How does Basic Medical Cover work?
The level of cover and type of treatment required will determine the exact process but the main variation depends on whether the policy includes outpatient cover.
No Outpatient Cover
With Outpatient Cover
Holding a policy without outpatient cover means that you run the risk of having to go through the NHS outpatient waiting list for diagnostic testing and initial consultations.
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Jacqueline AinsworthWhat is low cost private medical insurance?
By choosing a plan from the affordable range, possibly selecting the 6 week wait option and implementing an excess, low cost health insurance is a real possibility.
Plans from the low cost or basic range offer exactly the same inpatient benefits as a comprehensive plan but limit the cover for outpatient treatments and provide fewer additional benefits. Thus, if something serious happens that requires an operation, for example, don’t worry you’ll be covered.
It is a myth that health insurance has to cost a fortune. On the contrary, taking out an affordable plan with reduced outpatient cover and including fewer additional benefits, such as alternative medicines, can lower premiums by around 35%.
What is covered?
Inpatient treatment
Inpatient cover relates to consultations, treatments, tests and scans where it is necessary to occupy a hospital bed.
For example, supposing that you suffered a form of heart disease that required an operation, your medical plan would cover the full cost of specialist consultations, tests and the cost of the operation in private healthcare facilities.
The level of inpatient cover is the same with a low cost health insurance plan as it is with a comprehensive plan.It should be noted that affordable plans do not usually provide cover for psychiatric treatment, whether as an inpatient or outpatient.
Outpatient treatment
Outpatient cover relates to medical care where it is not necessary for you to occupy a hospital bed. Affordable plans will usually provide a limited amount of cover for consultations, diagnostic tests, MRI/CT & PET scans, radiotherapy/chemotherapy and physiotherapy, although there are large variations from policy to policy.
The majority of basic medical insurance plans will provide a limited amount of cover for outpatient specialist consultations. The best plans in this category allow for up to two consultations or a maximum cost of £500 per policy year. It should be noted that these consultations usually have to relate to prior inpatient treatment.
Leading low cost health cover usually provide full cover for outpatient MRI/CT & PET scans and radiotherapy/chemotherapy (used for cancer treatment), and a limited amount of cover for other diagnostic tests and physiotherapy.
Choosing the right policy
Although all family medical plans cover the cost of inpatient and day-patient healthcare in full, the cover provided for outpatient and additional healthcare benefits does vary considerably from plan to plan. In this sense it is important to consider your options and select a plan that meets the needs of your family most.
Generally speaking, the more comprehensive the plan the more outpatient treatment and additional benefits included in the health cover, although even the most basic plans include some important additional family benefits.
Additional policy options
Additional benefits relate to alternative medicines, dental/oral surgery, home nursing and the use of a private ambulance. Although the best affordable health insurance plans will usually provide a limited amount of cover for home nursing that relates to inpatient treatment and the use of a private ambulance it should be noted that dental surgery or alternative medicines are not usually covered.
Some plans have options where you can add alternative medicines (such as osteopathy and homeopathy), physiotherapy, oral surgery and routine dental & optical cover to your affordable medical plan for an additional monthly premium.
Reducing your premiums
When looking for low cost medical insurance there are a number of policy options that you can choose to reduce your monthly premiums, thus enabling you to sick within your budget
Adding an excess
It is possible to implement an excess on your policy in order to reduce your monthly premiums. If you choose to include an excess you will be required to contribute to your treatment up to the value of your excess. Once you have paid your excess in full you will not be required to pay any more towards your healthcare costs.
It is important to note that once you have paid your excess that is it and you will not be required to pay the excess again for subsequent treatment within the same policy year. At the start of the next policy year the excess will be reset to your chosen level.
Excesses usually range from a minimum of £100 to a maximum of £1,000. Including an excess of £100 can reduce your monthly premiums by about 5% and an excess of £1,000 can reduce your premiums by approximately 35%.
Six week wait options
Including a six week wait option can result in significant premium savings each month, usually by around 20%. If you decide to include this option then you agree to receive treatment on the National Health Service (NHS) if the waiting list is less than 6 weeks long.
If you have to wait longer than six weeks then you would go private straight away. The six week wait option is therefore a useful method of gaining affordable health insurance and avoiding potentially long NHS waiting lists.
Reduced hospital list
Choosing a reduced hospital list is also another method of gaining low cost health insurance. Some policies provide the option of choosing a hospital list of just NHS Trust and Partnership hospitals, which can reduce premiums by approximately 25%.
Excluding London hospitals can also lead to premium savings, which is especially appropriate if you live outside of the Capital.
If you live in Scotland or Northern Ireland then it is possible to choose a hospital list that just includes healthcare facilities in those countries, which can result in monthly premium savings of over 40%.
Need some guidance?
With all the different options and insurers available choosing the most appropriate health insurance policy can be quite daunting particularly if it needs to be done on a budget.
We have years of experience in the private medical insurance market and are here to help you navigate through the murky waters.
Please do not hesitate to give us a call on 0208 432 7333 and one of our experts will be available to help.
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