When it comes to private health insurance, one size doesn’t fit all and choosing the right health plan for you and your family isn’t always easy, especially with the number of plans available on the market.
From health insurance excess and policy costs to medical underwriting and what will be covered, there are so many factors to consider when looking to purchase a private health insurance policy that best suits your individual needs. That’s why we’ve put together 7 things to consider when buying private health insurance.
1. choosing the right cover for you
When purchasing a private health insurance plan, you generally have the option to choose from a variety of benefits and different levels of coverage. for example, your options might include:
- types of medical treatment (such as inpatient, day and outpatient treatment, alternative therapies, dental and vision coverage, mental health coverage)
- the maximum level of coverage for these treatments (i.e. how much you can claim towards the cost of the treatment)
- where medical treatment is provided (i.e. choose a list of hospitals)
- pre-existing conditions
- chronic diseases
- emergency treatment
- cosmetic surgery
- drug and alcohol abuse
- normal pregnancy
- mobility aids such as wheelchairs
- injuries from dangerous hobbies and sports
- medications and bandages prescribed after you leave the hospital
- self-inflicted injuries
- experimental or unproven medication or treatment
The type of coverage you choose will not only affect your premium, but also what you can claim later on your health insurance plan. therefore, it’s important to take the time to understand the coverage available to ensure you’re choosing the best options for you, as you typically won’t be able to switch mid-contract.
Learn more about how health insurance works.
2. understand excess health insurance
A health insurance deductible is the contribution that you are responsible for paying towards the cost of your medical treatment. Like the level of coverage, you can usually decide how much you want your excess to be, although a mandatory excess may apply. your excess can be between £0 and £1,000 and is directly influencing your premium. The higher the excess amount, the lower your premium and the higher your personal contribution to the cost of settling a claim. It’s important to consider excess health insurance when discussing your provider options, as it will be another expense to consider.
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Depending on your health insurance company or product, you may have to pay your excess each time you file a claim, or you may only have to pay it once during each policy year. the deductible will normally have to be paid by each person who makes a claim on the policy.
When you make a claim, the health insurance company will take your excess from the amount they have to pay for your treatment. They will let you know if you need to pay your excess directly to the health care provider or if your excess will be deducted from any amount you are due to be reimbursed. therefore, you should consider what type of franchise payment method best suits your needs.
3. what affects your health insurance premium
In addition to your level of coverage and your deductible, other factors can also influence the price of your private health insurance. Each health insurance company has its own criteria for calculating premiums, but the most important consideration is often your age. The older you are, the more expensive your premium will be, because your chance of needing medical attention increases with age.
Some companies may also price your private health insurance based on where you live (charging you more if you live in more expensive areas or larger cities), your medical history, or your lifestyle (such as smoking and drinking ). It pays to do your research and get quotes from various health insurance providers. The cheapest option may not necessarily be the best for you, so it’s a good idea to consider your personal needs and the plan that covers what’s most important to you.
4. cancer coverage
Cancer, as long as it is not a pre-existing condition, is usually covered by most health insurance policies, although some policies may allow you to select more comprehensive cancer coverage if you wish. Cancer cover will generally give you access to the most up-to-date private cancer treatment, including drugs and procedures that may not be available through the NHS.
However, during cancer treatment, you can use the NHS in conjunction with private healthcare, as some health insurance policies provide you with an NHS cash benefit if you choose to receive treatment through the NHS rather than through the NHS. in a private hospital.
Because the level of cancer coverage and cancer-related benefits vary between insurance providers and policies, it’s important to always check your health insurance plan’s cancer coverage before you buy.
5. health insurance subscription
Medical underwriting is a term used by health insurance providers to describe how your medical history is used to evaluate your health insurance application for pre-existing medical conditions. the most common forms of subscription are the moratorium subscription and the full medical subscription.
With the moratorium subscription, you will not be asked about your medical history when you purchase the policy. instead, the insurer will automatically exclude her pre-existing medical conditions for which she has experienced symptoms, received medical advice, treatment or medication in the previous five years. She may be able to cover a pre-existing medical condition if she does not experience a recurrence of that condition for a full, uninterrupted two-year period. read more about moratorium subscription.
full medical subscription
With full medical underwriting, you are asked to provide details of your medical history when applying for coverage. the information you provide must be complete and accurate to the best of your knowledge. Based on this, the health insurance company will decide if you have any pre-existing conditions that they want to exclude from your policy, which will then show up on your insurance certificate. this means that you will not be able to claim treatment for any of these conditions or related conditions. With this subscription form, you’ll know exactly what will and won’t be covered from the moment your policy starts. learn more about full medical underwriting.
6. understand the exclusions of your private health insurance policy
Each private health insurance plan has some medical conditions and treatments that will not be covered by the policy. These exclusions may vary depending on your health insurance provider, the type of policy, or your underwriting method.
A complete list of health insurance policy exclusions and other terms and conditions of your policy should be available to you when you purchase coverage. These are some of the most common general exclusions of private health insurance:
It is important that you understand what will and will not be covered so that you are prepared for and satisfied with your private health insurance plan.
7. your protection and rights as a consumer
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If you have purchased a private health insurance policy in the UK, you have certain rights as a consumer that you should be aware of:
the reflection period
As with any good or service purchased from a distance, health insurance comes with the right to a cooling-off period. this is the period during which you can change your mind about your purchase. the minimum cooling-off period you should get is 14 days, but some companies may offer you a longer time. If you decide to cancel your policy during the reflection period, you are entitled to a full refund as long as you have not used the policy to make a claim.
Because your health insurance company collects personal information, including medical details, it must treat it confidentially and tell you what it will be used for, to whom it may be given, and under what circumstances. You can also request to see any personal information an insurer has about you.
The UK private health insurance market is regulated and licensed by the Financial Conduct Authority (FCA), so you can expect a high standard of care. That said, you may have a negative experience that you want to address, in which case all health insurance companies should have a complaints procedure and should include information on how to file a complaint in your policy documents. If you are dissatisfied with any aspect of your health insurance policy or the company’s customer service, you can file a complaint directly with the insurer, following their procedure.
if you are not satisfied with the insurer’s response, you may have the right to consult an alternative dispute resolution (adr) service, which in the uk is usually the financial ombudsman service (fos). this information will normally be provided by your insurance company.
change to another health insurance provider
If you’re thinking of changing insurance providers, it’s best to wait until the end of your current insurance contract (usually 12 months) to avoid incurring early termination fees from your current provider. it is important to verify the benefits, terms and conditions. coverage conditions and limits of different policies to choose the right coverage for you. In addition, you should always check if all the diseases you are currently covered for will also be covered by your new insurer, as this is not always the case.
We hope we’ve answered all of your questions about what to look for in private health insurance and made you feel more confident about the type of coverage you might need and the considerations you’ll need to take into account. If you have any further questions, please do not hesitate to contact us and a member of our friendly team will be happy to assist you.
If you’re ready to apply for your private health insurance coverage, get a free, no-obligation online health insurance quote for you and your family, or get in touch today if you’re looking for commercial health insurance.
Disclaimer: The information contained on this page is for general information purposes only and should not be taken as advice or a recommendation. If you need specific health insurance advice, you can speak to an independent insurance broker. Click here for a list of available health insurance brokers in your area.