Private Health Insurance Guide
Introduction Classification for being treated by a hospital Finding
the
right
Critical
Illness
Insurance policy for
You What type of health insurance do I need? Comprehensive private health insurance policies Standard private health insurance policies Budget private health insurance policies Who are covered by private health insurance and for how long? Medical history Moratorium How to Claim Summary| Introduction | Top |
PPrivate health insurance or private medical insurance (PMI) is insurance against the cost of private treatment for curable, short-term medical conditions. The main benefit of private medical insurance is that it allows you to have treatment when you require it and not when the NHS can ‘fit you in’. Private health insurance is mainly nearly always used as insurance cover for non life threatening medical conditions, sometimes called minor conditions (not by me as when I am ill it is anything but minor!).
Private health insurance should not be looked at as a replacement for the NHS (National Health Service). It is taken out so that if you or your family requires treatment for a non-life threatening condition, you can choose when and where you undertake the treatment and how soon you want to have it done. The NHS provides medical treatment for emergencies, accidents, long-term illnesses and illnesses that cannot be cured, (sometimes called chronic illnesses), because most private hospitals have neither the facilities nor the equipment or the specialists to treat such conditions.
It should be pointed out that you do not necessarily receive better treatment from a private hospital than in the NHS hospital, but there may be more general facilities for the patient’s use and comfort, such as a better menu, private room, Internet access, wide screen TV, etc .It is important to ask yourself a question, are you taking out private health insurance to cover the cost of the treatment, or are you also paying a higher premium for being treated in luxurious surroundings by attractive nurses (male and female)? Choice is yours.
Please Note
It is important to understand what treatment you are not covered for such as:
- HIV/AIDS
- Cosmetic surgery
- Pregnancy
- Organ transplant
- Pre-existing medical conditions including Chronic (i.e. incurable) conditions
- Drug and alcohol abuse
- Accident & emergency admissions
Always double check with your private health insurance policy provider just exactly what is covered and what is not covered by your policy.
| Classification for being treated by a hospital | Top |
There are three main types of classification for people being treated by a hospital.
In-patient: Somebody who has private medical treatment during one or more nights (included in most private health insurance policies ).
Private health insurance cover usually includes insurance cover for the cost of inpatient accommodation (the bed etc.), all associated medical staff including doctors, surgeons, and anesthetists, all material associated with treating the condition such as bandages and dressings, medication including drugs, medical equipment such as operating theatres, chemotherapy, radiotherapy, diagnostics, including consultations, physiotherapy, radiology and physiotherapy.
Just how much additional treatment and extras you receive during your stay in hospital will depend on the level of private medical insurance cover you have taken out.
Out-patient: Somebody who has private medical treatment but does not need to stay in hospital. Again the level of treatment given will depend on the amount of cover you have taken out for private health insurance. It is your decision to weigh up the advantages of paying a higher premium against just what sort of treatment and level of service you may require.
Day-patient: Somebody who has private medical treatment during the day but does not need to stay in hospital over night. The same applies for treatment for Day patients as it does for Out-patients. The level of treatment given will depend on the amount of cover you have taken out for private health insurance. It is your decision to weigh up the advantages of paying a higher premium against just what sort of treatment and level of service you may require.
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What private health insurance do I need? |
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There are usually three different levels of private health insurance policies offered by private health insurance policy providers, and it may well be worth while discussing the various levels of private health insurance and what would be best for you and your family with your GP, so as to get a better understanding of what private health insurance cover you are likely to need.
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Comprehensive private health insurance |
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These are the ‘top of the range’ and cover all the three categories of hospital patient.
They also provide such things as home nursing, private ambulance services, complementary medicine and full treatment costs. Comprehensive policies offer a wide range of private hospitals, international cover and dental and optical treatment.
However, the final details of what is covered and what is not covered will depend on the individual private health insurance provider and what specifics you as the customer have requested.
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Standard private health insurance policies |
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These are more middle of the road private health insurance policies and they provide only limited cover for day care or out patient treatment. Some standard private health insurance policies also provide for very limited complementary medicines, and some ambulance services. The choice of private hospital where you obtain treatment is also more limited than that of a comprehensive private health insurance policy and many of the top hospitals are not included.
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Budget private health insurance policies |
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As the name suggests, this type of private health insurance policy only covers you for a limited amount of treatment, and usually has a set limit. Budget private health insurance generally only provides cover for specific treatment and does not provide health insurance cover for additional extras such as complementary medicine and ambulance services. The list of hospitals where treatment can be provided is also rather limited.
One way to reduce your private health insurance premiums is by having an excess limit built into to your private health insurance policy, for example if you had a two hundred pound excess on your policy then you would have to pay the first 200.00 GBP of any claim against the policy that you made.
Also remember that the premiums for private health insurance continually go up in price faster than inflation so you need to review your situation on a yearly basis and not just keep renewing your private health insurance premium with the same private medical insurance policy provider.
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Who are covered by private health insurance? |
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Private health insurance policies are usually issued on an annual basis and you can make payments for the premium on a monthly, quarterly, half yearly or yearly basis.
A private Health insurance policy can be taken out for a single person, married couple, partnership or a family. The cost of the health insurance premium will depend on the number of persons that it covers, and regardless of how many people there are covered by the policy, the cost of private health insurance premiums will increase each year due to medical inflation. The cost of premiums will also be determined by the age of the applicant (The older the person the more money the premium)
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Medical history |
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You are not usually asked to reveal everything about your medical history to the premium health insurance broker or provider, but you will have to fill in a form with details of any operations or illnesses you have suffered in the past. It is also sometimes the case that some private health insurance providers will ask for the name of your doctor (GP) and ask for your permission to write to him or her for information regarding your medical history. As with all insurance form filling, it is very important that you tell the truth and that you give accurate answers to all the questions asked. If you don’t, the private health insurance policy may not pay out. (Ouch!)
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Moratorium |
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If you suffer from an existing illness or condition, you may still be able to obtain private health insurance. You will be requested to complete an application form for private medical insurance that does not include details of your medical history. The private health insurance policy will not provide cover for any illness or condition that you suffered from in the last five years. If after five years you no longer suffer from the illness or medical condition, then providing that your doctor for that medical condition has not given you any treatment over a continuous period of (in most cases) two years after the start of your private health insurance policy. Do not be temped to delay getting treatment just to be eligible for private health insurance cover. Once again please check out all aspects of the moratorium arrangement for private health insurance and make sure you ask all the relevant questions before signing on the dotted line.
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How to Claim |
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The first thing to do is go and see your GP and if he/she decides you need treatment then he/she will probably refer you to a consultant. At this stage it would be wise to get a quote for this and then contact your private health insurance provider to make sure you are covered for the cost. Also, before starting any treatment, double check with your private health insurance provider that they will cover the cost of all treatment. If your private health insurance policy has an excess you will be liable for it when you commence treatment.
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Summary |
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Getting the right private health insurance policy for you is a very individualistic process. There are many various types of private health insurance products on the market, each one offering a range of potential benefits to the prospective client. It is well worth while to write out a list detailing exactly what your priorities are and what exactly you need private health insurance cover for. It may well be the case that by saving a few pounds on a private health insurance policy you lose some particular cover which may be critical to you. Do you really want five star accommodation or is your main concern five star treatment? Always read every bit of the private health insurance policy contract before signing it and remember, the basis of your private health insurance cover is dependent on the accuracy and truthfulness that was used to fill in the form.
