Claims Questions

Answers to some of the frequently asked questions about claims.

Q. What do I do if I need to make a claim on my policy?

Answer:

There are different benefits on a UK Health Insurance policy. Depending on what you want to claim for you may need to have a GP referral. Some policies will let you self-refer in certain circumstances such as for musculoskeletal claims. Insurers such as Bupa will even let you self-refer if you think you have symptoms of cancer. Speak to your health insurance broker if you want to know the best way to make a claim on your policy.

Q. Will I need a GP referral?

Answer:

For most claims you will need a GP referral. This can be from your NHS GP or from a private GP. Many UK insurers now also provide you with access to a private GP via a mobile phone app or video/ telephone consultation. Some claims do not require a GP referral such as musculoskeletal claims (relating to joints, bones & muscles). You will need to check your policy to see which claims do not require you to have a GP referral.

Q. Does Health Insurance cover pre-existing conditions?

Answer:

As a consumer/ SME company scheme it really will depend on the condition itself. How long since you were diagnosed? Do you still have treatments or check-ups relating to your pre-existing condition?

If you already have a policy in place, is the condition already declared as an exclusion?

There is not an easy answer to this question however, in some cases it is possible to obtain cover for pre-existing conditions. The underwriting type you choose will also play a big part in the answer.

If you are joining a corporate company paid scheme that has Medical History Disregarded (MHD) underwriting then you will have cover for conditions diagnosed before the policy start date. The chronic condition terms and conditions will still apply.

Q. What is a chronic condition?

Answer:

A chronic condition is a medical condition that has no known cure. It may need constant medication and be persistent and long lasting. If it does go away, it may come back and you might have to be specially trained to be able to cope with it.

Health insurance in the UK does not cover the routine monitoring and medication for chronic conditions as standard. Although there are policies that will allow some limited levels of cover for them.

If you have a policy in place prior to diagnosis, your policy will pay for a number of things. Essentially consultations, diagnostic testing and treatment up until a diagnosis has been made. Once diagnosed your treatment will be dealt with via the NHS. Your private health insurance would cover acute flare ups in this scenario.

Company Health Insurance Questions

Answers to some of the frequently asked questions about company health insurance policies.

Q. Does Health Insurance cover pre-existing conditions?

Answer:

As a consumer/ SME company scheme it really will depend on the condition itself. How long since you were diagnosed? Do you still have treatments or check-ups relating to your pre-existing condition?

If you already have a policy in place, is the condition already declared as an exclusion?

There is not an easy answer to this question however, in some cases it is possible to obtain cover for pre-existing conditions. The underwriting type you choose will also play a big part in the answer.

If you are joining a corporate company paid scheme that has Medical History Disregarded (MHD) underwriting then you will have cover for conditions diagnosed before the policy start date. The chronic condition terms and conditions will still apply.

Q. I am the only employee of my business, can I get a company policy?

Answer:

You certainly can, although it may be worth looking at personal cover too. A single person company scheme might limit your options of insurer.

Employee Benefits Questions

Answers to some of the frequently asked questions about employee benefits.

Q. What is a cash plan?

Answer:

A cash plan is a really popular employee benefits option. It provides employees with cash back on their everyday healthcare costs such as dental, optical and physiotherapy treatment. The premiums for a cash plan are low. Therefore the p11d liability to employees is far less than it would be for private medical insurance.

Q. I am the only employee of my business, can I get a company policy?

Answer:

You certainly can, although it may be worth looking at personal cover too. A single person company scheme might limit your options of insurer.

General Health Insurance

Answers to some of the frequently asked questions about health insurance.

Q. What happens if there is Medical Emergency?

Answer:

If there is a Medical emergency this is dealt with by the NHS. UK health insurance does not cover you for A & E treatment. This is because many of the private hospitals do not have the facilities available. For all accident and emergency situations you will need to use the NHS, even if you have a private health insurance policy in place.

Q. Do smokers pay more for private health insurance?

Answer:

As an individual health insurance client you will be asked your smoking status. If you are an ex-smoker, you will need to confirm how many years since you smoked or used nicotine products. Many health insurance companies will adjust your premium to reflect your smoking status and therefore a smoker would expect to pay a slightly higher premium.

If you are buying a company health insurance policy, you are not asked to declare the smoking status of your employees. On this basis there is no difference in premium for smokers and non-smokers who are insured on a company policy.

Q. Will health insurance cover cancer treatment?

Answer:

The majority of UK Health insurers offer excellent cover for cancer treatment. You can opt to reduce your cancer cover in some cases if you are happy to rely on the NHS. Many people want to know that their policy will offer full cancer treatment through to end of life care if the worst should happen.

The cancer cover available from each insurer is specified clearly in their literature. You can see at a glance all of the benefits you are able to access as a private health insurance policy holder for the treatment of cancer.

Q. Is there an age limit for health insurance policies?

Answer:

No, there is no age limit for health insurance cover in the UK although your options to switch provider may become limited. If you have a policy in place your insurer will not cancel your cover because you have reached a certain age.

If you are new to private medical insurance you may find that not all insurers will offer a policy to you once you are 74 or over.

Q. What is a chronic condition?

Answer:

A chronic condition is a medical condition that has no known cure. It may need constant medication and be persistent and long lasting. If it does go away, it may come back and you might have to be specially trained to be able to cope with it.

Health insurance in the UK does not cover the routine monitoring and medication for chronic conditions as standard. Although there are policies that will allow some limited levels of cover for them.

If you have a policy in place prior to diagnosis, your policy will pay for a number of things. Essentially consultations, diagnostic testing and treatment up until a diagnosis has been made. Once diagnosed your treatment will be dealt with via the NHS. Your private health insurance would cover acute flare ups in this scenario.

Q. What type of contract is a health insurance policy?

Answer:

Private Health Insurance is an annual contract. You can only cancel your policy mid-term under very specific circumstances. This applies to both Consumer and Business health insurance.

Q. Are Private Medical Insurance, PMI and Health Insurance the same thing?

Answer:

Yes, private health insurance, private medical insurance and PMI are essentially the same thing.

Q. What is Health Insurance?

Answer:

Health insurance is a policy designed to help you access and spread the cost of private medical treatment. You can pay your premium on a monthly, quarterly or annual basis. Once you have a policy in place you will have quick access to private medical consultations, diagnostic tests and treatment. The cover level that you choose will determine the benefits and options you have access to.

Personal Health Insurance Questions

Answers to some of the frequently asked questions about personal health insurance policies.

Q. I am aged 65, can I still get Health Insurance?

Answer:

Yes you can, if you want to buy a private medical insurance policy and you are 65 or older, there are still some really great options available for you.

Q. Does Health Insurance cover pre-existing conditions?

Answer:

As a consumer/ SME company scheme it really will depend on the condition itself. How long since you were diagnosed? Do you still have treatments or check-ups relating to your pre-existing condition?

If you already have a policy in place, is the condition already declared as an exclusion?

There is not an easy answer to this question however, in some cases it is possible to obtain cover for pre-existing conditions. The underwriting type you choose will also play a big part in the answer.

If you are joining a corporate company paid scheme that has Medical History Disregarded (MHD) underwriting then you will have cover for conditions diagnosed before the policy start date. The chronic condition terms and conditions will still apply.

Q. Am I eligible to buy a UK policy?

Answer:

To find out if you are eligible to buy a UK policy you will need to speak to your insurer. Each insurer has their own rules for buying a UK Health Insurance policy.  Do you spend much of your time abroad or have only just moved to the UK?  It is advisable to check whether there are limitations to the days spent outside of the UK or whether you need to be registered with a NHS GP for a specific time period prior to buying a policy.

If you do not meet the UK criteria you will have the option of International private medical insurance.

Saving Money on Health Insurance

Answers to some of the frequently asked questions about saving money on health insurance.

Q. Can I reduce the cost of Private Health Insurance?

Answer:

Yes, there are a number of ways that you can reduce your premiums. When you want to reduce the cost of your health insurance, speak to a specialist health insurance broker to find out the best way to do this. Depending on your current policy and any pre-existing medical conditions, you may have to look at specific options.

Q. Where do I go for a quote for Private Medical Insurance?

Answer:

If you want a quote for Private Medical Insurance you have a number of options available. You can speak directly to the insurer, use a cost comparison website or work with a specialist broker. If you have questions about pre-existing conditions, speaking to specialist will help you to make the right choice because cover may differ between insurers.

Q. Can I add an excess to my health insurance policy?

Answer:

Yes, you can add an excess to your policy and this will reduce the premium you pay. The excess is the amount you agree to pay if you make a claim. The higher the excess you choose, the lower your monthly/quarterly/ annual premium will be. Excesses are normally per person per policy year but in some cases you can have the excess per person per claim.

Q. How Much Does Health Insurance Cost

Answer:

Your Health Insurance Cost will depend on a number of factors.

For consumers, the cost will depend on your age, where you live, the policy benefits you choose and your smoking status. If you already have a policy in place, your claims history will also be a factor. Adding an excess to your policy will reduce the annual cost of your policy.

For businesses, the cost will depend on the number of people to be covered, the age profile of your group and the postcode of your company. Again, if you have a policy in place your group claims experience will be a factor. Just like consumers, adding an excess will reduce the annual cost of your policy.

Your choice of hospital coverage and underwriting will also make a difference to the Health Insurance Cost on both options.

Underwriting Questions

Answers to some of the frequently asked questions about underwriting.

Q. What is Health Insurance Underwriting?

Answer:

When you buy your Health Insurance policy you will be offered different underwriting choices. The option you take will have an effect on the premium you pay.

Underwriting is a way for the insurer to review your previous medical and health history. They can then decide whether any terms (exclusions) will be applied to your policy.


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