PRIVATE MEDICAL INSURANCE

As with buying any type of insurance such as home or buildings, before you choose a policy, it is sensible to sit down and decide what you need such a policy to do for you and/or your family. You might like to take into account any of the following: 

• Pre-existing conditions that apply (policies exclude incurable illnesses or drug addiction)
• What essential treatments you might need such as consultations, surgery, nursing and hospital care
• Any additional treatments you might consider such as complementary therapy
• Any additional requirements such as personal accident cover. 

Policies are generally divided into two types: 

Fully underwritten: the company requires full disclosure of all your medical history and can then decide what they will cover or exclude. 

Moratorium: a full disclosure is not required but the company can impose wide-ranging exclusions that go back a set number of years.

Specialist: Some insurers may have specialists policies, where they only cover if you have to wait longer than 6 weeks for an operation, or are only for over 55’s or focus on just the one disease. 

Check also if your provider (e.g., hospital) is covered by your insurance.

No private medical insurance covers accident and emergency and cannot guarantee shorter waiting times for serious illnesses. 

Other types of insurances are:

• Private Medical Insurance – Cancer cover
• Critical illness Insurance
• Life and critical illness cover
• Stand-alone critical illness cover
• Income Protection Insurance
• Personal Accident Insurance
• Life Insurance
• Travel Health Insurance
• Fixed Price Surgery Schemes
• Healthcare Cash Plan
• Cosmetic Surgery Insurance
• Dental Insurance/Denplan

Health Assessments

Since the emphasis today is as much on prevention of health problems as on treatment, health assessments can provide early warning of potential problems. Fixed price health assessments are offered by a number of private companies. 

They typically include a medical history and lifestyle questionnaire; a physical examination; a consultation with a doctor, trained health adviser or nurse, which gives you the time to ask questions. Most test results are available on the day, as is your personalised health report and an action plan to help you minimise future health risks. 

Self-paying Treatments

Some cosmetic dentistry, nonsurgical facial aesthetic procedures such as chemical peels, Botox or dermal fillers are covered by some private healthcare organisations. Cover can also be offered for self-referral to physiotherapists or osteopaths. Even seasonal flu vaccinations can be bought and administered through pharmacies such as Lloyds Pharmacy. 

Comparing Providers

You need to feel comfortable with your provider, whether that is a GP, dentist, hospital or surgeon. Any provider should offer you adequate information about their services, taking into account your needs. 

Always check that the hospital you choose follows an external complaints code, adjudicated by an external body, qualified to assess its procedures and services. 

All hospitals, primary dental care, healthcare and social care, and GPs in England (since April 2013), are monitored by the Care Quality Commission and their reports can be found at www.cqc.org.uk and for Wales at the Healthcare Inspectorate Wales (www.hiw.org.uk). Both NHS and independently funded or voluntary organisations are covered. 

Reducing the Costs of Health Insurance

As regards buying private health insurance, there are ways to ensure that you pay for only what you need. It makes sense as with buying any service to ask for and examine thoroughly several quotations. While health is an emotive issue for us, when you purchase insurance, you are entering into a contract with the provider of the insurance and you need to think carefully about what you are buying 

• Choose and pay for only the cover you need – a single person may not need cover for family, children or pregnancy. You may choose to limit cover to certain major illnesses.
• Share the risk – some shared risk policies have high excesses, while others mean your insurer covers 30-75% of the costs and you cover the rest.
• Choose the level of excess. Moving from £100 to £1000 can substantially affect your monthly premiums
• Choose your waiting period – for example, accept treatment on the NHS within six weeks then choose immediate treatment after that time.
• Build up no claims and low claims discounts on your policy. As with car insurance, discounts are available over a period of 8 years of no claiming.
• Restrict your choice of hospital provider. Some insurers offer restricted lists of hospitals, i.e.,  those they have negotiated discounts with and you benefit with reduced premiums. The wider your choice, as is possible, the higher your premiums
• Buy online – you can save up to 10% for buying online.
• Pay annually and receive discounts.
• Stay healthy – premiums are increased for people who are obese or who smoke, and reduced for those with a healthy lifestyle. 

Before you agree with a provider, make sure you receive a personalised treatment plan that itemises the costs and exactly what it includes.