Is your health insurance offering you a guided option?

There are numerous options available when it comes to buying health insurance.  The hospital options can really add to the confusion and massively affect the premium that you pay. Not all insurers have a “hospital list” and therefore, how do you know if your cost comparison is accurate?

More importantly than that, do you know whether your health insurance follows a guided option (the insurer tells you which hospital or consultant you should use) or whether you still have the option to choose which hospital you use?

Over recent years most of the health insurance providers in the UK have introduced treatment pathways for musculoskeletal conditions. These have worked well, allowing the insured member to call the insurance company directly for any claims relating to aches and pains affecting the joints, bones and muscles. This saves time in waiting for a GP appointment and can get you treated far quicker.

Is it cheaper when the insurer tells you which hospital or consultant to use?

As a rule the answer is yes, the insurer will have a network of hospitals and consultants that are recommended and part of their preferred network providers. These will be fee assured and regularly used by the insurer. All of the specialists and hospitals will still be fully qualified and regulated by the CQC. It is not a downgrade in cover.

Is it easier to have a guided option when you make a claim?

Many people think so. When you need to make a claim you obtain an open referral from your GP which specifies the type of consultant you need to see.

i.e. if you have a problem with your heart you would need to see a cardiologist.

When you call your insurer they would give you the name of the consultant and hospital to use. This will save you having to research a specialist yourself.

What happens if you have a recommendation for a specialist from a third party?

Providing that the specialist is listed as part of the insurers network of specialists then there should be no issue. If however, this is not the case you would have to use a consultant in their network for your treatment. There are rare occasions that an insurer may not have a specialist in a specific field and these are few and far between. When this happens you may be able to use the specialist you have been recommended to.

The team at SMP Healthcare can help you to understand the cover you have in place. We also have the expertise within our business to assist you when you are looking for a completely new health insurance policy for yourself, your family or for your business.

If you would like help in any way relating to your private medical insurance cover, please get in touch using one of the following methods:

Telephone 01245 929129/ 0800 047 0127