Is private medical insurance the same as health insurance?
Yes, you will see it written in both ways, but it is the same thing. Private medical insurance is also known as PMI or private healthcare.
Is COVID-19 covered by a private medical insurance policy?
Private medical insurance covers the treatment of acute medical conditions in a private hospital.
However, with coronavirus, private hospitals do not have the same facilities as the NHS to deal with the outbreak. This includes access to accident and emergency departments and intensive care beds, as well as isolation units and other infectious disease controls.
If you are admitted to hospital with coronavirus, you will be admitted as an emergency case, which private health insurance does not cover. In dealing with a global pandemic the NHS is better equipped to provide the care required in intensive care.
Why do I need private medical insurance when we have the NHS?
Private medical insurance has never been seen as a replacement for the NHS. The NHS is a fantastic asset to our country and provides many services private healthcare cannot, such as accident and emergency and maternity services.
The NHS waiting times are one of the main reasons for choosing private health insurance. To add to the burden on the NHS, COVID-19 has had a huge impact on waiting lists and in many cases caused treatment to be cancelled. Read more on NHS waiting times here.
Private health insurance offers faster and sometimes more convenient access to diagnosis and treatment in a private bed. You can also access drugs and treatments not available on the NHS.
Will private medical insurance cover me for pre-existing conditions?
This depends on several factors. If you are taking out private medical insurance for the first time you will not be covered immediately for conditions you have had recently or are currently suffering from.
However, if you already have a policy and are looking to switch to a new provider, pre-existing conditions can sometimes be covered. This will depend on when you last had symptoms and which underwriting method you choose.
It is always best to speak to one of our expert advisors who have an in-depth understanding of underwriting and how to ensure your previous medical history is covered. Read more on underwriting options here.
What is not covered by private medical insurance?
Private medical insurance is designed to provide cover for acute conditions such as cancer as opposed to chronic conditions like diabetes. Acute flare ups of a chronic condition will be covered if it is not already excluded on the policy.
It does not cover accident and emergency situations or rehabilitation and convalescence.
Most insurers have general exclusions such as:
- Chronic conditions
- Cosmetic treatment
- Addictions and substance misuse
- Pregnancy, childbirth, and infertility
- Learning difficulties and developmental problems
- Gender re-assignment
What does private medical insurance include?
The exact details of what a medical insurance policy covers varies considerably from policy to policy. Standard policies cover surgery, consultations, nursing, and hospital charges. While comprehensive policies cover much more, including out-patient appointments, psychiatric treatment, and complementary medicine.
There are usually two elements: core cover, which is the base policy, and additional benefit options for you to choose from, to either reduce or enhance your cover. Read more on health insurance product options here.
Can I choose which hospital I am treated in?
All leading insurers offer at least two, usually three, different hospital lists for you to choose from when taking out a policy. The hospital lists have excellent national coverage, and you can usually choose between a list that includes regional hospitals only or extend the list to include all London hospitals. Whichever you decide on the hospitals local to you will be included.
If you add the ‘guided option’ to your policy, you will be offered a more restricted list of either hospitals or consultants as selected by the insurer. In most cases these will still be local to where you live. You will pay a reduced premium for this option. Read more on ‘guided options’ here.
How will my medical insurance policy be underwritten?
There are several underwriting options you can choose from dependent on your current situation. Some require you to disclose your medical history and others do not.
Moratorium underwriting (MORI) is the most common method for people taking out health insurance for the first time. For the first two years of the policy, you will not be covered for anything you have had symptoms, advice, diagnostics, or treatment for in the five years preceding the policy start date.
If you go two consecutive years without symptoms, advice, diagnostics, or treatment for a previous condition it will then be covered by the policy.
If you are switching insurers, you have the option to choose continued personal medical exclusions underwriting (CPME). This underwriting transfers you from one insurer to another and you can get cover for conditions you have had in the past.
Medical history disregarded underwriting (MHD) is available when joining a business health insurance policy or switching from one business policy to another. It is also accepted by an insurer when you switch from a business policy to an individual policy. Read more on underwriting options here.
Do I need to pay anything towards the cost of private treatment?
You may decide to add an excess to your health insurance policy to get a cheaper premium, this is the amount you will need to pay towards a claim. There are several excess options ranging from £100 to £5000 and they are paid once per year should you claim.
How can I get cheaper private medical insurance?
Morehealth can carry out a comprehensive market review on your behalf, even if you did not purchase your existing policy through ourselves.
We will check your existing cover to see if there are benefits you no longer need, negotiate a discount with your current insurer or suggest a cheaper alternative in the market. Read more on how to reduce your health insurance premium here.
What is the best way to get my health insurance premium down?
Switching you health insurance to a new provider will always result in the biggest savings. However if you are unable to switch due to ongoing conditions there are other ways to reduce your premium.
The main way to reduce your health insurance premium is to review your policy benefits such as out-patient cover and add-on’s such as therapies and mental health cover. Reducing your hospital list or adding the ‘guided option’ will also save you a significant amount of money. Morehealth can assist you with the review and action any changes you want to make for you.
Is it more expensive to purchase private medical insurance through a broker?
No, in fact quite the opposite. Morehealth receive the most competitive rates from the insurers and there are often introductory offers available. Once you have purchased a policy through us you will benefit from our negotiation skills at renewal to ensure you never pay more than you should.
Our service is free, we are paid a standard fee by the insurer for arranging your policy and this is not included in your premium.
Do I pay Morehealth for reducing my health insurance premium?
Switching your health insurance to a new provider will always result in the biggest savings.
However if you are unable to switch due to ongoing conditions there are other ways to reduce your premium. It is a good idea to review your policy benefits such as out-patient cover and add-on’s such as therapies and mental health cover. Reducing your hospital list or adding the ‘guided option’ will also save you a significant amount of money.
Morehealth can assist you with the review and action any changes you want to make for you.
What can Morehealth do to reduce my health insurance premium?
Morehealth can negotiate discounts with your existing insurer at your renewal. Through our close working relationships with all leading insurers, we have helped thousands of clients save money year on year. We can also review the policy benefits for you to ensure they still meet your needs.
Can I switch my private medical insurance before my renewal date?
Yes, most health insurance policies are on a rolling monthly basis so there is no need to wait until your renewal. We can review your policy at any time.
Is there a cancellation charge if I switch my private medical insurance?
As most health insurance policies are on a monthly rolling basis there is no cancellation charge for switching before your renewal date.
Even if you have already paid your premium annually in advance most insurers will refund you if you cancel before your renewal date.
Is there a cancellation charge if I change my mind?
There is usually a 14-day cooling off period for new policies and renewals.
Is there an upper age limit for having private medical insurance?
Insurers have no upper age limit for either taking out health insurance or switching from one insurer to another, except for VitalityHealth who have an upper age limit of 79.
Can I get cover for when I am abroad?
Some insurers offer travel cover as an optional benefit under their private medical insurance policies for an additional premium.
If you have a business health insurance policy, you can include emergency overseas cover on some plans.
You can also consider an international health insurance policy which will cover you if you spend a lot of time travelling. Our expert advisors can provide a quote for international cover and the travel add-ons.
Will private medical insurance cover me if I get cancer?
A health insurance policy will give you immediate access to private cancer treatment should you be diagnosed. It gives you access to specialist cancer centres and the ability to choose your own cancer specialist. Should you require it, chemotherapy can even be delivered in your own home.
What is different about the treatment for cancer privately?
You will be able to access breakthrough cancer drugs and treatments that are not available on the NHS. Some insurers will also pay for experimental treatment subject to proven effectiveness and on a case-by-case basis. Read more on cancer cover here.
What if my cancer is terminal?
All leading UK insurers cover your cancer journey no matter what path it takes, including cover for palliative care.
Does private medical insurance cover pregnancy?
Private medical insurance does not cover pregnancy and childbirth. However, some insurers will cover you should there be complications of pregnancy or childbirth. This is subject to consultant approval as often the NHS is best placed to cover maternity services.
Can I add my child to my health insurance policy?
Yes, and often insurers will allow you to add new-borns for free until your next renewal. Other insurers will also give you free cover for the eldest child where there are two or more children on the policy.
What age can a child stay on a family cover until?
If there is a parent or guardian on the policy children can be added from birth and remain on a family policy until they are 21, if they are in full time education, they can remain on the family policy until they are 24. Once they reach the age limit for a child on a policy, they will be offered their own policy.
What is the guided option?
Most leading insurers offer a ‘guided option’ which members can apply to their policy, resulting in lower premiums for their health insurance. With this option, the insurer offers you a select list of consultants and hospitals to choose from rather than the full list. Read more on ‘guided options’ here.
What is the six-week option?
The six-week option is offered by some insurers as away to reduce your premium. Should the NHS be able to provide treatment within six-weeks then you will go down the NHS route rather than claim privately.
If the waiting time for NHS treatment is longer than six weeks you will be covered for private treatment straightaway. Read more on how to reduce your health insurance premium here.
Is mental health cover included?
Mental health issues are becoming more prevalent, with one in four people reporting a mental health issue. This has led to insurers enhancing their mental health cover, and some mental health benefits are now covered as standard on a health insurance policy.
You can get immediate advice and support through the insurer digital GP services which are included as part of all core plans now. Read more on digital GP here.
Should you wish, you can choose a separate mental health add on which will cover you for in-patient and day-case mental health treatment.
What is business health insurance?
A business health insurance policy works in a very similar way to individual health insurance, but it is a plan you would take out to cover your employees. All the leading UK insurers offer business health insurance.
Having private medical insurance as an employee benefit can help to reduce the cost of sickness absence and ensure employers can attract and retain the best staff for their business.
The cover levels, benefit options and underwriting methods are different to individual policies. Our expert advisors can assist you in taking out a new policy or reviewing your current business health insurance policy. Read more on business health insurance here.
Is there a minimum number of employees required for a business health plan?
Most business health insurance policies require a minimum of two employees to be covered.
Can employees add family members to the plan?
Yes, although some insurers have minimum age limits at the date of joining.
Can you add and remove employees at any time?
Yes, as your employees leave the company, or new joiners start you can make changes to the plan. Morehealth can administer these changes for you.
Can employees continue private medical cover after leaving the company?
Yes, employees can transfer to their own individual policy, this is a good idea if they have pre-existing conditions they wish to continue cover for. Morehealth can assist with the transfer and the underwriting of the new individual policy.
Are pre-existing conditions covered on a business health plan?
This is more often the case than with individual health insurance but will depend on the underwriting you choose. Medical history disregarded underwriting covers pre-existing conditions but is usually only available on plans with around 20 members or more.
Can I choose different levels of cover for each employee?
Yes, you can tailor your plan to offer different levels of cover for specific groups of employees. You may have some business travellers within your organisation who would benefit from the travel cover option. Or it could be that you want to offer more comprehensive cover for directors and managers.
Is business health insurance a taxable benefit?
Yes, it is a taxable P11D benefit in kind. Companies will also pay employers national insurance contributions on the premium.