Private medical insurance usually means you can get treated quicker than going on the NHS. But make sure you check what is and isn’t covered.
Like all insurance the cover you get varies – but basic private medical insurance may pick up the costs of most in-patient treatments (tests and surgery) and day-care surgery, and some extend to out-patient treatments (such as specialists and consultants).
Cover can be purchased on a full medical underwriting basis, which means you will be asked a number of questions about your health and, based on the information you provide, the insurer will decide the conditions of your cover. You can also apply for cover on a moratorium basis, which means you will not be asked any questions about your health, but if you have suffered from any health conditions in the last five years, these will automatically be excluded from cover initially.
What isn’t covered?
- You can’t take out cover now for treatment you know you’re going to need.
- If you’ve had health problems in the past (pre–existing conditions), your insurer may also exclude those conditions from your cover. If you are asked to disclose these when applying for the insurance you must do so, or you could invalidate your policy, which means the insurance company won’t pay out if you make a claim.
- It does not cover the treatment of chronic medical conditions. There are various definitions of chronic conditions depending on the policy, but broadly it is a long–term medical condition which is likely to continue to need regular or periodic treatment.
- Some exclude certain types of treatments such as out–patient treatments, routine treatments (such as health checks), dental care or experimental treatments.
- Most also exclude routine pregnancy, HIV/AIDS, fertility treatment, mental or psychiatric conditions, and elective treatments you may choose to have, such as cosmetic surgery.
Keeping costs down
Shop around – it’s a competitive market out there and both cover and costs vary from company to company. Many policies have a standard excess charge which means you agree to pay the first part of any claim, for example the first £50 or £100. If you agree to pay a higher excess you might get a cheaper policy. Or you could choose cover that only kicks in if NHS services are not available within a certain timeframe.
Be clear about what you need. You may not want the highest level of cover. Always compare what’s covered by a policy, not just the price. Some may be cheaper than others, but they may not offer the same level of protection.
For more information see the private medical insurance guides provided by the Association of British Insurers – see Useful links.
Top tips
1. Read the paperwork and ask questions if you don’t understand anything.
2. Make sure you check what you’re covered or not covered for.
3. Tell the insurance company if you have any existing medical conditions.
4. Find out if your employer provides health insurance as part of your benefits package.
