What is private medical insurance?

Having Private Medical Insurance will provide you with fast access to high-quality private medical facilities and will include medical treatments when and where it suits you. It also plays a very important role as it will help fund the costs of any early diagnosis and treatment for some acute conditions. This could range from physiotherapy sessions all the way to more complex procedures, like major heart surgery or biological therapy for the treatment of cancers.

What Does Private Medical Insurance Cover?

Private Medical Insurance is there for you to cover the costs of private medical treatment for acute conditions. An acute condition is a disease, illness or injury that is most likely to respond quickly to treatment so someone can have either a full recovery or have the quality of health they had prior to the condition.

Private Medical Insurance does not normally cover any treatment of long-term, or chronic, conditions where the primary focus is to keep symptoms under control – these are still treated by the NHS. Private Medical Insurance will also not cover any pre-existing conditions you may have when taking out a plan.

How will Private Medical Insurance Work?

For the majority of claims, Private Medical Insurance medical treatment will begin with a GP referral for specialist treatment. This can be done by either your NHS GP or a private GP. After this, any treatment you need will be managed by working very closely with your insurer so they can make sure you are getting quick access to the correct medical treatments you need.

How Is Private Medical Insurance Different from NHS Treatment?

Private Medical Insurance was always designed to work with all the services offered by the NHS, not to replace them, by focusing on providing faster access to treatment for acute medical conditions. Private Medical Insurance members are still able to use all services offered by the NHS. But as there are many pressures on the NHS to meet healthcare demands, which grows rapidly and is compounded by increasingly stretched resources – Private Medical Insurance plays a complementary role.

Frequently Asked Questions

What is an insurance premium?

This is what you pay to be covered by a plan like Private Medical Insurance. You will normally pay for your insurance premium via monthly or annual direct debit. Your premium is reviewed after a year and changes depending on your age, your insurance status, if you make a claim and any medical inflation.

What is an excess in private medical insurance?

Like with home insurance, the excess in Private Medical Insurance is a contribution you agree to make toward any claims. The larger the excess you agree to, the lower your premiums will be. A number of insurers ask for you to pay the excess after each claim, while others will ask you to pay it on the first claim in any plan year only, regardless of the amount of claims you make.

If I have a pre-existing medical condition, can I still get Private Medical Insurance?

Private Medical Insurance does not tend to cover pre-existing conditions, but you can still take out cover for conditions that may affect you in future.

What will not be covered with Private Medical Insurance?

Private Medical Insurance does not usually cover treatment of long-term, or chronic, conditions, where the ultimate goal is to keep symptoms under control – that would make premiums far more expensive. Private Medical Insurance will also not cover any pre-existing conditions you may have when you take out a plan.

There are, however, some standard treatments and conditions that we do not cover:

  • Any regular monitoring & treatment of long- term conditions, such as diabetes or allergies
  • Treatment you receive outside the UK
  • Emergency treatment or visits to your NHS GP
  • Pregnancy, childbirth and the majority of related conditions
  • Cosmetic treatment
  • Organ transplants
  • Any experimental, unproven or unregistered treatments or practices
  • Any treatment for learning difficulties, delayed speech disorders and other developmental problems

What to look out for when buying Private Medical Insurance

  • Waiting Lists – Private Medical Insurance takes away the uncertainty of NHS waiting lists by giving you access to the very best medical care, when and where it suits you.
  • Quick Diagnostic Tests – Waiting times are a major cause of anxiety in many health events so Private Medical Insurance offers the reassurance of a fast and full diagnosis. However, you will need to make sure the plan you choose includes Out-patient cover.
  • Choice of Hospital – Private Medical Insurance offers easy access to hundreds of private hospitals across the UK as well as the freedom for you to choose where and when you are treated.
  • Drugs & Treatment – Private Medical Insurance provides access to a wider range of drugs and treatment, including those which might not be approved for use yet, or paid for by the NHS.
  • Choice of Consultant – Private Medical Insurance gives you the freedom to choose a consultant for a specific claim.
  • Privacy – Private Medical Insurance offers you the comfort and privacy of your own room in a nationwide network of private hospitals, with no need to worry about shared wards.

will I need a medical exam before I can take out Private Medical Insurance?

If you have no pre-existing conditions when you join, there will be no need for a medical exam. Simply pick your preferred level of cover and answer some basic questions about your medical history.

If you do have a pre-existing condition, our insurance partners will need to ask you more questions about your health, or contact your GP. They will of course tell you if that is the case.

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