Health Assurance Guide

Private health insurance is designed to cover treatment for curable, short term illness or injury. The majority who own health insurance do so to have the peace of mind that in knowing that they can receive prompt treatment for their ailments.

Private health insurance also allows policy holders the choice of treatment and in which hospital they can receive it, bypassing the inconvenience of waiting lists that plague the NHS. You should note however that private insurance is not designed to replace all of the services that are available on the NHS. This is because certain illnesses and treatments, usually pre-existing conditions, will not be covered by your insurer.

It also does not cover GP services, ongoing treatment for an incurable disease or accident and emergency admission. It also does not cover dangerous hobbies, self inflicted injuries, normal pregnancy, sex changes or AIDS.

What level of cover do I need?

There is a vast array of schemes on the market all offering different levels of cover. Generally speaking the low cost schemes will be more affordable but offer a lower level of protection, whereas the more expensive schemes will offer a wider ranging level of cover and benefits.

Some providers will not offer overseas cover. You should consider which areas of cover are most applicable to your needs and be sure to read your policy documents carefully before signing.

Some policies will cover you as an in-patient or day patient, whereas others will not cover for out-patients, which generally include chemotherapy, physiotherapy, radiotherapy and psychiatry.

How much does it cost?

This can vary depending on your level of cover, age etc. As a rule of thumb as you get older you will become more likely to require medical treatment at some stage and your insurance premiums will be higher to reflect this.

Premiums are decided on your individual circumstances and are calculated based on your age, medical history and health amongst other factors.

How am I assessed?

There are two types of assessments that insurance companies use when considering your application – ‘moratorium’ or ‘medical history declaration’.

A moratorium is when you are required to fill in a form without details of your medical history. The insurance company will not provide any cover for a medical condition which existed in the last 5 years.

A medical history declaration is when you have asked to provide full details on your medical history and you may also be subject to a medical examination before being granted the policy. If you do not disclose certain information you may be excluded from future payouts. It is possible your insurer may also write to your doctor for more information.

Where do I purchase my insurance?

You can purchase your insurance either direct from the insurance company, through an independent advisor or alternatively one of the insurers agents such as banks or shops.

There are a number of comparison websites which allow you to compare policies from a range of different providers.

How do I make a claim?

All medical treatment must begin via a referral from your GP to an appropriate specialist (apart from A&E).

Before your receive any private treatment you should notify your insurance company to ensure that you are covered for the treatment you will receive. If you have the appropriate level of cover your insurance company will issue you a claim form to initiate proceedings.