Compare My Health Insurance | Compare Private Health Insurance | Cheapest Private Health Insurance | Health Insurance Advice

Understanding Private Medical Insurance

There are various reasons why individuals opt for private medical insurance (PMI), but the most common ones include avoiding long waiting lists in the NHS and having the freedom to choose when and where they receive medical treatment. The advantages of PMI are straightforward: quicker access to treatment, the ability to select your preferred consultant, and the choice of hospital or facility for your treatment. Some people have private health insurance as part of their work benefits package, while others choose to pay directly for treatment when needed, which is often referred to as self-insuring.

How do claims work?

• Before you can arrange private treatment, you typically need a referral letter from your NHS GP. However, it is becoming increasingly common for insurers to offer a Private GP option as part of their plans.
  

• Your doctor will either recommend a specialist consultant or you can conduct your own research and choose one yourself. Once you have made a decision, your doctor will write a referral letter on your behalf.
  

• If you have medical insurance, it is important to check if your policy covers the referral and obtain an authorisation reference from your insurer. This can be done by contacting the insurer directly or following an online claim process, if available.
  

• Once an appointment is scheduled with your chosen consultant, they will update your GP on their findings after the consultation.
  

• The consultant will then send an invoice to the insurance company, who will settle the bill, excluding any excess that may apply. If you must pay an excess, you will need to do so separately.
  

• If inpatient treatment is necessary, the hospital admission will be arranged, followed by a follow-up appointment with the consultant.
  

• The insurance company will cover all the bills, except for any excess that needs to be paid.
  

Budget Cover
For those who self-insure, payment for treatment is usually required in full upfront before being admitted to the hospital. This can often amount to several thousand pounds, but there are low-budget PMI plans available specifically designed to cover these major expenses, which can be obtained through a specialist PMI broker.

• If you have health insurance and you are consider switching check out our Easy Read Guide for customers who are already covered
  

Types of Health Insurance policies

There are typically three main types of health insurance policies

• Private health insurance policies: You pay a monthly premium, and the policy provides cover when you are ill. Joining your work scheme is usually cheaper than purchasing cover directly. The pricing of individual/family plans is based on a No Claims Discount Basis, where individual claims impact the price.
  

• Hospital cash plans: These plans have lower monthly premiums but only pay out predetermined amounts for hospital stays and have specific criteria for covered conditions. For example, they may not cover heart or cancer-related conditions.
  

• Critical illness insurance: This type of insurance pays out a lump sum if you are diagnosed with one of the specified conditions, such as cancer or a stroke.
  

General Exclusions

All insurance policies have general exclusions, which are illnesses and treatments that are not covered. These exclusions are typically outlined in the terms and conditions section of the provider booklet, but a specialist intermediary can help explain them in plain language. Some common general exclusions include active involvement in war and riot, AIDS/HIV, chronic conditions, and cosmetic surgery.

Most private health insurance policies do not cover patients for..

• Pre-existing conditions: Any disease, illness, or injury for which you have received medication, advice, or treatment in the past few years, unless you opt for a continuing underwriting option and meet the switch criteria with the prospective insurer.
  

• Long-term illnesses that cannot be cured (pre-existing chronic conditions).
  

• NHS services such as A&E and antenatal care for a normal pregnancy.
  

If you are interested in exploring the benefits of private medical insurance and finding the best option for your needs, an independent intermediary can provide a comprehensive and unbiased review of your healthcare options.

• You can Share Your Requirements and speak with an FCA regulated broker
  

• Feel free to check out our Easy Ready Guide for people taking out health insurance for the first time