What counts as 'pre existing' under Bupa (new to Bupa)

[Feckthelotofthem]

I've never used private medical but get Bupa cover with a new job I started several weeks ago. 'Existing conditions' are not covered and my query is, does it count as an existing condition if you had something but didn't know you did? (I have asked their helpline this question but didn't get a straight answer!).

I was recently heart scanned (on NHS ) as a precaution before starting some new ADHD medication. I got the all clear on the thing they were scanning for (atrial fibrillation - I had it v briefly after covid a couple of years ago). NHS gave me the go ahead to start my new meds all fine. The ADHD and A fib pre date my Bupa cover.

However, I've had a call this week from GP to say that, by chance, in the scan process they've noticed something else relating to my heart valve which is quite serious. It has no symptoms and if it wasn't for the scan it would not have been picked up. I am now on an NHS waiting list. Its unlikely this recently diagnosed problem has only just happened, I may have had it for years, no way of knowing. Does 'pre existing' count as pre- existing under Bupa if you/your GP didn't know you had something? I'm worried that because my scan WAS for something pre-existing, I might not be covered for this newly discovered problem.

Unfortunately I expect this will be classed as pre-existing as the condition was found before your Bupa cover started, from the sounds of things. If the scan had been after your cover started, you might have been able to argue it…

You can ask them, but I’d presume this will be rejected. I’m sorry and I hope the condition isn’t too bad.

Was the scan taken before or after you started your new job?
Did the BUPA cover start on the day you started your new job, or is it subject to you completing a form about your health.

Depends on the policy - company ones are often more flexible. We just have a personal Bupa policy and I’m fairly sure that they’d reject the claim in this instance considering the condition was diagnosed before the start date. It’s worth a try in the first instance though to see what they say. They’ll ask your GP to fill in a referral alongside a detailed form re: your past medical history and decide from there.

Thanks for responses. My cover started day one of my new job. The heart scan was 3 months after that. The A Fib they were scanning was one occurance a year before. The new problem was picked up on scan.

Sounds like it should be covered.

I’d call them back and be very clear about the sequence of events and what the diagnosis was at every stage. If you are looking to get treatment for this condition via Bupa they will have to approve it before you go ahead. If the heart valve issue isn’t linked to the AF I would surprised if they didn’t cover it. I have found them to be very helpful if you can get through to the right person, they usually have separate teams for certain specialities.

It will be partly down to your company policy. Ours is 3 months wait for preexisting as long as not under continued treatment

Ah you made it sound like the scan was before. If the scan was after cover started, you may be absolutely fine, unless they’ve got an exclusion period in place.

They're usually pretty helpful on the phone.