How does private health insurance work?

I have always simply used the NHS and now I have reached a point in my life with enough disposable income to consider my options. I want to know how private medical insurance works in comparison to the NHS?

Question asked by Adam Browne
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Answered by Andrew Jenkinson

What is medical insurance for?

Private medical insurance is designed to provide you with access to private healthcare facilities should you require treatment for an acute medical condition.

Most people look to the health insurance market to be reassured, knowing that treatment is available quickly if they become ill or injured. Other benefits include having choice about when treatment will take place, the hospital and the specialist who treats you.

Although different private medical plans can vary in the level of cover they provide, treatment usually starts with a referral by your GP to an appropriate specialist. From your GP it is very much dependent on the level of cover provided on your health insurance plan as to whether any treatment would take place privately or via the NHS.

Types of health insurance

A very basic health insurance plan may only provide cover for private treatment which requires a stay in hospital either as a day-patient or inpatient. As the plans become more comprehensive so the level of outpatient treatment they provide increases such as diagnostic tests and specialist consultations where a stay in hospital is not require.

A good mid-range plan will often offer up to £1,000 per policy year of outpatient treatment where a truly comprehensive health plan will cover outpatient treatment in full. As the policies become more comprehensive additional benefits are included such as emergency overseas cover and dental surgery.

It is important to recognise that private medical insurance is designed to work alongside, not to replace , all the services offered by the NHS. Services such as accident and emergency and the treatment of chronic conditions is not usually covered by a private health plan.

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This information does not constitute financial or other professional advice. You should consult your professional adviser or contact us directly on 02084327333 should you require financial advice. It is important to ensure any insurance policy you take out is suitable for your needs.
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