What is the Best Private Health Insurance?

Why Private Health Insurance?

• Health Insurance provides you with access to private healthcare, allowing for fast treatment without waiting lists
• Access new drugs and novel treatments that may not yet be available on the NHS
• Private hospitals usually have superior facilities, e.g. private, ensuite rooms and round-the-clock visiting hours
• This treatment is all paid for by your insurer (less any excess).

Getting The Best Cover

To get the best Private Health Insurance, you will want to be comparing a number of key factors including:

• The Insurer
  Does the provider have a good reputation? Do they have good reviews? How is their claims process?
• Inpatient and day-patient cover
  The level of cover provided where you’re admitted to hospital and occupy a hospital bed overnight, usually for surgery. Alternatively, minor procedures can be performed on a day patient basis, where you occupy a hospital bed for a period but leave the same day of the procedure.
• Outpatient cover
  The level of cover provided for consultations, diagnostics or treatment where no hospital bed is required (e.g. blood tests, x-rays, MRI scans etc.), starting with a referral from your GP. If necessary, the hospital may then refer you for inpatient treatment, such as surgery.
• Additional Benefits
  The level of cover for therapies such as physiotherapy, osteopathy or chiropractic treatment as well as mental health, dental and optical treatment.
• Medical Underwriting
  The method used to underwrite your policy based on your current health which defines what you can and cannot claim for. The most common forms of underwriting for an individual policy include moratorium and full medical underwriting.

Where almost all Private Medical Insurance covers inpatient treatment in full, the extent of the cover provided tends to be broken down by outpatient treatment with the best policies providing full outpatient cover.

• Basic Cover
  Tends to cover little or no outpatient treatment
• Mid Range Plan
  Will cover outpatient treatment up to a monetary limit often set at either £500, £1,000 or £1,500 per year.
• Comprehensive Health Insurance
  Designed to cover outpatient treatment in full.

Naturally the greater the level of outpatient treatment that is provided the higher your premiums are likely to be.

If you opt for limited or no outpatient treatment be aware that you may need to use the NHS for the initial diagnostic part of your treatment.

Given potential waiting lists this could mean delays in your care before you can use your medical insurance for any inpatient treatment.

Nadeem Farid
Head of Employee Benefits at Drewberry

Which are the Best Health Insurance Companies?

There has been a great deal of consolidation in the marketplace for Health Insurance providers in recent years, with many of the larger providers buying up smaller ones.

This has left us with a handful of large household names as well as a few specialist firms:

• Aviva
• AXA PPP
• Bupa
• The Exeter
• Freedom Healthcare
• General & Medical
• Vitality
• WPA

We provide instant online quotes from all the leading providers. Simply use our health insurance cost calculator by clicking below.

What Additional Options Will the Best Health Insurance Cover?

The top Private Medical Insurance providers will cover a range of additional options as standard on their best PMI policies. Mid-range and basic plans may require you to pay extra for these.

Some providers will offer a ‘menu’ of additional options for you to choose from that you can add and subtract from the policy, thus increasing or reducing the cost of cover respectively.

Therapies Cover

The big four therapies covered by the better Medical Insurance providers are:

• Acupuncture
• Chiropractic treatment
• Osteopathy
• Physiotherapy.

These will only be provided as standard by the best Health Insurance plans that offer a good level of outpatient cover.

Alternatively if it is not included by default some insurers will allow you to add therapies cover to your plan for an additional cost.

Some insurers offer a set number of physio sessions without having to see your GP, who is normally first port of call to get referral for private treatment.

However, certain insurers allow you to bypass this and get treatment straight away if you’re suffering from a joint or back complaint.

Drew Nelson
Health & Wellbeing Expert at Drewberry

Dental and Optical Treatment

These are among the most popular Health Insurance add-ons, as few policies cover all dental and optical treatment as standard.

Dental Treatment

Most policies will cover you for what’s known as ’emergency dental’, which covers treatment if you had an accident that loosens or knocks out at tooth. Many plans also cover oral surgery, which would provide cover for wisdom tooth extraction in a hospital.

However, if you want cover for everyday dental treatment – such as checkups, fillings, crowns and cleaning – you’ll likely need to consider an add-on to your policy.

Optical Treatment

While most PMI plans cover you for treatment such as cataract surgery, few offer cover for routine optical appointments as standard.

This will generally need to be an add-on to pay for everyday checkups and items such as glasses or contact lenses.

Psychiatric Cover

Although it’s not often requested as a ‘must have’ for many policies, the better Medical Insurance plans will cover psychiatric treatment. Others may require you to add this on separately.

The cover generally pays for a set number of days of inpatient or day patient treatment if you were to be diagnosed with a psychiatric condition such as schizophrenia or clinical depression.

Some policies only cover outpatient treatment, however, such as appointments with cognitive behavioural therapists or psychologists.

What’s the Best Health Insurance Underwriting?

For most people there are two underwriting options available: moratorium underwriting and full medical underwriting (FMU).

Moratorium Underwriting

Moratorium underwriting is the most common form of Health Insurance underwriting.

With moratorium underwriting, any medical condition that you’ve had advice, treatment or medication for in the past 5 years will automatically be excluded from the policy if you try and claim in the future.

Many insurers use a 2 year rolling moratorium, whereby the insurer will consider any claims for medical conditions that you suffered in the 5 years running up to the date your policy started providing you’ve served 2 years on the policy without needing any medical attention for that condition.

Full Medical Underwriting

Full medical underwriting (FMU) will examine your medical history before you take out the policy.

While this means you know exactly what you are and aren’t covered for, there’s usually very little opportunity to get any exclusions arising from the underwriting process removed.

Conditions occurring more than 5 years ago aren’t generally taken into account when insurers are underwriting you on a moratorium basis. However, they will most likely be examined when being underwritten on an FMU basis.

With full medical underwriting, an insurer might not decide to exclude a minor condition having seen the medical evidence from your GP, but this condition would likely be automatically excluded if it occurred in the 5 years leading up to the policy start date if the insurer was underwriting you on a moratorium basis.

Full Medical Underwriting or Moratorium Underwriting?

If you’ve had a minor condition in the past then an insurer might decide not to exclude it on an FMU basis once they’ve seen the medical evidence. This won’t likely be the case for moratorium underwriting.

Ultimately, whether full medical underwriting is better than moratorium underwriting will depend on you and your medical history. It is absolutely critical to get this right, if you need some help please don’t hesitate to pop us a call on 02084327333 or email help@drewberry.co.uk.

How Much Does The Best Medical Insurance Cost?

Naturally the more comprehensive the cover the higher the monthly cost. For this example we have defined the best type of health insurance as the most comprehensive and require it to meet the following criteria:

• It covers inpatient and outpatient treatment in full
• It has a comprehensive nationwide hospital list
• It has comprehensive cancer cover
• It has no excess
• It includes cover for therapies and mental health

The example cost for the best private health insurance is for a single person, who is a non-smoker living in Brighton with no pre-existing health conditions.

The cost will vary significantly depending on where you live in the UK and your current age. If the best health cover is beyond your budget then it is important to prioritise the cover which is most important to make the policy more affordable.

If you need any help working out what the best health insurance is for you then please do not hesitate to pop us a call on 02084327333.

What Is Not Covered By Health Insurance?

Private Health Insurance is designed to cover acute illnesses which can be cured quickly and did not exist before you took out the policy. As a result there are a number of general exclusions which are not covered on any Private Health Insurance, even the best policies.

• Pre-existing Conditions
  Conditions you suffered prior to taking out the the policy tend not to be covered. Depending on the underwriting you choose there are cases where they could be included after a set period, but you are best getting advice to make sure you are clear on the terms before taking out cover.
• Chronic Conditions
  These are conditions which will never be cured and will need ongoing treatment such as Crohns disease or diabetes.
• Emergency Treatment
  Most private hospitals do not have the resources to cater for emergencies, so if you suffered a heart attack or were in a road traffic accident the NHS is best placed to provide care.
• General Exclusions
  There are a usually a number of blanket exclusions which tend to include problems related to drug or alcohol abuse, HIV/AIDS, ‘normal’ pregnancy, cosmetic surgery and self-inflicted injuries.

The Best Way to Set Up Health Insurance

When setting up your Health Insurance policy you can opt to go direct to an insurer or take out cover through an intermediary. It is important to recognise the difference as one provides you with a lot more protection than the other.

• Going Direct to an Insurer
  If you go direct to an insurer to set up your policy it is considered a non-advised sale. As you personally have made the decision to take out this policy there is no financial protection should the policy be inappropriate – the responsibility lies on your shoulders.
• Using an Adviser
  Utilising an adviser who provides an advised sale means they are responsible for the policy they help you set up. They need to understand your circumstances fully including any existing health conditions to make sure you take out the most suitable cover for your needs. If it turns out their advice was not appropriate the responsibility sits with the adviser.

Here at Drewberry we provide a fully advised service so you benefit from expert advice and know you have that additional level of protection should something go wrong. We are proud of the service we provide and our clients think so too with 2198 independent reviews on Reviews.co.uk rating us at 4.92 / 5.

How Do I Make A Claim?

Should you choose to utilise our expertise when setting up your Health Insurance policy we will be on hand to help should a claim arise. Below is an overview of the general process and what you can expect.

When to make a claim?

Once your GP has confirmed you need to be referred for tests or to see a consultant you should contact your Private Medical Insurance provider.

Your policy documents should contain contact details and the insurer’s claims process. Some insurers will have a downloadable claims form that you’ll need to send away in the post while others are entirely online.

Approving a claim

Once your claim has been submitted the insurer will check your policy to make sure you have a suitable level of cover to make the claim as well as checking eligibility of your preferred consultant.

Moratorium underwriting could hold up a claim
If you have Full Medical Underwriting the insurer should be able to approve your claim quickly given they have your full medical history. If you opted for Moratorium Underwriting the insurer may need to contact your GP and make other investigations before they can approve your claim.

Paying a claim

Once a claim has been approved the insurer will usually pay the private practice directly. You simply need to turn up to your appointment with your policy details and the approval number provided by your insurer.

If your policy includes an excess in most cases you will be billed by your insurer or, alternatively, you may need to pay the private practice directly.

Review Top 5 Private Medical Insurance Providers

Aviva

Aviva is the largest insurer in the UK. Aviva’s PMI offering is their Healthier Solutions product, which you can tailor to your own budget.

• Underwriting
  Full Medical Underwriting / Moratorium / Continued Personal Medical Exclusions
• Excess
  £100 / £200 / £500 / £1,000 / £3,000 / £5,000 per year
• Core Cover
  Inpatient and day-patient / cancer cover
• Outpatient Cover
  £0 / Reduced (limited to £500 or £1,000) / Full outpatient cover

AXA PPP Healthcare

Based in Tunbridge Wells, AXA PPP Healthcare has helped people to access healthcare services since 1940.

• Underwriting
  Full Medical Underwriting / Moratorium
• Excess
  £100 / £250 / £500 / £1,000* / £2,500* / £5,000*
• Core Cover
  Inpatient and day-patient / radio/chemotherapy** / Optional mental health cover
• Outpatient Cover
  Standard or Full

Bupa

Established over 60 years ago, Bupa is a UK household name. Bupa Health Insurance has two tiers of over: Comprehensive (full inpatient and outpatient care) and Treatment & Care (inpatient-only). Both options include mental health cover as standard.

• Underwriting
  Full Medical Underwriting / Moratorium
• Excess
  £0-£500
• Core Cover
  Inpatient and day-patient / radio/chemotherapy / Mental health cover
• Outpatient Cover
  Paid in full or with optional limits of £500 / £750 / £1,000

The Exeter

Founded in 1927, Exeter Family Friendly is a mutual Friendly Society with over 60,000 members. The Exeter’s Health Insurance policy is known as The Exeter Health+, which includes mental health cover as standard.

• Underwriting
  Full Medical Underwriting / Fixed moratorium / Rolling moratorium / Continued personal medical exclusions
• Excess
  £0 / £100 / £250 / £500 / £1000 / £3,000 / £5,000
• Core Cover
  Inpatient and day-patient / cancer cover
• Outpatient Cover
  Paid in full or with optional limits of £500 / £1,000

Vitality

Vitality (formerly PruHealth) launched in October 2004 as a joint venture between Prudential and South African health insurance provider Discovery. Vitality has an innovative approach to health insurance in their Vitality plan, rewarding you with points and reduced premiums for healthy living.

• Underwriting
  Full Medical Underwriting / Moratorium / Continued personal medical exclusions
• Excess
  £0 / £100 / £250 / £500 / £1,000 once a year or once per claim
• Core Cover
  Inpatient and day-patient / cancer cover
• Outpatient Cover
  Paid in full or with optional limits of £500 / £750 / £1,000 / £1,250 / £1,500

*Not available with standard outpatient option
**For those who have had cancer before taking out the plan or who removed the cover for cheaper PMI, AXA's NHS Cancer Support will see the patient treated for cancer on the NHS but with any drugs not routinely available on the NHS paid for by AXA

Need Health Insurance Advice?

Finding the best Private Medical Insurance for your needs takes a lot more thought because it depends very much on your budget and your personal circumstances.

To lower the cost of Private Medical Insurance you may have to sacrifice the level of cover you receive. If you know which elements make up the bulk of the cost you can scale back your policy and still get a good level of cover even though it won’t have everything included that would be covered by the top policies.

Why Speak to Us…

We started Drewberry because we were tired of being treated like a number and not getting the service we all deserve when it comes to things as important as protecting our health and our finances. Below are just a few reasons why it makes sense to let us help.

• There is no fee for our service
• We are independent and impartial
  Drewberry isn’t tied to any insurance company, so we can provide completely impartial advice to make sure you get the most appropriate policy based solely on your needs.
• We’ve got bargaining power on our side
  This allows us to negotiate better premiums for you than you going direct yourself.
• You’ll speak to a dedicated expert from start to finish
  You will speak to a named expert with a direct telephone and email. No more automated machines and no more being sent from pillar to post – you’ll have someone to speak to who knows you.
• Benefit from our 5-star service
  We pride ourselves on providing a 5-star service, as can be seen from our 2198 and growing independent client reviews rating us at 4.92 / 5.
• Gain the protection of regulated advice
  You are protected. Where we provide a regulated advice service we are responsible for the policy we set-up for you. Doing it yourself or going direct to an insurer won’t provide this protection, so you won’t benefit from these securities.
• Claims support when you need it the most
  You have support should you need to make a claim. The most important thing when it comes to insurance is that claims are paid and quickly. We are here to support you during the claims process and make sure it’s as smooth and stress free as possible.

If it is all getting a little confusing and you want to talk through your options to make sure you find the most suitable cover please don’t hesitate to get in touch.

Pop us a call on 02084327333 or email help@drewberry.co.uk.

Tom Conner
Director at Drewberry