What Is Health Insurance?
Health insurance, often referred to as private medical insurance (PMI), is a policy that can be taken out in order to cover the expenses of private medical care. It allows an individual to receive medical attention outside of the NHS for what are commonly referred to as “acute conditions” or those diseases, illnesses or injuries for which treatment is likely to work in a short period of time so as to return you to your previous level of health.
What are the benefits of getting health insurance in the UK?
- Get attention and treatment quicker than you would on the NHS
- You will often have a choice as to where your treatment will take place
- You will be in more control over when the treatment happens
- You might even be able to choose the specialist you see
- Accommodation in hospitals might be more comfortable with many private hospitals offering private rooms
What is the difference between health insurance and a health care plan?
Some people get confused when they are confronted with both health insurance and health care plans because they do not know what each one covers but it is fairly straightforward. Health insurance is typically there to cover you should you require in-patient treatment or surgery in a hospital while a health care plan (sometimes called a cash plan) is designed to help individuals and families with the day-to-day costs of health care such as prescriptions or dental work.
What questions are asked when you apply for health insurance?
Most health insurers will require some detail of your current state of health along with the standard personal information required for all insurance policies. These may include:
- your height and weight
- your age
- your occupation
- your sex
- whether or not you are a smoker
- your medical history
The insurance company may contact your GP but this is not always the case. If you have any doubts whether you should mention something at this stage, it is best to do so as this will avoid claims being refused or policies being cancelled.
Not all types of cover will require you to answer questions regarding your health however. With what is known as moratorium underwriting (as opposed to full medical underwriting) your insurer will NOT provide any cover for conditions you have had treatment for, taken medication for, had symptoms of or asked advice on. In this regard, insurers will typically look at a number of years previous in which such conditions may have presented themselves – 5 years is a time frame that is often chosen.
Will I need to have a medical when applying for health insurance?
Very few, if any, health insurers in the UK require the applicant to go through a medical when buying cover; they only require you to be open and honest regarding your current state of health.
Are dental procedures covered by a health insurance policy?
Not many health insurance policies will include dental work as standard and instead you will want to look at getting a health care plan to ensure you can pay for such treatments as and when they are required. Many health insurers will offer these alternative cash plans.
Does health insurance cover you when you travel abroad?
Private medical insurance with a UK insurer will most likely cover you only when you are in the UK. If you are travelling abroad and wish to get cover for any hospital treatment you have while there you need to get a travel insurance policy which some insurance companies did not provide.
Can I add members of my family to my health insurance policy?
It is possible in most circumstances to add your spouse and/or children to a health insurance policy and it should just be a case of answering a few more questions on the application form. If your spouse or child has a condition that requires continuing treatment you might wish to consult your insurer to check whether you can add them to your policy or not.
Does health insurance cover cancer treatment?
Many health insurance companies will offer a plan that provides cover for cancer treatment although these are not likely to be standard and may cost more. BUPA for instance have a “Health care select heart & cancer” while AXA offer special “Heart & Cancer” cover as an option when buying.
Will a family history of cancer affect my application?
No, a history of cancer in your family should not have any impact on most insurers’ decision to offer you private medical cover.
Is it possible to get health insurance if I previously had cancer?
Yes you should be able to get health insurance if you have suffered from cancer but they may count this as a pre-existing condition and so exclude further cancer treatments from your policy. This means you can still benefit from cover for all other conditions, illnesses or injuries.
Can you get health insurance with pre-existing conditions?
While you can get health insurance if you have pre-existing conditions, any further treatments for these conditions will likely be excluded from the policy.
Does health insurance cover diagnosis along with treatment?
Many health insurance policies will provide some form of cover for diagnostic tests to ensure the proper treatment is provided.
Does health insurance cover accidents and emergencies?
Most private hospitals do not have an accident and emergency section to them and so in such cases you should always head to your nearest NHS hospital. If further treatment is then required you may be able to get transferred to your private hospital.
Does health insurance cover cosmetic surgery?
In almost all circumstances cosmetic surgery is one of the exclusions in a private medical insurance policy. You will have to cover the cost of this yourself.
Will health insurance pay for birth control?
Not many health insurance policies will cover the cost of any form of contraception or birth control.
Will health insurance pay for physio?
In many cases health insurance will give you some form of access to physiotherapy although the amount of cover you get (and thus the number of hours of physio you get) will likely depend on the level of cover you have chosen.
Can you get health insurance as a smoker?
Yes you can get health insurance if you smoke but you can expect to pay quite a lot more for your cover given the extra risks involved in smoking and the additional health problems generally faced by smokers.
Can I switch to a new health insurance company?
Yes, you are free to change which company you have health insurance with but remember to conduct a thorough comparison of the cover you get from both to ensure that you are not left with less protection after you switch.
Is the health insurance market in the UK regulated?
Yes, health insurers in the UK are regulated by the Financial Services Authority (FSA).
What is generally not covered by health insurance?
Many of the following are often not covered by health insurers though as always you should consult the small print or consult an independent advisor:
- Drug abuse
- Sex change
- Organ transplant
- Self inflicted injuries
- Kidney dialysis
- Dental services
- Chronic conditions
- Intensive care
- Physical aids
- Pregnancy & childbirth
- Sleep problems
- Speech disorders
- Treatment to correct eyesight
How Do I Know What Cover To Get?
With health insurance policies varying to some degree over their range of care options, it is important to speak to a qualified advisor before making any big decisions. Simply fill in the form on this page and you can get expert advice from an expert in the PMI market.