If a medical condition pushes up your UK travel insurance, this rule is on your side

Since 1 January 2026, a UK travel insurer that adds £200 or more to your premium because of a medical condition must point you to a specialist directory, and the same applies if it refuses you, cancels you, or leaves you with an exclusion you cannot remove. The threshold was £100 before then. The FCA recognises two directories, MoneyHelper’s and BIBA’s, and both exist to find firms that cover people with serious conditions. The rule only helps if you declare properly, because an undeclared condition can sink a claim that has nothing to do with it.

When does an insurer have to send you to the directory?

When any of five things happens because of a medical condition: you are refused a quote, your policy is cancelled, a condition is excluded and cannot be removed, the medical part of the premium is £200 or more, or the firm cannot tell you what the medical part costs. The rule is ICOBS 6A.4.6R in the FCA Handbook, and the wording matters, so here it is.

When one applies, ICOBS 6A.4.5R says the firm must give you “the contact details, including telephone number and website, of the medical cover firm directory”, its purpose, and “the potential benefits of accessing” it. That must be prominent, clear and accurate. FCA guidance adds that the message should tell you why you are getting it and should not, taken as a whole, discourage you from using the directory.

Two exceptions are worth knowing. A firm does not have to signpost if it can offer you, at the same time, a policy where none of the five triggers applies. And a firm that is itself listed on a directory can skip it if it knows you have already used that directory for the same trip and the only trigger is the premium. Neither exception applies where signposting would still be in your best interests.

What changed in January 2026?

The premium trigger doubled from £100 to £200 on 1 January 2026, and it will now move with inflation every five years. The FCA’s review of the rules, last updated on 3 December 2025, says it was “increasing the medical condition premium trigger point for signposting from £100 to £200.” The rule text sets £200 as the base, adjusted by CPI at the end of each five-year period, with the first period running from January 2025 to January 2030.

In plain terms: a medical loading of £150 used to trigger a signpost and now does not. If your quote rises by less than £200 because of a condition, nobody is obliged to mention the directory, but nothing stops you using it. The same FCA review estimated the signposting rules produced about 21,000 additional policy sales, which it called “a positive, albeit lower than we expected, impact on the market.”

Where are the directories, and what do they do?

The FCA says “two directories, for people with serious PEMCs, that meet our criteria”: the MoneyHelper directory, provided by the Money and Pensions Service, and BIBA’s. PEMC means pre-existing medical condition. Every firm selling retail travel insurance must show details of at least one of them on its website.

• MoneyHelper travel insurance directory: linked from the FCA’s policy statement PS20/3, at moneyhelper.org.uk.
• BIBA: the FCA lists its consumer line as 0370 950 1790, Monday to Friday, 9am to 6pm (hours updated by the FCA on 3 July 2026).

A directory does not sell you a policy. It points you to firms that are set up to quote for serious conditions, and from there you compare as you would anywhere else. GOV.UK’s foreign travel insurance guidance mentions both, and is the page we would send any older relative to first.

How do you declare a condition properly?

Answer every screening question fully and honestly, including conditions you think are minor, medication, and tests or treatment you are still waiting for. GOV.UK’s guidance says to “declare existing conditions or pending treatment or tests”, and that “you must declare mental health conditions or risk invalidating your policy.”

The legal duty is in the Consumer Insurance (Disclosure and Representations) Act 2012, section 2(2): “It is the duty of the consumer to take reasonable care not to make a misrepresentation to the insurer.” In practice, reasonable care means:

• Have your repeat prescription list and recent letters from your GP or consultant in front of you.
• Answer the question asked, about the period asked (some ask about the last two or five years).
• Declare for every traveller on the policy, not just yourself.
• Tell the insurer if anything changes between buying and travelling: a new diagnosis, new medicine or a referral.
• Keep a copy of your answers or a screenshot of the screening summary.

The FCA’s guidance also flags joint applications. If one traveller’s condition drives up a joint price, separate policies may work out better, and the firm is expected to consider that when it explains the directory to you.

What happens if you don’t declare?

It depends on how the insurer judges your answer: deliberate or reckless, and it can refuse every claim and keep your premium; careless, and the remedy depends on what it would have done had it known. The remedies sit in Schedule 1 of the 2012 Act, summarised below.

That last row is the one that surprises people: the Act lets the insurer “reduce proportionately the amount to be paid on a claim”, even on a broken ankle that has nothing to do with the condition you left out. GOV.UK puts it more simply: “failing to declare something may invalidate your travel insurance.”

Will a GHIC cover the gap if you go uninsured?

No: GOV.UK says “EHIC and GHIC are not alternatives to travel insurance” because they do not cover private medical costs, repatriation or additional costs. The card gets you state care in Europe on the same terms as a local, and it is free, so carry one. Our guide to the free UK GHIC and the gap it leaves covers where it works. What it will not do is fly you home after a stroke in Spain, which is exactly the claim a condition-related policy exists for.

Your checklist before you buy

Six steps cover it: gather your medical details, screen honestly, read the result, use the directory if the result is poor, keep the insurer updated, and carry a GHIC as well.

Our verdict

Declare everything, and treat a big medical loading or a refusal as the start of the search, not the end. The directories exist because the cheapest mainstream policy is often the wrong one for a serious condition, and the January 2026 change means fewer people will be told about them automatically. A policy that costs more and pays out beats a cheap one that does not. For how screening works in more depth, see what declaring a pre-existing condition really means, and if age is part of the picture, the age-limit traps in travel insurance for seniors.

Keep reading

Sources: FCA Handbook, ICOBS 6A.4 (6A.4.5R, 6A.4.6R and 6A.4.6AR in force from 1 January 2026; guidance updated 26 June 2026); FCA, Travel insurance signposting rules for consumers with medical conditions: review (first published 11 April 2024, updated 3 December 2025); FCA, PS20/3 Signposting to travel insurance for consumers with medical conditions (directory details updated 3 July 2026); GOV.UK, Foreign travel insurance (updated 2 August 2024); Consumer Insurance (Disclosure and Representations) Act 2012, section 2 and Schedule 1, legislation.gov.uk. All read on 9 October 2026. General information, not financial advice.

Cover photo via Pexels: Kindel Media.