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Guide to private medical insurance

In the UK, the National Health Service (NHS) provides state-funded healthcare to all residents. However, due to the demands and on the system, some people opt to pay for private healthcare. Private medical insurance (PMI) – sometimes referred to as health insurance – is designed to help meet the high cost of treatment.

With around one million people on NHS waiting lists and a quarter of those having waited longer than 12 months, it’s no surprise that many are persuaded to pay a monthly fee for the privilege of having private cover.

However, private medical insurance isn’t all about receiving medical treatment; it also has specialist care for some of the most common reasons behind hospital admissions, including cancer. Policyholders on more expensive plans may even benefit from annual health checks, eye tests and dentistry.

When thinking about taking out PMI it’s important to consider the options as it is an added expense that may not be necessary, especially as the UK provides a free health service.

Applying for Private Medical Cover

When requesting a quote for private medical insurance, applicants will have to complete a form. It’s essential that any pre-existing medical conditions and other relevant information is disclosed as it could render the cover invalid when claiming.

The insurer is likely to contact the applicant’s GP to confirm current state of health, making it all the more important that the details are correct.

What does Private Medical Insurance cost

There are around 25 private medical insurance providers in the UK, so it’s important to shop around for the right policy. The cost of PMI varies significantly between insurers and policies, so consumers will need to look at what is included as well as thinking about cost.

Standard insurance plans will cover essential medical treatment, including consultations, surgery and hospital stays. However, it’s unlikely to pay out in the event of terminal illnesses, personal accidents or pre-existing conditions.

Insurance premiums vary significantly in price, but in general they will be more expensive as people get older, current health condition and whether they are a smoker. The premium is also likely to increase each year due to the cost of new medical advances.

PMI has long been a luxury rather than a necessity, but due to the change in the market and the demand for cover, there are many budget plans now available. The only downside to these is that there will be much exclusion, such as outpatient appointments, choice of hospital and certain treatments. In this case it is worth establishing whether it is worthwhile paying for PMI.

What is included with Private Medical Cover?

A basic PMI policy will likely cover inpatient hospital treatment, such as surgery, consultations and so on, and will also include an overnight stay. However, outpatient treatment is rarely covered.

Next up is a mid-range policy, which generally covers the same as the basic, but with selected outpatient treatments too. For the complete package, a comprehensive policy will offer patients cover for all treatments as an inpatient and outpatient. Consumers that opt for private medical insurance don’t have to completely avoid the NHS as plans can be customised to suit their needs.

What are the benefits of Private Medical Insurance

Despite the availability of free healthcare on the NHS, there are many benefits to going private. One of the largest providers in the UK claimed that the most common reasons for taking out insurance was to avoid long waiting lists and cleaner hospitals.

The NHS waiting lists are a well-known problem that can’t be avoided when people have conditions that aren’t classed as an emergency. Some patients have been known to wait over a year to receive an appointment. With that in mind, PMI allows policyholders to be fast-tracked, giving them almost immediate access to healthcare.

In most cases the patient can also choose the date of treatments and in many cases, even the hospital and consultant. These sorts of choices can really help give the patient peace of mind when going into hospital for serious conditions.

Are there any limitations to Private Medical Insurance cover

Although there are some huge benefits to being covered by private medical insurance, it does have exemptions and limitations. Most policies do not cover emergency treatment; for example, if patient was in an accident, the emergency services would be contacted as normal.

Other drawbacks include that treatment is not always conducted in a private hospital as many insurers simply provide private areas in NHS hospitals. When there is a choice of hospital available, this is rarely an open choice; patients will have to choose from pre-determined list.

Finally, previous health problems and chronic conditions will are very rarely covered by insurance policies, at least for the first five years. Those with a serious medical history may not be eligible for cover at all.