Medical advances mean doctors can treat many more conditions, but new procedures, diagnostic methods, drugs and technology mean medical costs are increasing all the time. In addition, the population is growing larger and living longer, which is putting extra demands on the NHS in terms of both time and costs. Coping with this increased demand is a growing problem for the NHS. This is where the Private Medical Insurance comes in to help with this. Department of Health statistics on waiting lists show more people than ever are waiting for surgery or hospital appointments and pressure is also on NHS GP services.
TYPES OF POLICY AVAILABLE
Outpatient treatment
This is any appointment at the hospital that doesn't require an overnight stay. Your first meeting with the consultant will be an outpatient appointment.
There are three main types of PMI policy.
- Low cost policies tend to provide comprehensive cover only if the treatment isn't available from the NHS usually within six weeks. A budget policy will not usually include outpatient treatment or complementary therapy or physiotherapy.
- Comprehensive policies are the standard policies that usually include hospital stays, surgeon, nursing and anaesthetist costs, X-rays, outpatient and day-care treatment linked to hospital stays.
- Premium policies offer additions to comprehensive policies, such as critical illness cover, cover overseas, dental cover and a hospital cash plan.
Exclusions
The following conditions are usually not covered by PMI.
- Accident and emergency admission or outpatient treatment.
- Private GP services.
- NHS prescriptions.
- Normal pregnancy and childbirth.
- Chronic (long-term) conditions such as diabetes and asthma that required prolonged treatment.
- Pre-existing conditions (you can't insure yourself after it happens).
- Routine dental treatment.
- Cosmetic surgery, except for a disfiguring illnesses or an accident.
- Routine health checks.
- Outpatient drugs or dressings.
- Transplants (except skin grafts and corneal).
- Drug and alcohol abuse.
- HIV and AIDS, with some exceptions.
- Voluntary sterilisation, with some exceptions.
- Fertility treatment, with some exceptions.
- Services sought without referral from a family doctor.
- Appliances (eg wheelchairs).
- Some forms of psychiatric care.
- Preventive treatments.
- Experimental treatments.
There can be exceptions to these rules. For example, a company may agree to cover the cost of voluntary sterilisation if becoming pregnant would put a woman's health at risk.
Moratorium underwriting - Pre-existing conditions
If you do have a recurring illness, seek medical help for it straight away. It's not worth risking your health by waiting for two years so you can claim privately via a PMI policy as there is usually a clause that says they won't pay for treatment if you 'ought reasonably' to have sought treatment or advice in this time. You don't give details of your medical history when you apply, but you won't be covered for any medical condition you've received advice or treatment for in the last few years (usually five, but it does vary between insurer).
Any medical problems that are related to a pre-existing condition are also excluded. But because the insurer will only ask about your medical history at the point you apply for treatment, some pre-existing conditions might be included in your policy in the future. Usually this is when you haven't had any symptoms or treatment for at least two years after your policy starts. So, this type of policy may give you better cover if you've had a condition in the past that may flare up in the future - just remember that some conditions will always be excluded. Any insurer offering moratorium underwriting must also offer full medical underwriting.
Always seek authorisation from your insurer before undergoing treatment, otherwise you may end up with a large bill that you will have difficulty paying.
Advantages of Private Medical Insurance
Waiting times on the NHS can be months or years between referral and treatment, you won't have to wait this long for private treatment.
Disadvantages of PMI
It depends on your policy and any previous medical conditions, but most policies only cover short-term illness or injury.
Many different companies offer private medical insurance (PMI) in the UK, the main insurers are BUPA and Axa Healthcare who between them have a significant market share. So although there is competition, it isn't keeping monthly premiums as low as policyholders might like. Premiums are also linked to claim costs. This may be offered by referral to a partner firm.
CONTACT US
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Lawson Financial Ltd is a broker and not a lender
Your home may be repossessed if you do not keep up repayments on your mortgage
Lawson Financial Services will charge a fee for their services. The precise amount of this fee will depend on your circumstances but will be from £295.
Lawson Financial Ltd is directly authorised by the FCA
Lawson Financial Ltd is a broker and not a lender
Your home may be repossessed if you do not keep up repayments on your mortgage
Lawson Financial Services will charge a fee for their services. The precise amount of this fee will depend on your circumstances but will be from £295.
Lawson Financial Ltd is directly authorised by the FCA
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Registered Office: Lawson Financial Ltd, 8 Biscay Close, Hill Head, Fareham, Hampshire PO14 3RG | Registered Company Number: 09000180 | Registered in England and Wales.
© 2020 Lawson Financial Limited | Customer Complaints Policy | Privacy Policy
Registered Office: Lawson Financial Ltd, 8 Biscay Close, Hill Head, Fareham, Hampshire PO14 3RG | Registered Company Number: 09000180 | Registered in England and Wales.