Your Guide to Health Insurance

Health & Medical Insurance Packages

Health insurance companies provide a range of insurance packages which in turn provide different levels of cover and benefits. Basic packages tend to cover full in-patient treatment and limited out-patient treatment.

Beyond the basic package you can then opt for higher level packages, where you receive either an annual maximum of £x towards further out-patient care, for example, towards consultations with specialists, diagnostic tests and physiotherapy or you receive a growing range of benefits in your package. The premium/most expensive packages provide you with unlimited cover for all in-patient and out-patient treatment with no annual maximum. Some companies allow you to 'tailor make' your package, starting with the basic package and adding benefits that are the most appropriate to your needs. All plans tend to include a 24 hour helpline providing medical advice and some include emergency treatment abroad and repatriation where necessary. Some also include critical illness cover, permanent disability cover, major dental expenses, complications in pregnancy, psychiatric problems, alternative therapies and cash benefits paid directly to you if you are willing to take NHS treatment.

Specialised Plans

A number of companies also offer specialised plans, for example, for people over certain ages covering a limited number of conditions more prevelant in older people, for sportsmen or women, for people living abroad, the self employed, for accidents, dental treatment, etc. Take a look at these packages before making your final decision. They tend to be cheaper than the 'full' health insurance packages and may suit your needs.

Steps to selecting the right policy for you

The first step is to look at a variety of insurance companies' packages on offer and decide on the level of cover and benefits that you want. As different companies offer different benefits, it is best to consider your options. You may decide to go for a basic cover package which will best cater for your needs as an in-patient, or to go for a package that will also provide you with a better level of cover as an out-patient and additional benefits as described above. As the level of cover you eventally decide upon may depend on what you can afford, you might want to ask different companies to provide you with quotes for a number of or for all of their packages. Be aware that cheapest is not always best. You may find that the cheapest quote offers limited benefits in comparison to a company that may be offering a greater number of benefits for a not much higher premium.

The next step is to get quotes from different insurance companies. It is important to get quotes from a number of companies as premiums vary from company to company. Some require very limited initial information from you to provide you with a quote - name, postcode, age. Others want to know certain information about you, for example, your age, weight, height, whether or not you smoke, etc. They use this information to assess your 'risk factor', i.e. to assess how likely it is that you may need treatment in the future. The higher the risk, the higher your premiums.

Applying for Insurance Cover

There are generally three ways of applying for insurance cover.

Full medical underwriting requires you to fill out a medical questionnaire with the insurer then deciding on your conditions of cover which will include the exclusion of any pre-existing conditions you have mentioned on you questionnaire.

Moratorium which means you will not be asked any questions about your health, but if you have suffered from any health conditions in the last five years, these will automatically be excluded from cover. This includes having had any symptoms of a medical condition even though you may not have saught medical advice or received treatment. Some companies may reinstate pre exisiting conditions if you remain symptom free and have not received any advice, treatment or medications for the condition for at least two continuous years after taking out the policy.

Switching from another provider normally requires you to respond to a small number of medical questions. Providing responses that satisfy the insurance company means that you can automatically be 'switched' without any need for further medical underwriting.

Considerations of Exclusions

Pre exisiting medical conditions and any conditions that are likely to need on-going long term or permanent care for which there is no known cure, for example, diabetes, asthma, HIV, (although cover for the diagnosis of such conditions would normally be provided). The cover insurance companies provide is aimed at short-term accute conditions that you may develop after taking out an insurance package and from which you are likely to make a full recovery. Also usually not covered are conditons related to alcohol or drug abuse, cosmetic surgery, fertility treatment, routine examintations and consultations with your GP, dentist or optician, medical screening, prescription medicines and childbirth. On this basis, it is also very important to look closely at all the exclusions that are contained in the package. Considerable numbers of people have taken out policies with expectations of having all their health and treatment needs met only to find this is not the case. It cannot be stressed enough that you need to know exactly what you are covered for and what you are not before signing on the dotted line.

Considerations of ways to lower your premiums

The next step is to consider ways in which you may be able to reduce your premium. Most companies offer no claims discounts or reductions in premiums if you are willing to take and are able to get NHS treatment within a set number of weeks. For example, if the NHS is able to treat your condition promptly, you receive your treatment from them. If you have to wait any longer than six weeks for in-patient or out-patient treatment, depending on your policy benefits, then you will be covered by your insurance policy for immediate treatment at a private hospital recognised by the insurance company. This is a package gaining in popularity as it offers people some form of guarantee in that they will always have access to specialised medical treatment within two months. Reductions are also normally available for opting to pay an excess should you need treatment or for paying you premiums annually rather than monthly. You may find that reductions are also made if you elect to be treated only in a selected number of hospitals. PruHealth offers reductions in premiums based on a points system. Points can be earned by being/becoming a non-smoker, eating a healthy diet, maintaining regular exercise and health screening. The more points you can claim, the lower the premium. The policy also entitles you to discounts with selected gyms, screening clinics and courses to stop smoking. A novel and interesting approach that focuses on prevention of medical conditions that benefits the policy holder as well as the provider.

Final Premiums

In looking at the final premium you will be expected to pay, it is important to recognise that this will not be your premium for the lifetime of the policy. As medical costs, consultants' charges and your age rise, so will the premiums.

Health Care Plans

If you feel that health insurance is not for you, you might want to consider one of the many Health Care plans that are available. For reasonable monthly premiums, these can provide cash back for bills covering, for example, allergy testing, some alternative therapies, chiropody, dental care, optician's fees, physiotherapy, specialist consultations, stays in hospital, maternity benefit, etc. On these plans, you can normally claim within one month of taking out the plan but you cannot claim for any pre existing medical conditions. The higher the premium you pay the more cash back you can receive towards medical or treatment bills. Companies vary in the benefits, premiums and exclusion times and terms they offer so it is worth shopping around.

The Association of British Insurers (ABI) provides valuable consumer information on health and protection insurance which includes a downloadable guide to buying private medical insurance.

Website designed and created by websitecreations.biz © 2007. All rights reserved.