identify specialists in your destination city who treat your condition. Your home doctor may be able to recommend colleagues abroad.
6. Understand Your Medication Abroad
- Some medications available in your home country may be restricted or unavailable abroad
- Generic names may differ
- Dosages or formulations might vary
- Some controlled substances require special import permits
7. Build a Continuity of Care Plan
Work with your current doctor to create a plan that includes:
- How to transition care to a new provider
- What monitoring or tests you’ll need
- Emergency protocols specific to your condition
- When to seek urgent care
Cost Considerations
Students with pre-existing conditions should budget for:
| Cost Factor | Estimate |
|---|---|
| Insurance premium surcharge | 10–50% above standard |
| Out-of-pocket medications | €20–€100/month |
| Specialist visits (if not covered) | €50–€200/visit |
| Initial medication supply from home | Varies |
| Medical record translation | €50–€200 |
Questions to Ask Insurance Providers
Before purchasing a plan, ask:
- Are pre-existing conditions covered under this plan?
- Is there a waiting period? If so, how long?
- Are my specific medications covered?
- Will I need prior authorization for ongoing treatments?
- Are there annual caps on coverage for my condition?
- What happens if my condition worsens: is that covered as a new condition or pre-existing?
- Can I see specialists directly, or do I need referrals?
What If No Plan Covers Your Condition?
If you can’t find insurance that covers your pre-existing condition:
- Consider the destination’s public system: GKV in Germany, NHS in UK
- Contact your university’s international office: They may have experience with similar cases
- Look into your home country’s international coverage: Some national health systems offer limited coverage abroad
- Explore international patient organizations: They may know of specific resources
- Budget for out-of-pocket costs: Set aside funds for uncovered treatments
Take Action: Get the Right Coverage
Don’t let a pre-existing condition prevent you from studying abroad. With the right planning and insurance choice, you can access the care you need.
👉 Compare student health insurance plans and filter for plans that cover pre-existing conditions. Our tool helps you find coverage that works with your health needs, not against them.