Private Health Insurance
Protecting your health...
Private Health Insurance pays for healthcare treatment in private medical facilities. The scope of the cover varies considerably depending on the options you select.
Most plans will cover inpatient and day patient treatment in full which means that you would be covered for treatment, testing and consultations where a hospital bed is required either overnight or just for the day.
To cover initial consultations and diagnostic testing where a hospital bed is not required a level of outpatient cover will need to be selected. This is recommended to avoid NHS outpatient waiting lists.
The level of cover and type of treatment required will determine the exact process but the main variation depends on whether the policy includes outpatient cover.
No Outpatient Cover
With Outpatient Cover
Without any outpatient cover you run the risk of having to go through the NHS outpatient waiting list for diagnostic testing and initial consultations.
Do I need
Although the National Health Service (NHS) does a great job with limited resources, millions of people in the UK decide they would rather be treated privately.
Why should I go private?
Those with private healthcare cover benefit from speedier diagnosis and treatment, the highest quality care, lower infection risks, private rooms with internet access and round the clock visiting times.
Health Insurance is particularly popular with business people and the self-employed who need to return to work as quickly as possible and retired people where NHS waiting times for orthopaedic treatment has traditionally been one of the longest.
1. Choose the level of Outpatient CoverAlthough the level of outpatient cover makes a sizable difference to the premiums it does ensure that initial consultations and testing can be done privately.
2. Cancer CoverA popular option is to upgrade the policy so there is no time limit for the provision of biological cancer drugs (some plans have a standard limit of 12 months).
3. Therapies CoverIt is common for plans to cover therapies (such as physiotherapy) up to the outpatient limit, although GP referred therapies can be an additional option.
Private healthcare insurance is designed to cover the cost of curable (acute) medical conditions in private hospitals or private wards of NHS hospitals.
All policies cover the full cost of conditions that require an overnight stay in hospital (inpatient treatment) or require a period of time in a hospital bed (day-patient treatment).
For example, supposing an individual needed a heart by-pass, their medical insurance would cover the tests and consultations needed in the run-up to the operation and the operation itself.
More comprehensive plans also provide a higher level of cover for treatments, consultations, scans and tests for conditions that do not require a hospital bed.
Additional benefits include cover for psychiatric treatment, physiotherapy and dental surgery whilst other common extras include home nursing, private ambulance and overseas emergency medical cover.
In addition to full cover for inpatient and day-patient healthcare, mid-range and comprehensive plans also provide an extended level of cover for outpatient consultations, tests, scans, physiotherapy and psychiatric treatments.
An "outpatient" is someone who does not need to occupy a hospital bed for their treatment. Comprehensive plans will usually cover most outpatient treatments in full.
Dental & Optical Benefit
Although most policies cover dental/oral surgery some policies also provide an option to include a level of routine dental and optical treatment.
Including this option means that the insurer would provide a specified amount of benefit each policy year to contribute to routine dental or optical treatment (in a similar way to a health cash plan). It should be noted that a separate excess usually applies.
Implement an excess
In order to reduce premiums to obtain affordable health cover it is possible to implement an excess on your policy. Excesses range from £100 to £5,000. For example, an excess of £250 could reduce monthly premiums by approximately 10%.
Implementing an excess means that you would pay that excess amount once per policy year should you need to make a claim.
Six week wait option
If you are on a tight budget or are happy to use the NHS but worry about long waiting lists then a six week wait option may be right for you. With this option you agree to use the NHS for your treatment provided that the wait is less than six weeks.
If the wait is longer than six weeks then you will go private straight away. Including this option could reduce your monthly premiums by about 20%.
Depending on your choice of private health plan and hospital list you could access over 400 private hospitals across the United Kingdom, including the very best specialist hospitals.
Medical insurers use private hospitals provided by companies such as Bupa, Spire Healthcare, BMI healthcare, HSA Healthcare and Nuffield Health. Opting for a local (or reduced) hospital list could lower monthly premiums by over 25%.
Local hospital list: Local private hospitals which you can choose from when deciding where to receive treatment.
National hospital list: Extends coverage to a choice of hospitals across the country, including specialist hospitals.
London hospital list: Increased selection of London hospitals in addition to those contained on the national hospital list.
Premier hospital list: Receive medical treatment from any private hospital in the UK, including top London hospitals.
Your first port of call when seeking medical advice will still always be your GP and any emergency would still be dealt with at accident and emergency (A&E).
With all private health cover any recent medical treatment or symptoms you have suffered prior to taking out the policy are likely to be excluded from the plan.
When it comes to underwriting there are generally two options, moratorium or full medical underwriting (FMU).
With moratorium underwriting there is no need to disclose your medical history, lifestyle information or undertake a medical screening. With this option the policy would automatically exclude conditions you have suffered in the previous five years.
Existing conditions may be included after two years of holding the policy if you have not had to seek additional treatment or consultations. Moratorium underwriting is an option if you are below the age of 65 and have not suffered from heart disease, stroke, cancer or mental illness.
With full medical underwriting (FMU) you would disclose your medical history at the point of application and may be required to undergo a health screening. If you decide to take this option the insurer may place exclusions on the policy for conditions you have suffered in the past.
Being independent private medical insurance brokers, we are not tied to any insurers and work on your behalf to find you the most appropriate and competitively priced policy.
We have access to over 30 individual and family polices from 10 of the UK's leading insurers, including Aviva, AXA PPP Healthcare, PruHealth, Bupa and Simply Health.
Being expert PMI brokers we can talk you through your options to ensure you gain the cover you want, without any unexpected limitations.
If you have a pre-existing medical condition we are also able to speak to the underwriters at each insurer to try and gain you the most favourable terms available in the market.
Our aim is simple, couple expert impartial advice with a first class service. We are wholly independent and compare all the leading UK insurers.
We use our buying power to find you the most competitive rates. You are not a number in a queue getting pushed from pillar to post, speak to one of our experts with a direct phone line.
10/01/2015 N Tanner
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