Health Insurance
What is health insurance and what do I need to consider when finding the right policy?

What is health insurance?

Most people in the UK are entitled to free healthcare as part of the NHS. However, that does not mean that private medical aid does not have its benefits.

Health insurance pays some or all of your medical bills when you are treated privately. It will give you a choice on the level of care you get and how and when it is provided. This is not required insurance as you can still get private medical care without it. However, this is usually extremely expensive, and if you plan to have private treatment, health insurance is worth it.

Different types of health insurance

There are two main types of health insurance cover: fully underwritten or moratorium policies:

Fully Underwritten

If this is the kind of insurance you choose, you agree to give your provider your entire medical history.

Moratorium Policies

If you choose a moratorium plan, you will only be expected to provide limited information to your insurer. This is usually considered the more convenient way to buy a policy as there is no need to sit giving a detailed medical history. However, these plans are generally slightly more expensive, and you still will not be treated for pre-existing conditions. You may be asked to prove an illness or injury is new.

Although these are the two main types of policies, you may find that a specialist policy gives you what you want. These specialist policies can be changed to cover precisely what you need or want, from the wait list only covers specific diseases like cancer. These policies and their pick-and-mix style tailor the policy entirely to you.

What does health insurance cover? (most of the time)

As is the case with all insurance, healthcare insurance coverage depends on the policy that you buy.

Basic private medical insurance will pay for the cost of most in-patient treatments (tests and surgeries) and any day-care surgeries.

Some policies will stretch to covering out-patient treatments, such as specialists and consultants, and may pay you a small, fixed amount for each night spent in an NHS hospital.

In most cases healthcare insurance will not cover private treatment for:

Do you need private medical insurance?

This is something that is very much a personal choice. As in the UK, the majority of people receive medical treatment for free you only really need this insurance if:

Switching providers

Private health insurance is unlike home or car insurance, where switching your insurer every year can help you gain significant savings. Moving from one provider to another to get a better price can be tricky.

Any conditions you have developed over the span of your current policy are unlikely to be covered by your new policy. In most cases, this is because they will be seen as pre-existing conditions.

Furthermore, as you get older, health insurance generally gets more expensive. This is because you are considered more of a health risk as you get older, making it harder to find a cheaper deal.

When switching, it is also essential to compare your current and potential new policies to ensure that you are getting the same policies.

Pros and cons of health insurance

There are two main types of health insurance cover: fully underwritten or moratorium policies:

You can ask to be sent to a specialist by your GP to get a second opinion or specialist treatment.
If you cannot get a scan on the NHS or they delay your scan then you can use your insurance to cover a private one.
This is best when NHS wait times exceed 6 weeks.
This is something you cannot do on the NHS.

You can user it to get a room rather than staying on a larger ward.

Some specialist drugs and treatments are not available on the NHS, because they are too expensive, or they have not been approved.
You will get quicker access to physiotherpist than you will with the NHS.
Although not the case for a lot of treatments it can be for some more serious illnesses. For example, cancer, heart disease or a stroke, where you are given priority NHS treatment. This will also be the case in the occurrence of serious trauma. Some NHS hospitals are also considered better than private ones.
Premiums increase with every year, as you get older , and increase more if you become serious ill etc.
Most policies will not allow for the treatment of chronic illnesses which cannot be cured.
If you choose a policy with an approved list of doctors and hospitals, this might not include the expert consultant you want to see or a convenient location or treatment.
Some premiums set a maximum amount of money that can be claimed against certain treatments which means if you choose to see a doctor or specialist who charges more then you will be left paying the remainder of the bill.

Is private medical insurance good value for money?

It can be excellent value for money if you need a specialist or expensive treatment. For example, if you are a sporting enthusiast, you may want access to private specialist treatment not available on the NHS. You will need a policy covering the type of treatment you might need or want.

If you make more than one claim, then it is more than likely that you will be saving money by having insurance rather than spending more.

It is important to remember that when you have health insurance, you do not lose your right to use the NHS. As a result, many see having health insurance as their preferred form of treatment with the ease of mind that the NHS is still there if circumstances change.

Yes – we can help you reduce your premium. By speaking to one of our advisors, we can review your coverage and ensure you are not paying for anything irrelevant to your needs. We can also reduce your premium by choosing a reduced or local hospital list, adding a “waiting period” to your plan or choosing a higher excess.

Full Medical Underwriting (FMU) requires you to provide your complete medical history – and that of all policyholders when you remove your policy. The information you provide may mean the insurer excludes certain conditions from cover for the policy’s lifetime.
Moratorium Underwriting does not require you to disclose your medical history. However, for the first two years of your policy, you will not be covered for anything you’ve had symptoms, treatment, medication, diagnostic tests or advice on in the past five years before your policy start date. If you go symptom, treatment, medication or advice free from that condition after a consecutive two-year period, it will become eligible for cover again.
Switching your policy allows you to move from one insurance provider to another and still be covered for medical conditions you may have had problems with.

You must know what will and will not be covered before you take out a policy. Policies are intended to cover acute conditions like cancer instead of chronic conditions like diabetes. Most policies will cover acute flare-ups providing it is included in the underwriting. Typically the following are not covered:

  • Chronic conditions
  • Emergency treatment
  • Fertility Treatment
  • Cosmetic Surgery
  • Pregnancy and childbirth costs
  • Organ transplants
  • Treatment for alcoholism or substance abuse

Long NHS waiting lists and cancelled or delayed procedures are typical motivations for initial enquiries into health insurance. Depending on the condition, it is unlikely it will be covered in your plan. Although, if you have a pre-existing condition, speak to one of our expert advisors, as different underwriting options may suit your needs.

Yes – Basic, Standard and Comprehensive cover. Basic Health Insurance policies usually cover the bill of treatments and related inpatient hospital costs. Standard cover tends to cover both inpatient and outpatient care and support. Comprehensive policies are the highest level of cover you can obtain, including both inpatient and outpatient care, as well as cover for other treatments such as physiotherapy and mental health care.
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Depending on the plan you opt for, there may be some level of cover if you require emergency treatment abroad. Several of our policies allow you to add holiday medical insurance in addition to travel insurance which will cover the cost of lost passports, luggage and holiday cancellations.

Exeter Office

2b Manaton Court
Manaton Close, Matford Business Park
Exeter EX2 8PF
Tel: 01392 908750

Bristol Office

Henleaze Business Centre,
13 Harbury Road, Henleaze,
Bristol BS9 4PN
Tel: 01172 034186

London Office

56 Gloucester Road
London SW7 4UB
Tel: 020 3301 9859