Inpatient and outpatient treatment are the two key components of medical treatment.
Most Private Health Insurance covers inpatient treatment in full as standard (subject to your policy’s terms).
Outpatient treatment which includes diagnostics and consultations isn’t typically covered on the most basic basic policies and is often an additional option for a much more comprehensive plan.
If you choose to add outpatient cover to your plan you’ll generally be given the option of adding a limited amount of outpatient cover or full outpatient cover. Opting for the latter means all outpatient treatment is covered (again subject to your policy terms).
Inpatient cover refers to any treatment where you need a hospital bed overnight, such as after a surgical procedure.
For minor surgical procedures, you might be covered on a day-patient basis, where you need a hospital room but are discharged the same day of the procedure without spending the night in that bed.
The cost of inpatient treatment is made up of factors including:
Outpatient treatment refers to any diagnostics, consultations or treatment where a hospital bed is not required. It will often begin from an initial investigation following a referral from your GP and can be for a consultation involving blood tests, x-rays, MRI scans and so on.
Outpatient treatment may lead to a diagnosis of a condition that requires further treatment, such as a referral for further outpatient appointments, such as physiotherapy or chiropody.
However, often the initial diagnosis is that the patient requires surgical intervention, which will be inpatient treatment.
Choosing a more basic PMI policy (inpatient-only) will allow you to get cheaper premiums. However, you’ll be sacrificing your level of cover which might mean no outpatient cover at all.
If you don’t opt for outpatient cover, then you’ll have to wait for the NHS for diagnostic tests before being referred for private inpatient treatment if necessary.
If, however, the results of the diagnostic tests you’ve waited for on the NHS require more outpatient treatment – e.g. physiotherapy – you’ll again be subject to NHS waiting lists.
Ultimately, you should be aware that having no outpatient cover on your policy could result in a delay in your care.
There are options for finding cheaper Medical Insurance other than opting for inpatient-only cover. These include:
Note that the 6 week NHS wait only applies to inpatient care. This means if you’ve added outpatient cover to your policy, you’ll be seen for all diagnostic tests / scans etc. privately as soon as possible. The 6 week NHS wait only kicks in when it becomes apparent you need inpatient care.
Health & Wellbeing Expert at Drewberry
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