Health Cover Survey

According to Deloitte's 2010 Survey of Health Care Consumers only a quarter of respondents said they felt they had enough health cover: four out of five said they were only 'adequately insured.'

The Deloitte survey looked at 1,000 British adults in order to find out consumer attitudes about both private and NHS medical treatment. Over a third of respondents said that they had cash plan cover but despite people's dissatisfaction with the amount of cover they had only 2% had switched private health insurance plans. 58% of those who had changed plan did so to get better value for money.

One of the biggest complaints about medical insurance was the fact that 'experimental' treatments were not covered. Experimental treatments refer to those that do not yet have enough data behind them to certify them as conclusively effective. PruHealth, for example, do cover experimental treatments as part of their plans. This is unusual however. 69% of respondents said that they would be prepared to try experimental treatments.

The findings seem to support the health insurance market's move towards illness prevention. Over half of respondents said they had a 'strong interest' in taking part in wellness programmes and 49% said they would take part in healthy living programmes if they could get reduced private medical insurance.

NHS
The NHS didn't fair too badly in the Deloitte survey. 67% of respondents said that they were 'happy' with the NHS. 50% said that it was 'average', a fifth said that it was 'failing' but only 2% said that it was excellent. The most dissatisfaction concerned waiting times which 46% of respondents felt was 'poor' and the amount of accessible information about doctor's performance where 42% felt that it was poor.

How to Make a Health Insurance Claim

In order to make a health insurance claim it is very important to follow the correct procedure for each company.Doint this helps speed up your claim and avoid misunderstandings.

Having a good knowledge of your policy is probably the first step. Having an awareness of what you are and are not covered for will help you to have the correct expectations of your private medical insurance cover.

Your policy will also have specific details of how to make a claim. Being familiar with your policy claims proceedure is important as there are variations in what health insurance companies need to you to do in order to make a claim. Errors can cause distressing delays and misunderstandings.

The following details are a general guideline only.

The GP is always your first port of call. They are the ones that refer you for a consultation or treatment if they think this is necessary. You need to inform them that you would like to go via your medical insurance.

Normally your insurance company will provide you with a list of approved hospital networks and practitioners with which you will be covered under your policy. Your GP needs to refer you to establishments or individuals that will be accepted by your insurer.

Some companies, for example Bupa, will allow you to go to hospitals which are not on their approved lists but will not cover you completely for treatment there. They will give you an allowance instead. If the hospital you go to charges more then you have to pay for the difference.

The next step is to call your insurance company. They will let you know whether the treatment you need is covered by your policy. They will also advise you as to whether they can approve your chosen practitioner.

The insurance company may also then send you a claim form which you need to fill in and return to them. The next step depends on whether you have a moratorium or fully underwritten policy. If you insurance cover is under a moratorium policy then the insurance company sometimes need check your medical history with your GP to make sure that you are covered for treatment for the condition you are presenting with. This can delay their response.

When you go for your consultation or treatment you need to take your health cover details with you and show them to your consultant. In most cases this enables your health insurance company to be billed and not you.

With some types of health insurance policy you are given money directly by the insurer and then you are responsible for paying for your healthcare directly. This is unusual however and in most cases the medical insurance company pays.

If your consultant sends you for tests or hospital treatment you have to contact your private health insurance company again in order to check that the proposed treatments are covered.

When you go to hospital or for treatment you need to present your health insurance documents so that your bills are sent straight to the insurance company. After you have completed your treatment you will only have to pay for any outstanding personal expenses such as guest meals, telephone calls and newspapers.

If you have had any treatment that is not covered under your policy you will also have to pay for this. Normally your medical insurance company will alert you to the fact that you have an outstanding balance.

If you feel that your health insurance company should pay for something and they are saying that it is not covered, you do have redress. You can appeal to the company to review your claim. If you are still not happy you can complain via their official complaints procedure. If you are still not happy with the outcome you can take if further to the Financial Services Ombudsman.

18 Week Waiting Lists

Private medical insurance enables people to get prompt medical treatment for acute conditions. Early treatment of many conditions does not only decrease anxiety and suffering but also increases a patient's long term wellbeing and medical outcomes. This week health secretary Andy Burhnam, has caused a political controversy by telling the Sunday Telegraph that Labour plan to treat patients via the private sector if they have been on a waiting list for longer than 18 weeks.

18 weeks is still a very long time in health insurance terms. As covered by Health Insurance News UK there are policies which offer a six week option. This means that if the NHS cannot treat you within six weeks then you can be treated under the terms of your medical insurance. Apart from this kind of policy most health insurance clients are seen rapidly.

Some people object to NHS patients being treated in private health establishments claiming that it is unfair that they are paying for health cover yet the same kind of treatment is being given away for free to NHS patients.

However the partnership between the private sector and the NHS has been in existence for quite some time with many claims being made that it costs the NHS less money to contract operations out to private medicine than it does to open up theatres during weekends. In the last few years private health providers have increased their involvement with the NHS. A recent survey found that in 2007 53,500 inpatient and day patients were treated in private establishments but the figures rose to 151,000 in 2008. This represented 16% of total volume in mainstream independent hospitals

The new government directive will be passed as law. Mr Burnham said:

'This will be a key battleground for the next election. This is about embedding patient rights and will prevent a return to the days when people languished on waiting lists under a Tory government.'

Overall the government target of 18 week maximum waiting lists has been achieved. Its an improvement but far from being an ideal. The extra legal incentive for hospitals to comply or otherwise be forced to pay for private treatment will supposedly encourage trusts to find ways to improve waiting lists times.

New AXA Health Insurance Plan

The six week option is one way in which private health insurance companies try to reduce health cover premiums for their clients. As an extension to this type of scheme AXA PPP Healthcare have launched a new product for the business health insurance market: Corporate Health Plan 6.

In 1979 AXA PPP were the first company to introduce the six week option as part of their health insurance offerings. With the six week health insurance option customers commit to using the NHS as long as they can get their treatment within six weeks. If this cannot be guaranteed then they go privately.

The latest product Corporate Health Plan 6 was trialled in August and reportedly will enable companies to reduce their premiums by 15%. With this plan outpatient treatment can be accessed immediately and the six week plan is implemented with any inpatient treatment.

Cost is obviously a concern for every business but never more so than during a recession. Chris Rofe, AXA PPP healthcare head of client relationships said:

‘Businesses are under considerable pressure to contain their costs and Corporate Health Plan 6 is a valuable new cost-saving option for employers.

'It's also an attractive option for companies who want to consider different levels of cover for their workforce or as part of a flexible benefits package.'

Flexibility is something that is very much in focus at the moment in the health insurance industry. It helps the consumer because it gives us more options including being able to reduce costs.

Help for Back and Neck Problems

As reported by Health Insurance News, earlier this year Aviva (then Norwich Union) launched a special product which aims to help people deal with back and neck problems quickly and efficiently. Back-Up, as the product is called, was only offered to companies with the aim that it would help them to reduce time taken off by staff with back and neck complaints. The product has now been launched for individual private medical insurance customers.

According to Aviva subscribers to Back-Up have seen a reduction in the number of physiotherapy appointments they need by as much as 37.5%.

Clinical development manager for Aviva's UK Health business, Mark Sharpe said:

'Musculoskeletal conditions are one of the top causes of private health insurance claims, yet they have traditionally been treated with a broad brush '6-10 sessions of physiotherapy' approach which gives little consideration to the customer's exact circumstances. Our Back-Up service bucks this trend.

'Evidence now shows that tailoring treatment plans to the individual's personal needs, has a far better out-come for all parties - the individual recovers quicker, employers benefit from reduced sickness absence costs and our medical insurance claims costs, and therefore future premium increases, are controlled.

We are extremely proud of our Back-Up service which has already delivered numerous benefits for our customers. The feedback we've received is absolutely fantastic and we're delighted more of our customers can now benefit from this highly valued service.'

Back-Up provides a dedicated case manager who deals with your concerns. They provide a a 'personalised rehabilitation plan' that is then tailored to your individual needs.

This is an example of a medical insurance company which is diversifying into other health related products. The private health insurance market is thought to be in trouble. Increasing medical costs are set to force companies to increase premiums which will not be popular with consumers. The recession has also had an impact on how, where and if consumers spend money on health cover.

Questions for Cancer Health Insurers

When considering taking out health insurance for cancer it is important to ask yourself and potential providers very direct questions. Providers are obliged to give you answers to your questions and if they cannot they must find someone who can.

Do you want a specific policy that covers just cancer?
In theory providers who have specific cancer care policies should be trained to answer cancer specific questions compared to other providers.

Are you restricted to certain hospitals and consultants?
Most cover restricts you to their own network of hospitals and Bupa's select Heart and Cancer Care policy restricts you to consultants that work for them.

Are there limits to my care?
Most companies cover unlimited costs for treatments and inpatient care. Financial restrictions can apply to outpatient care and this is an important area to research.

What treatments are covered by the policy?
This is a bone of contention and providers are not always clear as to what can be covered when. Often issues are treated on a case by case basis. This is not helpful if you are looking to take out a policy. There have been calls for greater clarity and transparency.

Does the policy cover you if your cancer is 'incurable'?
Most policies will not cover cancer once it becomes incurable. It is then treated as a chronic condition (although policies do not spell this out) which is not covered under private medical insurance. Unless you are aware of this it can be a nasty shock when your treatment is no longer covered.

Some policies are not very clear and talk about "active treatment" which refers to the extent of coverage. For example radiotherapy may be given to shrink a tumour but hormone therapy which gives ongoing control of spread and symptoms may not be covered.

Some policies stop when cancer becomes chronic and some stop when only palliative care can be given.

PruHealth and Bupa treat cancer from its first diagnosis through to any palliative care.

Does a family history of cancer affect policy cover or price?
A family history of cancer can affect your premiums. Breast, ovarian and bowel cancers in close relatives can increase your premium considerably. There is also current moratorium on genetic testing for private health insurance.

Does previous pre-malignant conditions, eg polyps in the bowel, affect policy cover or price?
This varies from company to company. Usually any pre-existing condition or even symptoms which are linked mean that cover cannot be granted. Premiums are generally not increased although cover can be restricted. Abnormal smears for example may exclude certain types of cancer from cover.

A survey conducted in 2004 by British Association of Cancer United Patients found that health insurance consultants were not always clear when giving the answers to the above questions. They sometimes gave misleading or incorrect answers. The industry has bucked up its ideas since then but it is important to appreciate that the onus for obtaining the right policy is on you.

In the case of a dispute you would have a claim against a health cover company if you had been given incorrect information but if you have cancer will you really be in the state of mind to fight an insurance company?

Standard Life to Loose Jobs

There are mixed reports as to how much the recession has affected private medical insurance companies. However Standard Life Healthcare announced last month that they have to loose another 60 employees. The company line is that the changes are designed to improve efficiency in the business but how will it affect Standard Life Healthcare customers?

In April this year they cut customer service and back office jobs as part of the restructuring of the marketing function.

There are different reports as to the impact the recession is having on the medical insurance sector but at an industry conference Standard Life Healthcare's director Laurent Pochat-Cottilloux said that the private health insurance business could as a whole could loose 650,000 jobs by the end of 2012 unless the economy improved and the sector restructured their offerings.

A spokesperson for the company said that the job losses were not just because of the recession:

'All changes are the result of improved operational efficiencies and will not impact on service levels.'

What about the customer? Will claims take longer to process?

Currently in many companies the customer is not King as he once used to be in the UK. Health Insurance Awards are given out every year by Health Insurance Magazine. Winners of the customer services awards last year were BCWA followed by runners-up, Bupa and Norwich Union Healthcare. These companies are recognised as providing excellent customer services.

Standard Life Healthcare were the winners of the best customer service category for five years running previous to this (2002-2007). Will they be able to win again with their new 'operational efficiencies?'

The Standard Life Healthcare job cuts follow similar propositions in AXA PPP Healthcare were health cover staff members have been offered the choice of taking a paycut, losing members of staff or missing out on bonuses. It remains to be seen whether other health insurance companies will announce more job loses before we see an upturn in economic recovery and whether this will have an effect on the level of service that customers receive.

Counterproductive Screening

There has been a definite move towards looking at improving our health rather than just treating illness over the last 10 years. Health screening has become part of this initiative and is encouraged by private health insurance companies. In fact some companies use health checks as part of the criteria for discount schemes which reward healthier living. A new report by consumer group Which? however is questioning the veracity of these tests.

Which? conducted a survey of 4,000 people and found that 30% of them would have a screening test with the view that it would help to alert them to anything that might be wrong. Unfortunately research found that screening companies often delivered very different results to the same individual.

The survey sent undercover researchers aged between 46 and 62 to Bupa, BMI Healthcare and Nuffield Health to have comprehensive MOT's. None of them had any known health problems yet 8 of them were advised to get further GP tests within 6 months.

Editor of Which? magazine, Martyn Hockingsaid: 'Health MOTs often cater for the 'worried well' who want the reassurance of a clean bill of health, but they can cost hundreds of pounds for what sometimes amounts to little more than lifestyle and dietary advice. That might seem harmless, but a false sense of reassurance is potentially risky, and if the tests flag issues that turn out to be false alarms you could actually end up with unnecessary worry, rather than the peace of mind you signed up for.

Which? advises people who are considering a health MOT to check what information, tests or screening are available from their GP first, and to see their GP if they have symptoms.'

Which? Had concerns that the downside of tests were not explained. For example false alarms as explained above and the risk of cancer from unnecessary CT scans. One researcher was given conflicting advice about their risk of heart disease from each company despite having the same test results in each case.

A spokesperson from BMI Healthcare said: 'We are dedicated to delivering the highest quality of patient care. We firmly believe that our Intelligent Health assessments are good value for money and can deliver positive, life-changing benefits to our patients.

'It is clinically proven that early detection of conditions and diseases, which enables earlier treatment and more effective disease management, can extend survival rates and improve quality of life for the individual. We regularly review the clinical evidence base for each element of our BMI Intelligent Health assessments to ensure effectiveness and quality as well as achievement of specific national standards and quality assurance processes. Also, BMI Intelligent Health does not provide unnecessary MRI and CT scanning as highlighted in the Which? report.'

One lady was distressed because the tests discovered gall stones. Even though she had no symptoms she would now be obliged to inform her health insurance company. This meant that she would have higher health insurance premiums and possibly not be covered for this condition should anything flare up.

The Which? report does not condem health screening per se, some screening is undoubtedly life-saving, but what it does warn against is uncessary screening which could create more confusion rather than peace of mind. In the meantime it is unlikely that health cover companies will review their position on health screening and consumers do find premium reductions attractive. Conversely any uncovered condition may not then be covered when you come to renew your medical insurance policy even if the condition has not presented any symptoms.

9% Rise in Workplace Private Medical Insurance

According to Aon Consultancy there has been a 9% increase in the amount companies are having to spend on private health insurance for their staff. Despite this companies are generally still happy to pay which suggests that the benefits far outweigh the increases in premiums.


The study looked at 653 employers and found that the main reasons that employers continued to provide health care benefits for their staff were as follows:

53% - to make sure employees returned to work quickly

56% - employee wellbeing is part of their corporate social responsibility

67% - offered as part of a competitive benefits package

A third of companies were looking to review their schemes because of the higher costs but on the other hand many were considering the introduction of additional cover for their staff: 16% were considering cash plans, just over a quarter where were looking at employee assistance programmes and 39% were considering a dental health plan.

On a very positive note 22% had seen no reduction or decreases to their health cover premiums.

Head of health consulting at Aon Consulting, Alex Bennett, said,

'If companies are faced with 9%+ increases in the cost of their healthcare benefits, they should take steps to ensure that better terms cannot be arranged by more effective broking and insurer leverage or through re-designing benefits.'

Co-orporate health insurance is almost always secured via brokers who should be able to secure good deals.

New Health Assessment for Legal & General

Forward planning is important for employers. Being able to plan ahead for their staff's healthcare needs helps them to budget well but also means that staff will be well cared for and this is important not just for the efficiency of the workforce but also for their morale. Legal & General have introduced a new free health risk assessments via its employee assistance programme (EAP).

EAP's are becoming increasingly popular in the UK, having proved themselves to be valuable for employers and employees in the United States. The Legal &General EAP provides a whole array of services including: a 24hr helpline, access to qualified nurses and lawyers, telephone counselling, bereavement assistance.

The new free health risk assessments will help employees to have an awareness of healthy living factors and encourage them to improve their lifestyles. Managers will have access to overviews of the results which should help them to make decisions about any private health cover they may want to provide for their employees.

Benefits and medical underwriting director for Legal & General's group protection business, Vanessa Sallows, said:

'It is not only staff that need practical and emotional support. Time starved line managers and resource stretched HR staff are also looking for guidance and help on how to handle difficult conversations, manage their time better, promote team working and improve morale. This new support for managers gives them access to specialist professionals who can help them with employment issues such as workplace bullying, handling conflict or managing change. The online facility also includes a useful manager section with fact sheets and links for further information.'

Swine Flu Covered by PMI?

The government confessed yesterday that by October they expect to have 100,000 new cases of swine flu every day. What does this mean for people with private medical insurance? If they contract the virus will they be covered by their policy?

Most swine flu sufferers will not need any hospital treatment at all. A visit to the GP for a diagnosis and some anti-viral medication will be all they need apart from the usual over the counter medicines to deal with flu symptoms. In an emergency situation more serious cases may need to be admitted to hospital. Unfortunately emergency treatment of any kind is not covered by health insurance.

The NHS Choices direct website says that so far there have been 7,447 confirmed swine flu cases in the UK. 100 have involved hospitalisation, and four people have died as a result of complications.

Health insurance is only designed to cover pre-planned, booked appointments. A representative from Bupa said:

'We don’t cover emergencies. Treatment would be down to the NHS.'

The Bupa medical advice pages cover a lot of information about swine flu, how to spot it and how to avoid its spread. They direct you to a video showing the correct way to wash your hands to spread infection.

So treatment for the usual swine flu symptoms will not be covered by private health insurance however, in theory any secondary complications of swine flu which are not emergencies should be covered as long as they fall within the other stipulations of your policy. The little girl, Sameerah Ahmad, who died from swine flu last Friday for example, would not have been covered by health insurance as she had a pre-existing condition known as microvillus inclusion disease which meant she could not fight off infection.

There is not a lot of information out there about swine flu from the health cover companies at the moment. As the pandemic unfolds it remains to be seen how developments will affect those with private medical health insurance. This sector will not be as under pressure as the NHS but will no doubt experience its knock-on effects.

The latest information about swine flu is available from the following sources:

NHS latest information:
BBC News

Healthy Workers

Work places want healthy employees. It makes sense, a healthy workforce is a productive one. Private medical insurance helps. 14% of UK companies offer company health insurance which covers employees when they are ill.

As the recession bites there is a dual pressure now on employers. They need to cut costs but they also need employees to be as healthy as possible so that they are fit and active for work. In other words companies need a good return of investment.

The Chartered Institute of Personnel and Development (CIPD) say that there is extra emphasis now on employers helping their staff to stay well and come into work.

Charles Cotton, advisor for performance and reward with CIPD said,

'I think there is still a concern out there that encouraging employees to be healthy is not their role but I think that attitude will change now that businesses realise the proportion of their companies' revenues that are being spent on healthcare benefits.'

Research published in employee benefits magazine said that employees are much more interested in return on investment for their health cover provision than they were five years ago and 91% of the employees surveyed said they used sickness absence levels as a measure. The research however said that it is very difficult to measure the effectiveness of wellbeing initiatives. They suggest that companies who use employment engagement interviews are finding this a successful way to find about their employees behaviours and attitudes.

Reports vary on the current levels of workplace medical insurance. The research published in Employee Benefits magazine suggests there is no decline in uptake but on the other hand recent reports from analysts Laing and Buisson suggest a small decline in the business private health insurance market. For employers health insurance is a valuable perk, coming second only in popularity to pensions.

Private Medical Insurance Growth

Despite the recession a new report by analysts Laing and Buisson states that the private health insurance market is still growing. 7,562,000 UK citizens have private medical insurance policies or trusts and this figure represents 12.3% of the population. This report contradicts other reports which have registered health insurance market decline.

In comparison to 2006 and 2007, where the industry experienced 2% growth each year, the increase last year was a modest 0.6%. Nonetheless this is a significant growth which came from individual policy holders rather than business policyholders. This sector of the business declined by 0.2% in 2008 despite a growth of 5.6% over the previous two years.

Philip Blackburn, a Laing and Buisson economist said: 'Individual purchasing of PMI held up well in 2008 as insurers offered a wide choice of policy options and budgeting, and insurers worked hard on retention, though there is a growing ‘trading down' trend, as individual spending levels remain relatively fixed while PMI costs continue to rise strongly.'

The figures suggest that people are reluctant to give up their private medical insurance. However rising health cover costs are forcing people to look at alternatives that perhaps provide less cover at a cheaper cost. Health News UK has been giving advice over the last few months on how to find lower cost policies that still offer the best health insurance cover.

According to Laing and Buisson some people are likely to drop their medical cover in 2009 as rising levels of unemployment are likely to reduce people's disposable income.

Blackburn said, 'The ongoing recession in 2009 is certain to have a more acute impact on PMI demand than the previous year as increasing unemployment across industry and services delivers a fallout in employee benefits, and downward pressures on household incomes and personal net worth (savings/investments) deliver more cautious individual spending, with reductions in many purchases that are considered non-essential. '

Private Health Insurance Overcharged?

Consumers are likely to be outraged by the current news that some medical establishments may be charging health insurance companies up to 50% more for treatments than they do private individuals. Ultimately what consumers will ask is whether premiums could be cheaper if health insurance companies were being offered the same deals as independent self-pay patients?

An article in the Daily Mail last week revealed that one patient was sent two bills by accident. One bill was sent to them as an individual for an MRI scan for £477 and another one which charged them £720 for the same treatment as a private health insurance patient. On the last invoice they were asked to ignore the first invoice 'as we were unaware patient was insured'.

Industry experts argue that over-cutting costs will ultimately lead to an unsustainable business model and will decrease the quality of care and that most people who use private medicine do so via either individual or corporate health cover. This means that companies can afford to offer independent individuals reduced treatment costs particularly if business is slow. So, it could just be a case of self-payers having been offered particularly silly reductions rather than medical insurance clients being ripped off.

However, Steve Broker from Consumer Focus said, 'This seems a clear case of double standards. Any additional costs have to be justified and should be made clear to the patient.'

The chief executive of the patient's health insurance company WPA, Julian Stainton said, 'In fact, and in law, every patient receiving treatment in the private sector is a self-pay patient.

'The legal position is that prices should be fair, displayed, clear and readily understood; they are not. The public has every right to expect at least as much consumer protection buying healthcare as when they buy any other goods or services.'

With some less traditional health insurance policies you can get the best of both worlds. Freedom Healthnet Ltd offers a cash payment for your in-patient treatments should you fall ill. This means that you have all the security of private health insurance and also the buying power of an independant self-payer. You take the cash and you make the choice of where, when and even if you pay for your treatments. You can choose to use the NHS and keep the cash if your treatment time is reasonable. Freedom can offer cheap health insurance because you take on the responsibility of choosing, arranging and paying for your healthcare so their administrative costs stay lower.

HealthFund also offer an alternative private health insurance. As part of their policy they have introduced a savings fund where you can withdraw money and spend it on health care in anyway that you choose, including treatments such as plastic surgery which is usually prohibited under normal insurance policies.

Using an Independent Advisor

There are three ways to find the best health insurance for you, your family and your business: independently researching the market, using web-based comparison sites or taking the advise of independent advisors. This article outlines the advantages and disadvantages of using a third party to help you.

Independent advisors work on a commission basis and are rewarded with a fee from the health insurance companies for selling you their policy.

ADVANTAGES

The Right Policy for you
An independent advisor should have a thorough knowledge of a range of policies. They will spend time getting to know your needs and this enables them to help you to choose the right policy for you.

Time
A reputable advisor will save you oodles of time. Their job is to know the policies they recommend inside out, saving you the time it would take you to research each policy.

Money
Agents often have deals with insurance companies and may be able to provide discounts that you may not be able to get if you applied for a policy alone.

Disputes
When you go through a third party there is more room for misinterpretation. If you have a problem with a private health insurance claim and you can prove that you were not initially advised correctly by your broker then the main onus may not be on you but on your advisor and a claim may be upheld when it might otherwise not be.


DISADVANTAGES

Vested Interest
When you are looking for health cover and no one is more invested in your wellbeing than you are. No matter how professional and helpful an advisor is you are ultimately responsible for the choice of health cover that you make and no-one will be more interested in getting it right that you.

Privacy
You may not want to discuss your health issues with an advisor. Some people prefer to complete on-line forms as they are embarrassed to discuss their health issues face to face.

Choice
Each agency will have a range of policies it can advise you on. No agency will have detailed knowledge of each and every policy on the market.

Split Loyalties
It is important to be aware that medical insurance companies offer advisors incentives to sell their policies. However a reputable advisor will only have your best interests in mind and will not be swayed by any incentives offered.

Accuracy
When a third partly is involved you increase the possibility of misunderstanding and misinterpretation of policy detail. Working directly with a provider should mean less room for error. An insurer should be fully trained on their specific policies and should be able to answer detailed questions. However an advisor will have a range of policies that they work with and may not be as familiar with the details of each. However the onus is on them to find the answers to any questions which you may have about any policies that they sell.

It is important to be prepared before you visit an advisor. Familiarise yourself with the market a little and be ready with questions about health insurance . This will help you to get the most out of your meeting with the advisor.

Health Insurance Statistics

We all love statistics. They can provide an awful lot of information very succinctly. When it comes to medical insurance it is in consumers best interests to see who is providing what, what claims are being made and how many of them are being upheld.

There has been pressure on the health insurance industry to provide transparency, particularly since there has been much public criticism of companies who appeared to refuse cover that individuals believed they were entitled to.

Pressures for transparency can only be good for the consumer and have led to better regulation of the industry. The Association of British Insurers (ABI) has now published a non-disclosure code of conduct that states that consumers must be treated fairly in the processing of claims where non-disclosure is an issue. The ABI has 96% of British insurers within its membership.

Disclosure is a term in private health insurance which refers to the obligation of the buyer to reveal accurate details of their medical and lifestyle background. Non-disclosure, failure to disclose information, is taken very seriously by health cover providers who can invalidate a claim if their customers are found to have been withholding information.

Claims complaints are said to have declined in the last year due the non-disclosure guidelines which were developed in response to calls for more transparency from health insurance providers.

Insurers are said to have had mixed reaction to the idea of publishing statistics. Critical Illness cover statistics have been published for some time in the UK and not everyone from the industry is happy with the reaction they have received. Alison Turner-Holmes, head of marketing at Scottish Provident, said: ' I do believe that media focus on the percentage of declined claims has, if anything, been detrimental.'

However the sharing information with the general public can only be good for consumers and will enable them to make informed choices when they come to choosing a provider. It is expected that there will be increasing pressure on providers to 'reveal all' as the pressures of the current recession will mean that people will be looking for the cheapest health insurance that gives them the best cover. Companies which seem to payout on claims less than others will rightly be the subject of consumer scrutiny.

New Independent Advisor

A new health insurance advisor has opened for business. BJIC Health is offering products from a range of well known medical insurance providers. They are based in Deeping St James and headed by owner Keith Laws who has experience in various medical insurance roles.

They offer health insurance products for both individuals and corporate organisations. They also offer dental insurance, critical illness cover and international private medical insurance as well as travel insurance.

Keith Laws said, 'We have obtained some amazing deals through our suppliers that allow us to offer some of the best prices in the UK.

Currently we have negotiated agreements with major UK insurers, such as Bupa, Norwich Union and Pru Health.'

Mr Laws advises that people should seek the help of an advisor as the health insurance market is growing ever more complicated:

'Medical insurance can be a complicated product for consumers to get their head around, and with more and more policies in the marketplace, good advice is essential.

As a specialist medical insurance broker, not only do we give our clients advice on all the products on offer, but we also provide an overall review on the best-priced ones as well.'

BJIC Health, as with all medical insurance advisors in the UK, are bound by the FSA (Financial Services Authority) which is the regulatory body for all UK insurance services. They 'regulate financial services and protect your rights' so if you have any concerns about any insurance services you can contact the FSA for advice.

Looking for Health Insurance? 7 Top Tips

If you are thinking about taking out medical health insurance there are several things which you need to think about before you start looking. There are many policies out there so you need to be armed with a good idea of the different options which may be available to you.

Budget
Before you start your search for private health insurance you need to have a budget in mind. This will enable you to find the best medical insurance for you without worrying about the cost of monthly premiums later on.

Reducing Costs
There are several ways that you can reduce the cost of private medical insurance:
-Paying higher excesses. If you are prepared to pay more on an excess then you will be able to find cheap medical insurance. Some policies offer huge excesses for much reduced premiums.
-The six-week option (waiting to see if the NHS will treat you within six weeks before you use your private health insurance).
-Co-payment where you agree to pay part of your treatment costs up to a certain level.
-Shopping around. In the current climate companies are offering incentives to get your business.
Family policy
Do you want to add your children to your policy? Some companies offer reduced premiums for family policies.

Exclusions
Each policy will have a list of exclusions which are conditions and situations which a health insurance policy will not cover. The basic things to be aware of is that health cover is designed to cover unexpected acute medical conditions. It will not cover long term illness and it will not cover any conditions which you are or have suffered from in the last two (sometimes up to five) years before taking out a new policy.

Add-ons
Companies offer add-on products which are designed to extend the basic scope of a policy and offer additional benefits. Examples of this are: psychiatric cover and complimentary therapies. Its important to check details carefully as some companies will offer things as a standard part of each policy and some will not.

Moratorium or Full Underwriting
Depending on your circumstances you will either be offered a policy which either requires you to fill in a detailed health questtionnaire (full underwriting) or one where you wil only be asked basic questions (moratorium). Which one you are offered will depend on a number of things: your health history, your age and the health insurance company policy.

Buying Options
You can buy private medical insurance in three main ways: Using a reputable broker who should be able to help you to compare policies and pick the right one for you. Using internet comparison sites which provide a brief summary of the benefits of each policy and finally, contacting the private medical insurance companies directly.

Quinn Healthcare Removes Psychiatric Hospital

Last month private medical insurance company, Quinn Healthcare removed health cover for St Patrick's Hospital, a not-for-profits private psychiatric facility. St Patrick's is the largest psychiatric hospital in Ireland with over 300 beds and a reputation for excellence in the treatment of eating disorders and depression as well as alcohol and substance abuse.

Reportedly Quinn have not contacted all their 400,000 customers but have informed current and past patients of St Patrick's of their situation:

'We have been in negotiations with St Patrick’s since June 2008 and ideally we would not be in this position.

'However, we have been unable to resolve contractual issues and agree reasonable reimbursement rates. Quinn Healthcare covers a range of alternative facilities which have similar programmes of similar length.'

VHI, Quinn's state owned competitor, said that it would take Quinn customers and would not make them wait the customary two year period before they could make a claim. They said, 'It’s unthinkable to leave vulnerable people in a situation where they’ve effectively no cover for a centre such as St Patrick’s for at least two years.'

According to VHI, the average stay in St Patrick’s over 30 days long and claims average between €15,000-€20,000.

Psychiatric health insurance cover can be expensive and many medical insurance policies do not cover it as standard. If offered psychiatry will usually only be available in the more expensive policies. Alternatively many companies offer psychiatric cover as an add-on package.

Many conditions that are treated in psychiatric hospitals are not actually covered by health insurance companies. Sometimes this is because they are part of the exclusions within the health cover policy. For example all conditions triggered by alcohol and substance abuse are not covered. Also, anything which is long-term, for example, some types of depression, are not covered. Health insurance covers acute illness (short term) only.

New NHS Top-Ups Guidelines

Although taking out a private medical insurance policy is a cost effective way to deal with any unexpected ill health it is not an option for some people. Chronic or terminal illness, for example precludes you from health cover and if you have a pre-existing condition this will not be covered on a new policy. People who are excluded may still want the benefits of private health insurance but may not be able to afford to pay the full costs. An alternative is to use the NHS and top up with private care.

Top-ups have caused a great deal of controversy over the last year however the government have revisited their first attempt and after a twelve week review that started on 4th November 2008 have now published their final guidance on NHS patients wanting to pay for additional private care. The new guidance became effective as from the 23rd of March.

One of the important things about top-ups is the fact that the more expensive and life-prolonging drugs that are not offered as part of the National Institute for the Health and Clinical Excellence (NICE) guidelines can be purchased privately by the patient. However despite the new guidelines top-ups may still create an administrative, moral and logistical minefield.

The main points of the guidance are as follows:

-The NHS should not withdraw care if a patient chooses to buy additional private care
-Private care should be delivered separately
-NHS should never subsidise private care
-The patient should never be charged for NHS care
-There must be a clear separation between NHS and private care

Conflict of interests, for example, is one important issue as many consultants also work in private practice. The guidance here is clear:

'In the course of their NHS duties and responsibilities, consultants should not initiate discussions about providing private services for NHS patients, nor should they ask other NHS staff to initiate such discussions on their behalf'

Other problems will arise if a patient wants treatment where the NHS part and the private part cannot be separated. The government guidelines gives the following example:

'Patient E needs a cataract operation. This procedure normally involves removal of the crystalline lens from the eye and replacement with an artificial lens with a single focus. After cataract surgery, patients normally have to wear glasses for some purposes, usually for close work. Patient E asks his NHS Trust to insert a multifocal lens at the time of surgery as this may reduce the need for him to wear glasses. The multifocal lens is not routinely available on the NHS. Patient E is willing to pay for the cost of the multifocal lens but wants the NHS to provide the surgery involved free of charge as part of the cataract operation. The Trust informs him that it is not possible to pay for the multifocal lens while carrying out the surgery on the NHS as it is not possible to separate the private element from the NHS element of care. The Trust informs him that he can have the single focus lens free of charge on the NHS or the multifocal lens as an entirely private operation. Patient E is not allowed to have additional private care because the NHS element of care and the private element of care cannot be delivered separately.'

In more serious cases where the patients life would be endangered if they had to be moved in order to receive the private part of their care then the trust managers can made discretionary decisions along with the patients consultants.

It remains to be seen whether the new guidelines are enough to satisfy the trusts, the public and the medical establishment.