Health Insurance - Frequently Asked Questions (FAQs) About Private Health Insurance

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Health Insurance - Frequently Asked Questions (FAQs) About Private Health Insurance

Buying private medical insurance (private health insurance/ PMI) can be a complicated process, and there are often misconceptions about what a policy will and will not cover. Below are answers to the most frequently asked questions about PMI to help you make an informed decision.

How does private medical insurance work?

Private medical insurance premiums are paid on a yearly, quarterly or monthly basis, and give you the choice of going private if you don't want to be treated on the NHS.

What types of cover are available to me?

Traditionally, health insurers offer comprehensive, standard and budget policies. However, many insurers are moving away from this approach and offering a 'pick-and-mix' scheme. This usually includes a core cover policy, supplemented by a choice of additional options.

Comparison websites will show you all the options available from each insurer so you can easily get health insurance quotes tailored to your needs and budget.

How can I save money on my PMI policy?

With PMI, your premiums will directly affect your level of cover. But there are ways to save money on your health insurance without sacrificing on cover. Discount schemes include:

Excess: reduce the premium by volunteering to pay the first part of any claim up to a fixed number of pounds

Co-payment: reduce the premium by volunteering to pay a percentage of any claim

Six week wait: If the NHS can provide treatment within six weeks, you will be treated on the NHS. If not, you will go private straight away.

Reduced hospital cover: don't pay extra for hospitals that you don't need.

Will my premiums increase as I get older?

Yes, your premiums will increase as you get older, because you are more likely to make a claim on your policy. The increase will depend on your insurer and your policy.

Will I be covered for illnesses I've already got?

Health insurers will not cover you for pre-existing conditions. However, Moratorium plans could provide cover for these conditions in the future. With moratorium, the insurer will automatically exclude any pre-existing medical conditions for which you have asked advice on, required treatment for, or suffered symptoms of, during the five years before your policy starts.

However, if you go treatment, symptom and advice free for two continuous years after the start of your policy, your insurer will reinstate cover for that condition.

Will health insurance cover me for cancer treatment?

Only patients with comprehensive cancer cover will have access to certain treatments on their policy, like re-constructive surgery, stem cell transplantation, biological therapies and hormone therapies. Patients with basic cancer cover may only be able to claim up to a certain annual limit, such as £30,000.

A good comparison website will show you the full details of each health insurance policy, allow you to tailor your quotes online with instant updates to the price, and adapt your cancer cover to your needs and budget.

Will health insurance cover pregnancy?

Since pregnancy is not considered an illness, health insurance does not cover hospital treatment for normal pregnancy and childbirth. If you want to be treated privately for a normal pregnancy, you would have to pay for the cost yourself.

However, women who already have health insurance for a certain qualifying period could be covered for complications of pregnancy and childbirth.

Will I be covered for a chronic condition?

If the chronic condition develops after the start of the policy, cover will be provided to stabilise the condition.

This means:

Your insurer will pay for any treatment to stabilise the condition.

If a condition is declared chronic, no further cover will be available for the ongoing management of the condition.

However, if there is a sudden deterioration of the condition (an acute flare-up), the policy will cover its stabilisation.

What happens if I have a medical emergency?

Medical emergencies are not covered by health insurance. If you require emergency care, you will be treated on the NHS in Accident and Emergency. After you are stabilised, you will be transferred to a private ward in an NHS hospital or to a private hospital to be treated.