Beginner's Guide to Private Health Insurance

This blog aims to answer some questions for people who are considering taking out a private health insurance policy.

What is Private Medical Insurance?
Usually private medical insurance covers the costs of the private medical treatment of acute conditions that start after your policy begins. 'Acute' refers to conditions that are short term.

Why would it benefit me to take out Private Medical Insurance?
There are many reasons why people choose to take out medical insurance:
A desire to be treated quickly and have more time with specialists
To increase their choices: which hospital they go to and which specialists they are seen by
A concern for the high rates of MRSI and other superbugs within NHS environments
A desire to be treated in a more comfortable and private environment

How do I choose which Insurance Company to go with?
Research is key to this in order to find the right policy for you. Private medical insurance is sold in three different ways:
Directly from the insurance companies
Through independent advisors
Through agents (bank, building society or retail outlet, such as a supermarket)

It is important for consumers to look carefully at all policy documents before making a decision. Independent advisors will search for the best policy for you but if you are dealing directly with an insurance company, it is important to be aware that they can only advise you on the best health insurance policy for you from within their own portfolio.

How do I know if I am dealing with a reputable company?
The FSA (Financial Services Authority) is the regulatory body for all UK Insurance Companies. They 'regulate financial services and protect your rights' so if you have any concerns with an insurance company you can contact the FSA for advice.

What will happen when I take out my medical insurance?
Insurance companies do not cover you for any medical condition that you have at the time of taking out the policy, so it is very important to be honest about your medical health because if you later make a claim and your insurance company discovers that you did not disclose everything, your insurance will become null and void.

When you are taking out your policy you will find that companies work in one of two ways:
Full Medical Underwriting where they ask you a series of detailed questions about your medical history.
Moratorium Underwriting where they do not ask details of your medical history but will check your details with your GP should you make a claim.

You will receive a full policy document from your insurer which you are advised to read carefully.


What will be covered?
This varies from policy to policy, and it is important for you to choose the best medical insurance for you. A broker can help you to compare medical insurance policies. Some questions to think about:
How much can you afford to pay each month? What level of cover would you like? Do you want your insurance to cover all treatment costs or would you be willing to part pay? Do you want your cover to include diagnostic tests? Do you want outpatient cover?

What will not be covered?
Generally, private medical insurance is not designed to cover long term treatment or chronic conditions. This list of exclusions is taken from the ABI's consumer guidelines.*

• Going to a general practitioner (GP)
• Going to Accident and Emergency
• Drug abuse
• HIV/AIDS
• Normal pregnancy
• Gender reassignment (sex change)
• Mobility aids, such as wheelchairs
• Organ transplant
• Injuries you get from dangerous hobbies (often called hazardous pursuits)
• Conditions you had before taking out the insurance (commonly known as pre-existing conditions)
• Dental services
• Outpatient drugs and dressings
• Deliberately self-inflicted injuries
• Infertility
• Cosmetic treatment
• Experimental or unproven treatment or drugs
• Kidney dialysis
• War risks


How much will it cost?
The cost depends on the kind of medical insurance cover that you choose. It is advisable to research the costs of a range of treatments and then carefully compare health insurance policies.

If I change my mind, can I cancel the policy?
You have the right to change your mind, and have your money back within a set period (usually 14-30 days) after purchasing your medical insurance.

*For further Information
The Association of British Insurers represents the interests of the UK's insurance industry and has published a comprehensive consumer guide for people who are looking to buy private medical insurance.