Self Employed Private Health Insurance

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15-01-2021

Self Employed Health Insurance offers people working for themselves access to private medical care. It enables them to have prompt treatment so they can get back on their feet quickly. As a group which rarely gets sick pay, few such people can afford to take time off work while on a waiting list for NHS healthcare.

What Does It Cover?

All medical needs you’ll have are broadly divided into:

  • Inpatient / day-patient care
    All healthcare requiring a hospital bed overnight (inpatient) or only for the day (day-patient). This will usually be after surgery. All policies cover this in full.
  • Outpatient care
    Any medical care not needing a hospital bed, such as diagnostic tests and scans. This is an optional extra for an additional premium.
IMPORTANT NOTICE 🧐
Choosing no outpatient cover cuts costs. However, it means you rely on the NHS for all outpatient healthcare. This could delay access to private inpatient care under your Health Insurance plan.

Cancer Care

One of the most valuable components of any Private Medical Insurance (PMI) policy is cancer care. This is because private medical care can offer access to drugs, treatments and therapies the NHS may not yet offer due to cost.

All policies cover cancer treatment as standard, offering:

  • Chemotherapy
  • Radiotherapy
  • Biological therapies
  • Cancer surgery / reconstruction
  • Cash towards prosthetics / wigs you need as a result of cancer therapy.

Digital GP Services

All Health Insurance plans offer access to a remote GP. This provides either telephone or video appointments with a UK-registered GP, typically 24 / 7, at a time and place to suit you.

This means no more waiting for an NHS GP appointment and having to duck out of work during traditional surgery opening hours.

A remote GP offers all the same services as your NHS GP, including providing medical advice, issuing prescriptions and making onward referrals for private healthcare under your plan.

What’s Not Covered?

Firstly, any medical conditions that are pre-existing will not be covered. PMI covers the treatment of unknown future illnesses rather than paying for treatment you know you already need.

There are two main types of health concerns you could develop:

  • Acute conditions
    These are treatable conditions that pass with time and medical attention. This includes cataracts requiring surgery or joint pain fixable with a joint replacement.
  • Chronic conditions
    These conditions remain with you for life. There’s no cure — doctors can only manage them. For example, this includes diabetes and asthma.

Health Insurance covers acute conditions only and works in tandem with the NHS. It isn’t designed to provide ongoing management of chronic conditions. The NHS will continue to provide this for you.

Other services that tend not to be covered privately include:

  • Pre-existing conditions
  • Emergency services
  • Routine pregnancy
  • HIV / AIDS
  • Cosmetic surgery that’s not medically necessary.
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Do I Need Private Medical Insurance?

When you’re self-employed, you can’t always simply take a break from work if you fall ill or injure yourself. Any health problem stopping you working will likely see your income dry up.

This can be problematic given that NHS waiting times for certain treatments and procedures are measured in weeks or even months.

self employed builder

While the NHS does a fantastic job, and it’s quite rightly a beloved national institution, a budget squeeze and growing demand for healthcare has put it under strain.

For instance, at the end of July 2020, there were 4.05 million people on NHS waiting lists in England. 2.15 million of these patients — more than half — had been waiting for more than 18 weeks. 83,203 had been waiting more than a year.

If an acute illness or injury stopped you working but medical help to resolve it was at least 18 weeks away, how would you and your business manage?

It’s here Health Insurance can step in to get you the medical attention you need faster and have you back on your feet and earning again as soon as possible.

How Much Does Self Employed Health Insurance Cost?

Working out the cost of private medical insurance isn’t always simple. Any quotes you get depend firstly on personal factors, such as your:

  • Age
    The older we are, the more likely we are to develop health concerns needing treatment and so the higher premiums will be.
  • Medical history
    If you’ve had a medical condition, or a history of one, especially if it’s a severe condition, then insurers typically charge higher premiums.
  • Smoker status
    Smoking makes you more susceptible to a range of illnesses and so your premiums will be more expensive as a smoker.
  • Address
    Living in an area with more expensive private hospitals, such as London, will increase the cost of cover.

Key Policy Options

Also at play are various policy options you can choose to either make your plan more or less comprehensive depending on your needs. For example, you’ll have to consider:

Level of Outpatient Cover

As mentioned, outpatient cover is an optional extra. Private Health Insurance with coverage for outpatient procedures is more expensive than a basic, inpatient-only cover.

However, this option provides access to private diagnostic tests and scans and other treatment not needing a hospital bed. This can considerably speed up your diagnosis and pathway to treatment.

If a policy covering outpatient treatment in full is too expensive but you still want some level of outpatient coverage, you could choose a mid-range plan. With this, the insurer caps the amount of outpatient care it pays for per year at a set financial limit, typically £1,000.

Your Medical Insurance Excess

An excess is the amount of money you agree to pay upfront towards your private medical care. Once you pay the excess (typically once per policy year), your insurance kicks in to pay for the rest.

The higher your excess, the lower your premiums. Excesses start at £100 and can go all the way up to £5,000 depending on the treatment you need and the insurer you choose.

ADVISER TIP  🤓
When setting your excess, it’s vital you don’t set it too high simply because it reduces premiums. Your excess has to be practical and affordable should you need to make a claim.

Your Hospital List

Some insurers will give you several tiers of private facilities to choose from.

Choosing a more comprehensive hospital list gives you more options as to where you can be treated, including top UK hospitals in Central London. However, the more comprehensive your list, the more expensive your premiums will be.

The 6 Week NHS Wait

Another option to reduce premiums, this means your Health Insurance will only pay for inpatient treatment if the NHS waiting list for that treatment is more than 6 weeks.

If the waiting list is more than 6 weeks, or the NHS doesn’t offer the procedure you need, then you have it privately. Should the wait be less than 6 weeks, you’ll have treatment under the NHS.

Which Medical Underwriting Is Right For Me?

There are two main underwriting options for Health Insurance: moratorium or full medical underwriting.

Which one is right for you depends on your medical history, not only on the conditions you’ve had but also how severe these were.

  • Moratorium Underwriting (MORI) is the most common form of Health Insurance underwriting. Here, your insurer will usually decline to cover any condition you’ve had advice, medication or treatment for in the past 5 years.
  • Full Medical Underwriting (FMU)  requires you to fill in a form declaring your medical history upfront. Once the insurer has this information, it will usually exclude any conditions you’ve mentioned.

If you have any pre-existing conditions, we recommend you speak to an expert. It’s critical to get your underwriting correct, so don’t hesitate to pop us a call on 02074425880 for help and advice.

Example PMI Premiums

To calculate the below Private Medical Insurance quotes, we’ve assumed each individual is:

  • In good health
  • A non-smoker
  • Looking for comprehensive Private Medical Insurance
  • Willing to pay a £250 excess
  • Going to be underwritten on a moratorium basis
  • Not looking for any additional extras on their plan
  • Based in the same postcode as our Brighton office.

Single Applicant

30 Year Old

40 Year Old

50 Year Old

£57.64
per month

£73.08
per month

£97.50
per month

Joint Cover

40 Year Old Couple

£136.10
per month

Family Cover

Parents Age 35, Children Age 13 and 11

£165.06
per month

I’m Self-Employed: Can I Expense My Health Insurance?

This depends how you’re set up as a self-employed worker.

If you’re a sole trader and don’t work via a limited company or a similar vehicle, then it’s unlikely you’ll be able to write off Health Insurance as a business expense.

This is because, for HMRC to consider a policy an allowable business expense, there typically needs to be some form of business entity to own it and pay the premiums.

If you’re self-employed you can still get Health Insurance, but you’ll need to pay for it personally rather than put it through the business.

Paid Via A Limited Company

However, if you do work for yourself via your own limited company, either as a contractor or a director, then your business can pay. In this case, Health Insurance is generally a business expense that you can write off against corporation tax.

If you pay for private medical insurance via your limited company it is considered a P11D benefit. You will be required to pay employer national insurance contributions on the premiums.

Compare Top 5 UK Private Medical Insurance Companies

The UK has five major Health Insurance providers all of whom cater for self employed individuals:

There are also a handful of smaller providers on the market some of which are particularly competitive for soletraders looking for cover.

We compare health insurance quotes from every single UK insurer to ensure our clients get the most appropriate coverage for the best price. If you need help researching the market give us a call on 02074425880 or email help@drewberry.co.uk.

Annual Market Review

Health Insurance renews annually. Your insurer will write to you yearly to inform you what your premiums will be for the upcoming year.

The cost of your policy may rise slightly over time. Generally, this is down to medical inflation, which accounts for the rising cost of healthcare inputs, from the wages of medical professionals to paying for medical advances such as brand new cancer drugs and therapies.

Once you have Health Insurance, it’s important you regularly review premiums to ensure you’re getting the best deal. Your adviser will be happy to help with this and search the market on your behalf.

If we find premiums cheaper elsewhere, we’ll then handle the policy switch. It’s vital this is done carefully to provide continuity of coverage, so we’ll port you over on a continued personal medical exclusions (CPME) basis.

Other Types Of Self Employed Insurance

As well as Health Insurance, there are a variety of other policies on the market that you may want to consider if you work for yourself. These can help fill the protection gaps you may have as someone who works for themselves.

For instance, self-employed people rarely get sick pay. If you couldn’t do your job for any length of time and had no money coming in, how would you cope financially?

For this reason, many of our self-employed clients consider Income Protection, which pays a regular income each month if you can’t work for any medical reason.

Long-term Income Protection will continue paying you for as long as is required, right up until retirement if necessary.

If you are set-up via a limited company you can also opt for relevant life insurance which is  tax-efficient life cover paid for by your business.

Compare Medical Insurance Quotes & Get Expert Advice

Health Insurance is one of the more complex policies to compare due to the many different combinations of options available.

That’s why if you’re self employed looking for cover it is worth speaking to a professional who knows these policies inside and out.

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 are self employed and need help setting up health insurance or reviewing an existing policy, give us a call on 02074425880 or email help@drewberry.co.uk.

I’ve held a policy with Drewberry for several years now. They are always friendly, insightful and offer great service.

Dan Pettitt
13/01/2021
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