Over 50s Health Insurance provides private healthcare to those approaching or in retirement. It gives you access to medical care in private hospitals, letting you skip NHS waiting lists and get treatment when you need it the most. It’s perfectly possible for people over 50 to get cover, there are even specific products designed with this age group in mind.
While it’s true that many types of insurance become more expensive as we age, options exist to adjust your coverage to make it more affordable. In this guide, we show you what’s available and how to obtain the best private medical insurance for your needs.
What Does PMI Cover?
Medical treatment, regardless of whether it’s private or NHS, is split into:
- Inpatient / day-patient care
All treatment where the patient needs a hospital bed, most commonly after surgery. This can either be overnight (inpatient) or just for the day (day-patient).
- Outpatient care
All treatment and procedures that don’t require a hospital bed. For example, this includes diagnostic tests and scans or appointments for physiotherapy.
All Private Health Insurance covers inpatient care as standard. This offers coverage for major and minor surgical procedures. However, outpatient cover is an optional extra for an additional premium.
Including Outpatient Cover
While you don’t have to add outpatient care to your policy, this means you rely on the NHS for outpatient procedures. Given there can be a significant wait for outpatient diagnostic tests and scans, for instance, this could delay your inpatient care.
We therefore typically recommend at least some level of outpatient cover. If a plan with full cover for outpatient procedures is out of your price range, you have the option to choose to limit your entitlement to outpatient care to a set monetary amount per policy year. This figure is typically £1,000.
Acute vs Chronic Medical Conditions
All illnesses are divided into:
- Acute conditions
Those which pass with time and treatment, such as broken bones
- Chronic conditions
Those which remain with you for life and can’t be cured, only managed, such as asthma and diabetes.
Health Insurance treats acute conditions only. It doesn’t provide cover for ongoing management of chronic conditions, which the NHS will continue to take care of.
Some of the most common ailments that are covered and commonly treated under a private medical insurance policy include:
- Joint replacement surgeries
- Cancer care (including access to cutting edge drugs and treatments the NHS may not yet provide due to cost)
- Heart bypasses
- Cataract removal.
Additional Benefits Including Virtual GP Services
All plans now offer some form of virtual GP service. This provides either telephone or video appointments with a UK-registered GP, typically 24 / 7, at a time and a place to suit you.
You therefore no longer need to wait for an NHS GP appointment in traditional opening hours. You can book a consultation in the evenings and at weekends if you prefer, all from the comfort of your own home or indeed anywhere else that works for you.
Digital GPs offer the same help, medical advice and reassurance as your NHS GP would. They can also issue prescriptions and make referrals for private treatment under your Health Insurance plan.
Is Medical Insurance Worth It?
Many of us will experience ill health in our later years. That’s why retirement may be the time when private health insurance is most relevant to your needs.
According to AgeUK, of the 18.7 million adults admitted to hospital in 2017, 7.6 million (41%) were aged 65 and over.
The number of older people requiring inpatient care has also risen considerably over the past few years. There were 16.2 million older individuals admitted to hospital between 2015 and 2016. They also stay longer — an average of 9.1 days per admission compared to 5 days across all age groups.
Ultimately, the older we are, the more likely we are to need healthcare.
It’s true that Medical Insurance won’t meet all of your healthcare needs in retirement, such as admissions for chronic / pre-existing conditions or emergency care. However, it can go a long way to helping when it comes to skipping queues for care such as joint replacements.
What Are My Options for Healthcare In Retirement?
When you need treatment in retirement, you have a few options to choose from. However, not every option is viable for every individual needing treatment.
Using the NHS
The most obvious option is to use the NHS. We’re incredibly lucky that our health system offers treatment free at the point of use, so we might as well make the most of it.
However, the downside of using the NHS is that you could face a significant waiting list depending on the treatment you need. A funding squeeze and rising demand for healthcare as placed pressure on the system.
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.
Self-Funded Private Treatment
If you’d like private care but don’t want to buy insurance, you have the option to pay for treatment using savings.
However, the cost of this can be prohibitive. For example, the going rate for a private hip or knee replacement is between £10,000 and £12,000 depending on your chosen provider. Meanwhile, you should expect a bill of around £2,500 per eye for cataract removal.
Few could afford such out of pocket expenses, especially in retirement when they no longer have an income from work.
Continuing A Company Policy
Some people are fortunate enough to have their employer pay for Group Health Insurance. If this applies to you, there may be an option to continue your health cover after you retire.
There are both pros and cons to doing so, however, most of which are dependent on your insurer and your employer. As the terms of your ongoing cover are up to them, you can’t know for sure whether you’ll be able to keep your plan or just what it will cover.
Some insurers may hike up premiums after retirement to reflect the fact that you’re no longer part of a group and are underwritten as an individual.
Personal Health Insurance
Personal Health Insurance is the most common option to pay for private treatment. Yet getting a personal policy in retirement can be tricky, taking a considerable amount of work to find and maintain.
Not only will you need to look for good value today, but you will also need to review it regularly to ensure that you retain the best plan for the premiums you’re paying.
If you’re over 50 and considering arranging health cover we are here to help, call us on 02074425880 or email email@example.com.
How Much Does Over 50s Medical Insurance Cost?
The cost of the monthly premiums can vary considerably based on both personal factors as well as the options you choose for your coverage. The biggest factors include:
- Level of cover
- Policy additions
- Smoker status
- Medical history and current state of health.
To provide a rough estimate of cost we have calculated the monthly prices for adults aged 50+ based on the most competitive quote from across the market for individuals who are:
- In good health
- Looking for a comprehensive plan
- Willing to pay a £250 excess
- Underwritten on a moratorium basis
- Based in the same postcode as our Brighton office.
Can I Reduce the Cost of Health Insurance?
Yes, if you’re concerned about the price of premiums you have a number of options available to cut the price of cover.
Limiting / Removing Outpatient Cover
As mentioned, outpatient care is an optional extra for an additional premium. To save money, you can opt for no outpatient cover at all, in which case you’d be 100% reliant on the NHS for such treatment and procedures.
Alternatively, you can choose limited outpatient cover. Known as a mid-range plan, this places a cap on the monetary amount of outpatient cover you’re entitled to per policy year, typically at £1,000.
Add an Excess to Your Policy
One of the best options to reduce the cost of cover is to add an excess. This is an amount that you agree to contribute upfront to your private care.
Excesses typically begin at £100 and can go all the way up to £5,000 depending on the insurer and the type of care you require.
The more you agree to pay upfront, the lower your premiums will be.
Include the 6 Week NHS Wait
Another option to make premiums more cost effective is to add the 6 week NHS wait to your policy.
Here, when you need inpatient care, your insurer firstly looks at the local NHS waiting list for the procedure you need. If the NHS waiting list for that treatment is longer than 6 weeks, or it isn’t available at all, then you have the procedure privately.
If the waiting list is shorter than 6 weeks, you have treatment under the NHS.
Reduced Hospital list
The cost of private treatment varies around the UK. The most expensive facilities are those in Central London. If you want to use such hospitals and clinics, your premiums will be more expensive. You can opt to exclude pricier facilities to save money on premiums.
Also, some insurers give you various tiers to choose from in terms of the facilities and hospitals which provide your care.
To cut the cost of your policy you can choose a reduced hospital list. This limits the hospitals you can visit, typically to treatment in private wards in NHS hospitals rather than using an entirely private facility.
Your Medical Underwriting Options
The underwriting you choose will impact your policy’s coverage. It will also govern whether the plan provides care for certain pre-existing conditions, which are illnesses you had before the policy began.
There are two underwriting options available:
Moratorium Underwriting (MORI)
Under moratorium underwriting, your insurer excludes any condition for which you’ve had treatment in the past 5 years.
However, most insurers offer a ‘rolling moratorium’. This means you may be able to get the excluded condition covered if you serve 2 years on the plan without having any advice, medication or treatment for that condition.
The re-inclusion of any condition is subject to the insurer’s discretion, but it may mean that your plan covers pre-existing conditions after a set period.
Full Medical Underwriting (FMU)
Here you’re required to disclose past medical conditions upfront when you apply for cover. It’s at this point the insurer decides whether it will offer cover for those conditions.
Given you have to make a full declaration of your medical history, this is time consuming and can involve a lot of paperwork.
Moratorium or Full Medical Underwriting?
This all comes down to the nature of your medical history.
Full medical underwriting typically excludes any serious conditions that you have experienced in the past (even if it was over 5 years ago). With a moratorium this would not likely be the case if you last had symptoms more than 5 years ago.
On the other hand, with the moratorium method, a consultation that may not have actually amounted to anything could potentially exclude a whole area of the body if it was within the last 5 years.
Who Are The Best UK Health Insurance Providers?
When considering your health insurance options there are five major providers in the UK market. Each offering a range of policy options and premiums to suit your needs.
It is important to recognise each insurer has their own underwriting philosophy. Given age, location and medical history all have a significant impact on the cost it is vital you obtain quotes from all of the leading UK insurers when doing your research.
Make Sure Your Regularly Review Existing Cover
If you have an existing private medical insurance policy it is important to research the market every couple of years to ensure your policy is still competitive.
We too often speak to individuals who have held their cover with the same insurer for many years only to find out there are significant savings to be made.
Can I Get Health Insurance Over 65?
Yes, you can get Health Insurance for the over 65s. While these plans are less common, it’s perfectly possible to get coverage if you’re in this age bracket. However, you may face a number of challenges.
Firstly, the main barrier retirees tend to face is the price of cover. The older you are when you take out a policy, the greater the risk to the insurer because you’re more likely to need medical care. Premiums therefore rise with age.
By choosing the right options at the outset, you may find it’s possible to mitigate some of this price increase, however.
Secondly, if you have any pre-existing conditions, which is more likely the older you are, you may find your policy won’t cover these. Insurers typically exclude existing conditions from your policy, at least for a set period.
Lastly, some insurers won’t offer new policies to those over a certain age. This could be as low as 65 or as high as 80+, so it really pays to check each insurer’s terms and conditions carefully.
Will My Premiums Increase If I Use the Policy?
Yes, as with many other types of insurance, the more claims you make on a policy the more likely it is that the price will go up the following year.
Policies work on a no claims discount basis. If you don’t claim on your policy, premiums may stay the same or even fall depending on how many years have passed without a claim.
However, if you make a claim, you start to lose that no claims discount. The more times you claim, the more likely you are to be pushed down tiers in the no claims discount structure and trigger an increase the following policy year.
Can You Get Joint Health Insurance?
Yes, you can. At Drewberry we commonly see partners aged 50+ taking out joint private medical insurance, which rolls up all of the administration for two people under one policy.
It’s not necessarily cheaper to buy joint cover, however. In most instances, the price of premiums for a joint policy for two people will be roughly double that for two single policies. Nevertheless, it’s a great way to reduce administration and hassle, especially when it comes to your renewal date.
Compare Over 50s Health Insurance Quotes & Get Expert Advice
Although it can get a little harder to find the most suitable Private Medical Insurance the older we get, having an expert on hand to get quotes and review the market on a regular basis can pay real dividends.
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 want to talk through your options to make sure you are looking at the most suitable cover then don’t hesitate to pop us a call on 02074425880.