What Is Comprehensive Health Insurance? What Does It Cost?

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23-10-2020

Comprehensive Health Insurance pays for private healthcare, letting you bypass NHS waiting lists. A comprehensive policy is the best health insurance available. It covers both inpatient care (where you need a hospital bed, such as after surgery) and outpatient care (where you don’t need a hospital bed, such as consultations, diagnostic tests and scans) in full.

What Makes Health Insurance Comprehensive?

The best and most comprehensive medical insurance policies will include cover that cheaper plans may have only as an optional extra, such as alternative therapies or psychiatric cover as standard rather than as an additional add-on.

With comprehensive policies, you get cover for both inpatient and outpatient care. This is compared to a basic policy, which won’t provide outpatient treatment at all.

Basic Insurance Without Outpatient Cover

With no outpatient cover under a basic plan, you use the NHS for diagnosis and up to the point of private inpatient treatment.

Basic Cover No Outpatient Cover

Given there can be significant waiting lists for NHS outpatient appointments, this could delay your care.

Comprehensive Insurance With Outpatient Cover

Outpatient cover speeds up your diagnosis. Going private for all aspects of your healthcare can reduce waiting times.

Comprehensive Outpatient Cover

In addition to covering outpatient treatment in full, a fully comprehensive plan will provide extended cover for other methods of treatment such as physiotherapy, cognitive behavioural therapy and acupuncture.

The details below provide an overview of the cover that is included in a typical comprehensive health insurance plan:

  • Full, unlimited outpatient cover, including diagnostic tests and scans
  • Cover for therapies, such as physiotherapy, osteopathy and acupuncture
  • An extensive hospital list that usually includes some of the UK’s best private hospitals
  • Psychiatric cover for mental health care
  • Advanced cancer cover, including payments towards prostheses / wigs, extended access to biological therapies, scalp cooling to reduce hair loss from chemotherapy and counselling services.

You’ll be seen in private UK hospitals, generally faster than under the NHS. You may also potentially get access to drugs and treatments the NHS does not yet provide due to cost.

Policy Upgrades

To extend your coverage yet further, there are some upgrades you can choose for an additional premium. These include:

  • International cover
    International Medical Insurance provides health cover overseas if you’re abroad and have a medical emergency.
  • Routine dental and optical care
    Policies typically cover surgical procedures such as wisdom tooth extraction and cataract removal as standard. However, a plan won’t cover everyday treatment from opticians and dentists, such as checkups or fillings. You can choose to add this for an extra premium.
  • Upgraded hospital list
    Every Health Insurance plan has a list of hospitals and facilities you can receive treatment in. For an extra premium, you can upgrade this to a premier or Central London list, offering medical treatment in some of the UK’s most prestigious private healthcare settings.

Additional Benefits Including Virtual GP Service

With waits to see an NHS GP rising, private medical insurance offers an alternative. All policies now provide access to an online / remote GP service. This lets you have a telephone appointment or a video consultation with a UK-registered GP, usually 24 / 7, whenever and wherever suits you.

As you can book in a slot at evenings and weekends, for example, you therefore no longer have to wait for an NHS GP appointment during traditional opening hours.

These GPs offer all the same advice and reassurance as your own NHS GP. They can also issue prescriptions and make onward referrals for private healthcare under your Health Insurance scheme.

What Medical Conditions Are Covered?

Broadly speaking, there are two types of medical problems you could suffer from:

  • Chronic Illnesses
    These conditions persist for life and don’t subside with time and treatment. For example, asthma and diabetes fall into this category as they can’t be cured, only managed.
  • Acute Conditions
    Conditions which through treatment can be cured. This might include needing a heart bypass or joint replacement surgery.

Even the best private health insurance only covers acute conditions. For ongoing management of chronic illnesses, you’ll continue to receive NHS care.

Policy Exclusions

The vast majority of UK health insurance policies tend to have some broad general exclusions. These include:

  • Pre-existing conditions
  • Emergency treatment
  • Normal pregnancy
  • Kidney dialysis
  • HIV / AIDS
  • Cosmetic surgery that’s not medically necessary.

Do I Need Medical Insurance?

The NHS does a fantastic job, and we’re truly lucky to have a healthcare system in the UK free at the point of use.

However, a funding squeeze over the past decade and rising demand for healthcare has put a strain on our beloved health service.

As a result, waiting lists are growing. For example, at the end of March 2020, NHS data reveal that there were 4.24 million people on NHS waiting lists in England awaiting treatment. More than 1 in 5 such people had been waiting more than 18 weeks.

An 18 week wait, especially if the condition is painful and debilitating, could significantly impact your life. It could even stop you working and earning during that period.

It’s here PMI can step in to provide treatment for eligible conditions, getting you seen faster and back on your feet quickly.

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How Much Does Comprehensive Medical Insurance Cost?

Insurers base premiums on both personal factors, such as your age and smoker status, and policy factors, such as your excess and the options you choose.

It’s therefore difficult to establish just how much your policy would cost without taking into account your needs and circumstances and doing thorough market research.

However, to give you a rough idea of premiums, we’ve laid out example quotes in the table below, along with a mid-range and a basic option for comparison.

To calculate these premiums, we’ve assumed the individual is:

  • 30 years old
  • In good health
  • A non-smoker
  • Willing to pay a £250 excess
  • Based in the same postcode as the advisers in our Brighton office.

Basic Policy

No Outpatient Cover

£35 per month

Mid-Range Policy

Capped Outpatient Cover

£51.66 per month

Comprehensive Policy

Unlimited Outpatient Cover

£58.64 per month

Premiums correct as of August 2020

Can I Reduce the Cost of Medical Insurance?

There are several options to lower the cost of a plan. However, be aware that most of these will also lower your level of cover.

Add an Excess

An excess is the amount you pay upfront towards the cost of your private healthcare. After this initial sum, the insurance covers the rest. Excesses typically start at £100 and can be as high as £5,000 depending on your insurer.

An excess won’t impact how comprehensive your plan is, but will lower premiums.

6 Week NHS Wait

With this option, if you need inpatient care the insurer checks the NHS waiting list in your local area. If the wait for that treatment is less than 6 weeks, you have it under the NHS.

It’s only if the procedure you need either isn’t available on the NHS or the wait is longer than 6 weeks that your Health Insurance kicks in.

Note that this only applies to inpatient care. Your entitlement to outpatient care is unaffected.

Reducing Outpatient Cover

A truly comprehensive plan has no limits on outpatient cover. The insurer covers the cost in full, less any excess.

However, this obviously comes at a cost. Here, you can cut costs by choosing a mid-range policy instead. This caps the amount your insurer pays towards your outpatient treatment per policy year, typically at £1,000.

Which Medical Underwriting Should I Choose?

The underwriting you choose will impact the coverage you receive. With medical underwriting, the insurer examines any pre-existing conditions you may have suffered from in the past and decides whether or not to offer coverage for them.

There are two types of underwriting available to individuals:

  • Full medical underwriting (FMU)
    You declare your entire medical history to the insurer from the start. There can therefore be a considerable amount of paperwork involved. The insurer then typically excludes pre-existing conditions from the outset of the policy.
  • Moratorium underwriting
    The most common option, this doesn’t need an upfront declaration of your medical history. Instead, any conditions you’ve had in the 5 years up to the policy start date will likely be excluded. However, there may be an option to have those conditions included after spending 2 years on the plan without any treatment for them depending on your circumstances.

Which Underwriting Is The Most Comprehensive?

With the answer depending so much on your circumstances and medical history, it’s impossible to say which underwriting is best for you without getting to know you as an individual.

Certain medical conditions may be better disclosed on a full medical underwriting application where others would have a greater chance of being covered in the future if the policy had moratorium underwriting.

A big part of our job is to make sure our clients get the best possible cover given their personal circumstances. For expert advice and to compare quotes from all the top UK insurers give us a call on 02074425880.

Who Are The Best UK Medical Insurance Providers?

With a team of independent experts we have relationships with all the leading UK health insurers. The insurers listed below make up the core however we do have access to more specialist providers  depending on your occupation and medical history.

Given policies are priced on a number of factors including your age, location and medical history it is vital you compare all of the leading insurers to find the most competitive cover.

If you already have private medical insurance you will want to do a full market review every couple of years to ensure your policy is still the most competitive based on your circumstances.

Compare Comprehensive Health Insurance Quotes & Get Expert Advice

Being aware of all the options that are available to you when looking to obtain the greatest level of cover can be a bit of a minefield.

Our expert advisers are here to cut through the jargon and undertake the research to find you the best cover for your circumstances

Why Speak to Us?

We started Drewberry™ because we were tired of being treated like a number.

We all deserve a first class service when it comes to issues as important as protecting our health. Below are just a few reasons why it makes sense to talk to us.

If you need help getting the best medical insurance, give us a call on 02074425880 or email help@drewberry.co.uk.

I had a great experience with Drewberry, they have a lot of knowledge and expertise with life insurance and income protection and were able to advise me and arrange suitable products. Highly recommend.

Lachlan Mellings
12/08/2020
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