Getting Private Health Insurance Advice

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09/09/2024
10 mins

Private Health Insurance is a way of providing you and your family with private healthcare.

It allows you to bypass NHS waiting lists, getting you care faster than would be available otherwise.

You’ll get superior service, such as a choice in where your treatment takes place and potentially choice of the consultants/specialists you see.

Should I Have Private Medical Insurance?

No one can deny that the NHS does a fantastic job. However, the service has faced a real-terms spending squeeze over the past decade.

At the same time, the population has become older, sicker, frailer and generally harder to treat, resulting in resources being stretched to the max.

As a result, many are looking into Private Medical Insurance to get treatment faster than would be available under NHS care.

According to NHS statistics…

  • In the quarter to March 2018, there were more than 31,000 people on the waiting list for a diagnostic appointment who’d been waiting for more than 6 weeks
  • Meanwhile, at the end of March 2018, more than 1 in 10 people waiting for hospital treatment had been waiting for more than 18 weeks.
  • In the quarter ending September 2018, 18,460 operations were cancelled
  • 1,255 patients were still waiting for treatment more than 28 days later after the cancellation.

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Your Health Insurance Options

Our team of experts are often asked which is the best Health Insurance. However, the answer isn’t simple. There are various types of Private Medical Insurance, each with their own policy options that benefit different people with different needs. The important thing is to find the most suitable policy for you based on your needs and budget.

What is Inpatient Care?

Inpatient or day-patient care – where a hospital bed is required, either for the night or for part of a day, respectively – is a core part of all Health Insurance cover.

This will cover you for surgical procedures and all related costs.

What is Outpatient Cover?

As well as core inpatient cover, you can also add outpatient cover to your Medical Insurance policy.

Adding outpatient cover allows for diagnostic tests in the lead up to a potential operation to be done privately, rather than waiting for the NHS.

With inpatient-only cover, you’ll have to wait for the NHS to diagnose your condition before using your Private Medical Insurance to resolve the issue.

Adding outpatient treatment means you get the extra layer of cover that comes with having your diagnostic tests and potentially any therapies, such as physiotherapy, covered privately.

Which Health Insurance Underwriting?

The type of underwriting you have on your Private Medical Insurance policy is important as it may have an impact on what you can claim for, especially when it comes to pre-existing conditions.

For individuals, there are two main types of medical underwriting.

Moratorium underwriting

Moratorium underwriting excludes most pre-existing conditions you’ve suffered over a set period, usually the last 5 years.

If you have suffered from a medical condition in the past 5 years, you’ll need to satisfy a set period on the policy – typically 2 years – without having any treatment, advice or medication for that condition before the insurer will consider covering it.

Full medical underwriting (FMU)

With full medical underwriting, you disclose your entire medical history upfront and the insurer places outright exclusions on most pre-existing conditions.

They’ll usually rule out covering any pre-existing conditions, although there may be leeway to negotiate cover for more minor illnesses at your insurer’s discretion.

It’s important to be well-informed when choosing your medical underwriting as it could have a massive impact on what you’ll be able to claim for at a later date.

If you have pre-existing medical conditions or are concerned with what will and won’t be covered please don’t hesitate to pop us a call on 02074425880.

Nadeem Farid
Head of Employee Benefits at Drewberry

Other Health Insurance Options

As well as deciding whether you need to add outpatient cover to your Private Medical Insurance, you’ll also have a number of other options to consider. For instance, would you want to add:

  • Therapies cover
    Sometimes not covered as a standard part of outpatient treatment, this gives you access to therapies such as physiotherapy, osteopathy and acupuncture
  • Routine dental care
    While most policies cover emergency dentistry, say if you lost a tooth, as well as if you require oral surgery, routine dental care (e.g. fillings, checkups etc.) can be added on as an optional extra
  • Routine optical
    Again this can be added as an optional extra, giving you cover for glasses and sight tests as well as things covered as standard, such as surgery for cataracts
  • Psychiatric cover
    As mental health conditions can be debilitating and very tricky to treat, psychiatric cover is often included as an ‘add-on’ option to medical insurance plans for an additional cost.

Private Medical Insurance Top Tips

If you’re looking to get this cover in place, check out our top Health Insurance tips when you’re buying PMI.

Of course none of these tips are a substitute for speaking with an expert adviser, but they’re designed to give you a rough idea of factors you may want to look out for when purchasing cover.

  • 1. Check Your Medical Insurance Excess

    You can add a Health Insurance excess to most policies.

    Just like with car insurance, an excess means you’ll have to pay the first portion of the claim out of your own pocket.

    The higher the excess, the cheaper your monthly premiums because you’ll have to pay a larger proportion of the cost of the claim upfront.

    While you can opt for Health Insurance with no excess, this will be at the cost of higher monthly premiums because the insurer will have to cover the entire amount of your claim.

  • 2. Adding Outpatient Cover

    While inpatient and day-patient treatment comes as standard with ‘core’ or ‘basic’ Health Insurance, adding on outpatient cover is an optional extra.

    If you’re only worried about waiting for operations and the need to have surgery in a timely manner at a date convenient for you, then it may be sufficient to just have inpatient cover.

    However, it’s important to realise that with inpatient-only treatment, you’ll have to rely on the NHS for everything that gets you to the point of being operated on.

    This includes scans, tests and other diagnostics, which can all also have significant waiting lists.

  • 3. Get Health Insurance Cashback for Using the NHS

    Some insurers offer you cashback if you use the NHS for operations and procedures rather than relying on your Private Medical Insurance.

    This will usually be in the form of a set amount per night you spend in an NHS hospital recuperating from an operation.

    So if the NHS waiting list for the procedure isn’t too long and you’re happy to not use your insurance then you may be able to use the NHS cashback option.

  • 4. Using the 6 Week NHS Option

    You can reduce the cost of cover with certain insurers by choosing the 6 week NHS wait option.

    This means your Health Insurance will only kick in if the waiting time for the inpatient procedure you require is in excess of 6 weeks in your local area.

    Doing so will reduce your premiums because the NHS still deals with many cases in that time period.

    Due to the current length of NHS waiting times, some insurers such as AXA aren’t offering this option. The market changes regularly, so if you’re unsure, give us a call on 02074425880 or email help@drewberry.co.uk to find out your options.

    The 6 week NHS wait option only applies to inpatient treatment. If you’ve added outpatient cover to your policy to receive private care for diagnostic tests / scans etc., this will always go ahead privately as soon as possible.

    Joseph Toft
    Health & Wellbeing Expert at Drewberry

  • 5. Restrict Hospital Lists for Cheaper Health Insurance

    Private Health Insurance is designed to give you access to private healthcare in the best hospitals in the country.

    However, some of the best hospitals and clinics charge more than others due to how prestigious they are and/or their location (e.g. on Harley Street or elsewhere in central London).

    Drew Nelson Health & Wellbeing Expert at Drewberry

    Health Insurance providers have ‘tiers’ of hospitals and clinics you can get access to, with the best hospitals being in the top tier and then other, still private, facilities being in lower tiers.

    Restricting your access to hospitals in the lower tier can end up saving you a lot of money on your premiums.

    Drew Nelson
    Health & Wellbeing Expert at Drewberry

  • 6. What to Do When Your Health Insurance Premiums Increase

    It’s important that you review your cover regularly, especially if you find that the cost of Health Insurance has increased at renewal. This can happen due to a variety of reasons, but the biggest cause of a hike in Private Health Insurance premiums will be because you’ve made a claim.

    Obviously we can’t avoid getting ill and needing to use our Private Medical Insurance, but a cleaner claims history could help keep a lid on the cost of your Health Insurance the following year.

    Another reason the cost of PMI goes up includes medical inflation, such as the cost of new drugs and treatments.

    Insurance Premium Tax (IPT) has also been hiked in recent years – despite extensive industry lobbying, the government has continued to increase this tax on insurance.

Compare Best UK Health 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 / £1,000 / £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

Get Expert Health Insurance Advice

Getting Health Insurance advice is so important because setting up the most suitable product can be complicated, particularly if you have existing medical conditions. There are so many nuances to the cover that make it hard to get it right if you go it alone without the help of an expert.

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.

  • There is no fee for our service
  • We are an award winning 🏆 independent insurance broker who works with all the leading UK insurers
  • You’ll speak to a dedicated expert from start to finish
  • We are very proud of the 3895 and growing independent client reviews rating us at 4.92 / 5
  • Claims support when you need it most.
  • We are authorised and regulated by the Financial Conduct Authority. You can find us on the financial services register here 🧐
  • Claims support when you need it most.

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 02074425880 or email help@drewberry.co.uk.

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Contact Us

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If you are unhappy with our service, we have a complaints procedure, details of which are available upon request. If you are unhappy with how your complaint has been dealt with, you may be able to refer your complaint to the Financial Ombudsman Service (FOS). The FOS website is www.financial-ombudsman.org.uk.

Drewberry Ltd is registered in England and Wales. Companies House No. 06675912

Drewberry Ltd registered office: Telecom House, Preston Road, Brighton, England, BN1 6AF. Telephone 0208 432 7333

Drewberry Ltd (Financial Conduct Authority No. 505473) is an Appointed Representative of Quilter Wealth Limited and Quilter Mortgage Planning

Limited, which are authorised and regulated by the Financial Conduct Authority.

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