General Health insurance information?

What is Health Insurance?

Health insurance is a policy designed to help you access private medical treatment. You can pay your premium on a monthly, quarterly or annual basis. Once you have a health insurance 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.

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

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

What type of contract is a health insurance policy?

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.

What do you need to consider before buying a Health Insurance policy?

Am I eligible to buy a UK policy?

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.

What is a chronic condition?

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 of a chronic condition, 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 of a chronic condition in this scenario.

Is there an age limit for health insurance policies?

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.

Does Health Insurance cover pre-existing conditions?

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 it?

If you already have a policy in place, is the pre-existing 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 pre-existing conditions. The chronic condition terms and conditions will still apply.

Does Private Medical Insurance cover pregnancy and childbirth?

Most UK health insurance policies will not cover you for routine pregnancy and childbirth. Many offer cover for complications of pregnancy and these are very specific. Check within the terms and conditions of your insurance policy to see what cover would be available.

There is currently a policy available on the UK market that will pay for private maternity up to £5000 as well as complications of pregnancy. This is a comprehensive cover level and the premiums will reflect the high levels of cover available.

If cover for pregnancy and childbirth is a priority to you, you could consider buying an international health insurance policy with maternity included from an insurer who will allow you to use the policy in the UK.

To clarify, health insurance is designed to cover acute medical conditions. Pregnancy and childbirth are a natural occurrence not an illness or medical condition and therefore insurance companies would not cover this unless there are complications.

Will health insurance cover cancer treatment?

Insurance companies in the UK offer you 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 for cancer treatment. 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 whichever provider you choose, this is so that 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.

Can I add my family members to my health insurance policy?

Absolutely, if you would like to cover your immediate family on your health insurance policy you can add them at any time throughout the policy year. You would pay a pro-rata premium for the addition of dependants.

FAQ’s relating to the cost of health insurance

Can I add an excess to my health insurance policy?

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. In some cases you can have the excess per person per claim. Make sure you know which option you have been quoted for.

How expensive is health insurance in the UK?

The cost of your health insurance will depend on many factors.

As an individual, your health insurance premium will be affected by:

  • Your age
  • Where you live
  • Medical History
  • The cover levels you require
  • Underwriting type
  • What level of excess you add to your policy
  • Previous Claims that have been made
  • Your smoking status
  • The hospital access you choose

What about the cost of health insurance as a company scheme?

If you want to buy a policy for your employees, it will be affected by:

  • The postcode of your business
  • Number of employees
  • Age profile of the employees
  • Cover levels that you require
  • Underwriting type
  • The level of excess you add to the policy
  • Hospital access you require
  • Claims history of the group (for existing policies).

Do smokers pay more for their insurance?

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. This is done because of the higher health risk that smoking brings.

When you buy 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.

Where can I buy a cheap private medical insurance policy?

The easiest way to save money on private health insurance is to compare private health insurance options from the whole market rather than limit your options to one insurer. This way you will get to know of any new business deals that are available.

To keep the cost of your health insurance as low as possible, make sure you only pay for the cover you need. If you can afford to pay a reasonable excess then include this on your policy because it will reduce your premium.

Is there VAT on health insurance?

There is no VAT on private health insurance. Your policy would be subject to IPT which is Insurance Premium Tax.  The current rate of IPT is 12%.

Claims and the claiming process for health insurance

What is Health Insurance Underwriting?

When you buy a private medical insurance policy in the UK you will be given options of how you want the policy to be underwritten. The underwriting 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.

Will I need a GP referral?

For most claims you will need a GP referral. This can be from your NHS GP or from a private GP. Many UK insurers 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.

Is it easy to make a claim on private health insurance?

Yes it is. Contrary to popular belief, health insurance providers really do try and make the process easy for eligible claims to be made. Claims can be made by telephone, online or in some cases via a mobile phone app.

What happens if there is a medical emergency?

Medical emergencies are dealt with by the NHS. UK health insurance does not cover you for A & E treatment.  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.

Can I use my private health insurance when I am abroad?

You may have an element of emergency overseas cover or a travel insurance add-on attached to your UK health insurance policy. If you have either of these you can use the policy up to the benefit limits in place when you are abroad.

Do not think of emergency overseas cover as an alternative to travel insurance because it not the same thing and does not have a high monetary limit. If you did not have the correct travel insurance in place this could result in you having to pay large medical bills abroad.

What hospitals are covered by my insurance policy?

When you buy your policy you will be given the choice of which hospital list you would like cover for. If you opt to exclude the higher charging central London hospitals to keep your premiums lower, then you will not be able to use them for your treatment. You may be able to use these hospitals for out-patient treatment.

Not all insurers have multiple hospital list options and therefore you could have access to all UK private hospitals. It is worth checking the hospital coverage available before you buy your policy.

Renewals and Changing Health insurance provider

Is it risky to change health insurance provider at the renewal of my health insurance?

This would be assessed on a case by case basis. If you are in the middle of treatment, waiting for test results or have medical treatment planned or pending then your most sensible option would be to remain with your current insurer.

If however you are perfectly fit and healthy and have no on-going medical issues or have not made a claim in a year or two then you could consider a change of provider.

You can compare your premiums with other insurers and if a switch will save you money, make sure that this cost saving does not jeopardise your current cover.

When I am leaving a company plan, can I continue with my cover as an individual?

Yes you can. Either you can continue as an individual with your current insurer as a group leaver or you can compare their offer with other providers in the market. You can look at switching your cover with continued underwriting terms or look at a brand new policy. Your medical history will determine which option is best for you.

Am I able to change the cover level on my health insurance?

You cannot make benefit changes to your policy mid-policy year but you can make changes at the renewal date. Any increase in cover level will have to be agreed by the underwriting team of your provider.

If you choose to remove cover to save money on your health insurance you can also do this at renewal. If you want to increase your cover at a later renewal date, this would have to be agreed by the underwriters.