Why Private Health Insurance?
• Health Insurance provides you with access to private healthcare, allowing for fast treatment without waiting lists.
• Access new drugs and novel treatments that may not yet be available on the NHS.
• Private hospitals usually have superior facilities, e.g. private, ensuite rooms and round-the-clock visiting hours.
• This treatment is all paid for by your insurer (less any excess).
Getting The Best Cover
To get the best Private Health Insurance, you will want to be comparing a number of key factors including:
• The Insurer
Does the provider have a good reputation? Do they have good reviews? How is their claims process?
• Inpatient and day-patient cover
The level of cover provided where you’re admitted to hospital and occupy a hospital bed overnight, usually for surgery. Alternatively, minor procedures can be performed on a day patient basis, where you occupy a hospital bed for a period but leave the same day of the procedure.
• Outpatient cover
The level of cover provided for consultations, diagnostics or treatment where no hospital bed is required (e.g. blood tests, x-rays, MRI scans etc.), starting with a referral from your GP. If necessary, the hospital may then refer you for inpatient treatment, such as surgery.
• Additional Benefits
The level of cover for therapies such as physiotherapy, osteopathy or chiropractic treatment as well as mental health, dental and optical treatment.
• Medical Underwriting
The method used to underwrite your policy based on your current health which defines what you can and cannot claim for. The most common forms of underwriting for an individual policy include moratorium and full medical underwriting.
Where almost all Private Medical Insurance covers inpatient treatment in full, the extent of the cover provided tends to be broken down by outpatient treatment with the best policies providing full outpatient cover.
• Basic Cover
Tends to cover little or no outpatient treatment
• Mid Range Plan
Will cover outpatient treatment up to a monetary limit often set at either £500, £1,000 or £1,500 per year.
• Comprehensive Health Insurance
Designed to cover outpatient treatment in full.
Naturally the greater the level of outpatient treatment that is provided the higher your premiums are likely to be.
What Additional Options Will the Best Health Insurance Cover?
The top Private Medical Insurance providers will cover a range of additional options as standard on their best PMI policies. Mid-range and basic plans may require you to pay extra for these.
Some providers will offer a ‘menu’ of additional options for you to choose from that you can add and subtract from the policy, thus increasing or reducing the cost of cover respectively.
Therapies Cover
The big four therapies covered by the better Medical Insurance providers are:
• Acupuncture
• Chiropractic treatment
• Osteopathy
• Physiotherapy.
These will only be provided as standard by the best Health Insurance plans that offer a good level of outpatient cover.
Alternatively if it is not included by default some insurers will allow you to add therapies cover to your plan for an additional cost.
Dental and Optical Treatment
These are among the most popular Health Insurance add-ons, as few policies cover all dental and optical treatment as standard.
Dental Treatment
Most policies will cover you for what’s known as ’emergency dental’, which covers treatment if you had an accident that loosens or knocks out a tooth. Many plans also cover oral surgery, which would provide cover for wisdom tooth extraction in a hospital. However, if you want cover for everyday dental treatment – such as checkups, fillings, crowns and cleaning – you’ll likely need to consider an add-on to your policy.
It’s important to check what you’re covered for if you do opt for a Private Dental Insurance add-on, as many policies will only contribute towards the cost of treatment up to a set limit, or only cover dental emergencies, rather than paying for full dental cover.
Optical Treatment
While most PMI plans cover you for treatment such as cataract surgery, few offer cover for routine optical appointments as standard.
This will generally need to be an add-on to pay for everyday checkups and items such as glasses or contact lenses.
Psychiatric Cover
Although it’s not often requested as a ‘must have’ for many policies, the better Medical Insurance plans will cover psychiatric treatment. Others may require you to add this on separately. The cover generally pays for a set number of days of inpatient or day patient treatment if you were to be diagnosed with a psychiatric condition such as schizophrenia or clinical depression. Some policies only cover outpatient treatment, however, such as appointments with cognitive behavioural therapists or psychologists.
What’s the Best Health Insurance Underwriting?
For most people there are two underwriting options available: moratorium underwriting and full medical underwriting (FMU).
Moratorium underwriting is the most common form of Health Insurance underwriting.
With moratorium underwriting, any medical condition that you’ve had advice, treatment or medication for in the past 5 years will automatically be excluded from the policy if you try and claim in the future. Many insurers use a 2 year rolling moratorium, whereby the insurer will consider any claims for medical conditions that you suffered in the 5 years running up to the date your policy started providing you’ve served 2 years on the policy without needing any medical attention for that condition.
Full medical underwriting (FMU) will examine your medical history before you take out the policy.
While this means you know exactly what you are and aren’t covered for, there’s usually very little opportunity to get any exclusions arising from the underwriting process removed. Conditions occurring more than 5 years ago aren’t generally taken into account when insurers are underwriting you on a moratorium basis. However, they will most likely be examined when being underwritten on an FMU basis. With full medical underwriting, an insurer might not decide to exclude a minor condition having seen the medical evidence from your GP, but this condition would likely be automatically excluded if it occurred in the 5 years leading up to the policy start date if the insurer was underwriting you on a moratorium basis.