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Private Medical Insurance FAQ’s

Researching private medical insurance policies should take time and effort. You and your family’s health is vital and you want to make sure you find a policy to suit your circumstances. If you would like to see more on the many types of private medical insurance policies available, read out Guide to Health Insurance Types here.  

Read on to find the answer to some frequently asked questions about private health insurance.

What is Private Medical Insurance?

Private medical insurance (aka private health insurance) covers the cost of treatment for illnesses and injuries. These illnesses and injuries are usually covered if they are acute (i.e. short term) and curable over a relatively short period. This insurance can cover out-patient, in-patient and day-patient procedures, surgery, and other medical expenses. Add-on services may also include psychiatric treatment, dentistry, and optical care, amongst other treatments and therapies.

Can I Still use the NHS if I Have Private Medical Insurance?

Yes, you may still use the NHS with private medical insurance. You can choose to go through the traditional route to free healthcare, or make a claim on your insurance for private treatment. People often choose to go private if they wish to skip NHS waiting lists, would prefer their own room for hospital stays, or wish to access the latest medical treatments for their recovery.

How Much Does Private Medical Insurance Cost?

The cost of premiums is dependent on three different things;

1. The nature of the policy you opt for and what services are included
2. The amount of cover you would like to access
3. You and your family’s ages, state of health and lifestyle

Can I Get Private Medical Insurance for a Pre-Existing Condition?

Depending on the insurer you opt for, you may be able to find some insurance cover for a pre-existing condition. However, there are likely to be restrictions. For example, you may have to wait for a period of time (this could be something like two years) with no medical intervention during that period, before you may be covered for a limited number of specific pre-existing medical conditions. Alternatively, you may find a policy which can offer you short-term treatment for unexpected aggravations of a chronic disease. Here the cover can offer you help with the costs of bringing the condition back under control again. In general, across the whole of the private medical insurance industry, pre-existing and chronic medical conditions are excluded from private medical cover.

What Other Restrictions are Placed on Private Medical Insurance Policy?

You will not usually be able to find cover for the following medical conditions, under many private health insurance plans;

• Drug-use, alcoholism, and self-inflicted injuries
• Cosmetic surgery
• Mobility aids
• Fertility treatments

Can I Get Private Health Insurance with No Medical?

Moratorium underwriting policies can offer you cover in exchange for you filling out a health survey. These policies can be set up with less medical background information than fully underwritten policies. However, it is very likely that you will need to answer some questions on your health and medical history.

What are Guaranteed and Reviewable Premiums in Health Insurance?

• Guaranteed Premiums – This refers to health insurance policies where the premium costs are fixed for the length of the policy term. So, they will not increase over time.
• Reviewable Premiums – Under these policies, your records will be reviewed after a specified length of time (this may be five years, for example). When this policy is reviewed, the insurer will be looking at your past claims, the expectation of you making claims in the future and other tax and economic factors. After this has been carried, your premiums may increase.

What is a ‘Hospital Network’?

When you sign up for private medical insurance in the UK, your insurer will send you details of participating hospitals and health centre where you can receive treatment under your plan. This gives customers increased choice in their medical treatment. You may be able to receive treatment which is closer to your home or seek advice from doctors and consultants in your preferred medical centre. With some insurers, you may need to make your preferred hospitals (network) known when you sign up. Treatments from these centres will then be covered by your plan. Any treatment you seek within a medical centre that is not named on your list may then be charged for. It is, therefore, wise to choose your hospital network carefully.

Can I Get Cover for Chronic Medical Conditions?

A chronic medical condition is a disease, illness or injury which needs ongoing medical attention in the form of treatments and tests. You may also have ongoing symptoms or require rehabilitation to manage your condition. For an illness to be classed as chronic, it may also not have a cure and may stay with you indefinitely, even if the symptoms subside for a length of time.

Do I Need my Own Private Medical Insurance if I Have Some Employee Cover?

If you are offered some medical insurance for treatment for acute conditions through work, you may benefit from some additional extras, like limited protection for your family’s medical costs. This may be sufficient for your needs. Or, you may look to ‘top-up’ your private health cover by taking out your own policy.

Can I Find Private Medical Insurance for Cosmetic Surgery?

For the vast majority of insurers, medical insurance is designed to cover unexpected medical costs only. Therefore, cosmetic surgery would be seen as a lifestyle choice and not an insurable procedure. However, if the nature of the cosmetic treatment is required for medical reasons, for example, cases of reconstructive surgery, then some insurers may cover you for the costs.

Is Tax Payable on Private Health Insurance?

If you are seeking a single individual policy for you or your family, then your income used to pay the premiums will have already been taxed. This means that you may not be required to pay additional taxes on private medical insurance premiums. Insurance premium tax, is also usually already included in the price of your premiums.

However, if you are benefiting from private health insurance through your job, your employer may pay your premiums out of your wages i.e. pre-taxed earnings. This may make you liable for Benefit in Kind tax. In this circumstance, your tax code can be altered to reduce your personal allowance, to take account of this tax liability. Please check with a qualified financial advisor, as tax legislation is subject to change.

What is Full Medical Underwriting in Private Medical Insurance?

With policies that offer full medical underwriting, you fill in an in-depth medical questionnaire, or undergo a health check from a medical professional, in some cases. Alternatively, you may have to supply verifiable medical reports/letters. With this information, the insurer will highlight any pre-existing medical conditions you have. And, if they have restrictions on cover in this area, you may not be able to make a successful claim on your insurance. Some policies, however, will cover you for pre-existing conditions. This may take immediate effect, or you may have to wait for a specified length of time before a successful claim can be made.

What is Moratorium Underwriting in Private Health Insurance?

These policies may require you to fill out a questionnaire or supply medical records. If you have a pre-existing medical condition, under these type of agreements, you will not be covered for related treatments. These policies can look at your history with a condition, over a number of years, before you sign up for insurance. Treatment under these policies can be included on your private medical insurance plan, only if the symptoms of a condition occur after you have taken out insurance. Also, if you have not shown symptoms or received treatment for it in the past. However, some insurers may place further restrictions on you. Pease check the fine print of your policy before parting with your money.

If you have any questions about private medical insurance and you would like to get a free, no-obligation quote from an advisor, get in touch today.