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Health Insurance

• What is Health Insurance?
• What are the benefits of Private Medical Insurance?
• How do I choose which policy is best for me?
• Types of PMI Policies
• Frequently asked Questions and Useful Information

What is Health Insurance?

Health insurance works in a similar way to any other type of insurance, the insured will make payments (or premiums) to an insurer, and in return is able to claim a payment from the insurer if the individual requires medical attention. This payment is used to pay for treatment and can be for anything from an in-growing toenail to a life threatening illness.

How does health insurance work

If you fall ill, the standard process involves a visit to your local GP who will then arrange a private appointment with a specialist consultant. You will then have to check with your insurance company that you are insured before the treatment commences. Your claim form will need to be signed by your GP and the specialist consultant, the insurance company will then either settle the bill directly with the hospital or will ask you to settle the bill and will later reimburse the cost.

What are the main benefits of Private Medical Insurance

Numerous medical improvements and advances now mean that modern doctors can treat far more conditions than they could 20 years ago. This is due to the introduction of new procedures, better drugs and technological advances, however these advances tend to be expensive and a growing problem is that the NHS waiting lists continue to grow for the limited facilities available. This now means that more and more people are considering private treatment.

The reason patients go private is due to the speed and convenience that private services will offer and also due to the concerns about the availability of resources within the NHS.

This is a massive incentive for individuals to take out private medical insurance policies as it removes the possibility of having to wait for treatment on one of the NHS waiting lists whilst suffering from a painful or disabling condition. However, health insurance plans have been known to be quite complex and should not be rushed into until you have carefully read the small print.

Taking out a private medical insurance policies can lead to a better sense of security. Individuals will feel safe in the knowledge that if they become ill or need an operation that they can get treatment quickly and can exercise a certain degree of choice. An example of this is that a private operation is can usually be performed at you convenience at a hospital of your choice and by a surgeon that you can choose

How do I choose which policy is best for me

Insurance companies offer different policies for different customers, some policies may appear at first glance to be a cheaper and better deal, however the policy may be unsuitable for your needs and requirements. There are a number of factors that you need to consider before applying for a health insurance policy:

• Private Medical Insurance policies willgenerally cover short-term curable illness. Chronic illnesses which cannot be cured are not normally included
• Many companies will refuse to cover you if you have pre-existing conditions.Others may impose a moratorium, this means that if you had a heart attack, then they will not insure you until at least two years after you take out the policy and sometimes they will not insure you at all.
• Other insurers will sometimes operate a restricted specialist fee schedule, by doing this they limit the amount that they will have to pay out to you for each operation.
• Some Policies will involve you paying an excess and others will not have fixed premium's, i.e. premiums you pay could rise each year. (this normally is normally unavoidable to a certain extent)
• A lot of marketing material that private health companies release is complex which makes comparisons by a non medical individual difficult.

For this reason it is advisable to look at several different companies and the types of policy that are on offer before making a decision

Types of PMI Policies

There are three main types of PMI policies available, Comprehensive policies and low cost/budget policies. There are also standard policies which0 are a combination of comprehensive and low cost/budget policies.

A Comprehensive PMI policy usually covers the following costs:

• Inpatient Treatment.
• X-rays.
• Physicians and Anaesthetists and Surgeons bills.
• Home nursing if requested by a consultant after inpatient treatment.
• Hotel and nursing costs.
• Outpatient and day-care treatment

Low cost/Budget PMI policies do not usually include outpatient treatment such as complementary therapy and physiotherapy..

Frequently asked Questions and Useful Information

• Make sure that you provide accurate information about your state of health when taking out a policy, if your insurer believes they have been misled or misinformed then they may refuse to pay your claim
• Premiums are usually lower the younger you are and will increase as you get older, this is due to the fact that you are more likely to make a claim at an older age.
• Prescription drugs can be fairly expensive and some policies may not include refunds for these costs, make sure you check what is included with the policy and what isn't, it may be useful to visit your local GP and ask for his/her advice
• There can sometimes be age limits to policies, 70 is the standard age that insurers will not offer cover, however some companies will provide cover up to 80 years of age
• Although you may be tempted to choose the cheapest option, you should consider that this is likely to cause certain policy exclusions such as limiting you no out-patient care.