What type of UK Health Insurance do I need?

So you have decided to buy Health Insurance but do you know how it works here in the UK? Unlike many other countries, we are lucky to have the services of our NHS. When you buy a private medical insurance policy for instance, this does not replace the services of the NHS. The two elements work alongside each other and give you the best possible access to all aspects of healthcare.

What type of Health Insurance policy do you want?

When you think about health insurance there are a number of policy types you may be interested in such as:

  • Private Medical Insurance; covering more serious in-patient and day patient conditions including the treatment of cancer, heart and mental health conditions
  • Hospital Treatment Insurance; covering non urgent surgical procedures such as varicose veins and hernia operations
  • Cash Plans; contributing to the cost of everyday healthcare costs such as dental and optical treatment
  • Dental Insurance; cover for major and routine dental treatment
  • Employee Assistance Programmes; taking care of the wellbeing of your staff
  • Occupational Health; Varied options for workplace healthcare and wellbeing

Once you have decided which type of policy you want, you can then move on to the next step.

Choosing your Health Insurance provider

There are a number of UK Health Insurance providers in the UK. In most cases you can buy direct from them or via a specialist Health Insurance Broker or cost comparison website. You can obtain feedback from Trust Pilot or client testimonials in most cases. If you decide to speak to the insurer directly, they can only advise you on their own products and therefore this would not provide you with an overview of the market.

Choosing your benefit and cover levels

If you opt to work with a specialist Health Insurance broker you can discuss what you want to have cover in place for. They will explain to you how the cover works, what will be covered and how to get the best out of your policy. As no two providers offer the exact same cover, it is a great way to find out what is available. Most policies are modular which means that you can tailor the cover to what you want. There is no point in paying for a benefit you will never use if you can avoid it.

Making a Claim on your Health Insurance

Depending on which type of policy you choose, this will affect how you make a claim. If you buy a Private Medical Insurance policy, then the claims are often settled directly between the insurer and the treatment provider. You are generally required to obtain pre-authorisation and you would need to pay any excess that is due. If you have chosen to add a £250 excess to your policy to reduce your annual payment, then when you make a claim, this is the amount you will need to pay. Excess’s are often per person per policy year, but can be per person per claim.

There are some benefits that allow you to speak to your insurer without a GP referral. As an example, Bupa offer a self referral system if you have symptoms of cancer. Many insurers allow you to claim for conditions affecting your knees, hips, back and neck directly too. These claims are referred to as musculoskeletal. Aviva’s Back to Better and AXA’s Working Body are good examples.

Cash Plan claims are different, you pay for your treatment and then claim the money back from your cash plan provider. Each benefit category will have a maximum limit and you can therefore only claim up to your policy limit. You do not need to pre-authorise treatment on the majority of cash plan benefits.

Your Health Insurance broker can help you to understand how to make a claim on your policy. As the Covid pandemic has affected so many sectors, the Health Insurers in the UK have really tried to make the claiming process much easier. Many offer excellent options for remote GP appointments to save members from having to wait to see their NHS GP.

What payment methods are available?

As a consumer you can pay for your Health Insurance by direct debit, bank transfer or credit card in most cases. When you choose to pay monthly Direct Debit your payments are taken one month in advance. Some insurers will offer you a discount for making payment by annual direct debit.

As a business you can pay by the same method. Please note however that the payment must come from a business bank account.

Will there be exclusions for Pre-existing Conditions?

Private Medical Insurance

Make sure you disclose your pre-existing medical conditions to your broker or insurer. If there are any conditions that will be excluded, they will be able to confirm this to you Before you buy a policy. If you take moratorium underwriting you may not have a specific exclusion shown on your certificate, however, if a pre-existing condition falls under the moratorium clause you will not have cover until you have reached the relevant time period for it to become eligible.

Large corporate policies are eligible for Medical History Disregarded (MHD) underwriting. If you are part of an MHD policy, pre-existing conditions will not be excluded. Chronic conditions and general exclusions will still apply.

One of the UK insurers will allow you to add an element of cover for up to 2 pre-existing conditions for a small additional cost. The list of considered conditions is readily available and includes:

  • Crohn’s Disease
  • Glaucoma
  • Hypertension
  • Varicose Veins

Cash Plans

If you have a consumer cash plan, there may be qualifying periods applicable and exclusions for pre-existing conditions, however, if you are part of a company cash plan you do not have to disclose your medical history and pre-existing conditions are not excluded.

Do you need help with choosing the right Health Insurance?

We can help you decide which type of policy would be appropriate because our team have Years of Experience in the Health Insurance Market. We do not charge any fees and you will have a dedicated account manager to look after you. This applies whether you are a consumer or business policy holder. All of our clients are important to us and we provide the same high level of customer service to all. If you would like to know more about our services, please get in touch.

You can contact us via email: enquiries@smphealthcare.com or via telephone 0800 047 0127 or 01245 929129.