Q: What is Private Medical Insurance?

A: Private Medical Insurance is an annually renewable insurance policy designed to cover the cost of private medical treatment for curable short-term illness or injury, commonly known as acute conditions, which start after your policy begins.

As a private patient you can often choose when the treatment will take place, the specialist that treats you and the hospital used.

It is important to remember that this insurance is not designed to replace the services offered by the NHS. Some such as Accident and Emergency are beyond the scope of private insurance.

Q: What are the benefits of private medical insurance?

A: There are a number of benefits of buying private medical insurance. Results from Bupa’s annual Health of the Nation survey claim that access to clean hospitals is the most important reason for taking out private medical insurance for 62 per cent of Britons. Added to this, the Association of British Insurers (ABI) also state that most people purchase the insurance to:

• Be reassured, knowing that treatment is available quickly if they become ill or are injured
• Have a choice about when treatment will take place, the specialist who treats them and the hospital; and
• Have the privacy of an en-suite room with a TV and other home comforts

Q: Why should I use a broker rather than going directly to an insurer?

A: There are many advantages to utilising the services of a broker rather than working directly with an insurer yourself. Probably the most important aspect is utilising the knowledge and expertise held by the specialist to ensure that you are purchasing the policy that nest matches your needs. The benefits you are eligible to claim will vary enormously depending on the type of cover you choose and there can be complex areas surrounding exclusions and benefit levels.

You should ask your broker to complete a comprehensive review of the market, they should then offer advice on the options that they feel best suit your needs - answering any questions and addressing any concerns you may have, so you can be certain you are making the right decision.

An industry respected and well established broker will also have good relationships with many insurers and by using their services you may be able to gain advantage of their buying power and negotiation skills within the marketplace.

There is also the element of saving you a great deal of time. Having a broker in place means that you can get them to do all of the work for you, reviewing the market, negotiating a discount with your current insurer if you are already covered and ensuring that you are opting for the right level of cover to meet your specific needs.

Regulated by the Financial Services Authority (FSA) any broker is required to operate in an honest and fair manner towards their clients.

Utilising the knowledge and expertise of these specialists doesn’t need to cost you anything; many brokers will offer this service at no cost.

Q: What will it cost me?

A: It would be unfair of us to claim there is a typical cost for private medical insurance. It is a very complex area and there are a number of factors that will determine your final premium. A basic example for a 45 year old man living in the Midlands on a comprehensive plan type would be £62.41 per month, but please note there are a number of areas that may affect this premium including:

• Age
• Gender
• Geographical location
• Medical History
• Social habits e.g. if you are a smoker
• If you currently have private medical insurance.
• Number of people on the policy
• The type of cover you want

Making the right decision to suit your specific needs and ensuing that you have the package that best suits your needs both from a cost and benefits perspective can be complicated. Speaking to an expert at The Private Health Partnership is FREE and the independent advice you will receive could prove invaluable.

Q: How do I decide what is the best policy for me?

A: You will need to consider what benefits are most important to you. There are lots of different sorts of policies from low cost, offering limited cover, to those that offer wide-ranging cover and benefits.

There are a number of things to think about when making your decision

• How much you want to spend
• Are you willing to pay for part of your treatment
• Do you want a choice of hospitals or would you be happy to use a designated hospital of the insurers choice
• What will you not be covered for
• Do you want your insurance to include out-patient and diagnostic treatment

Your answers to these and further questions could have a significant effect on the cover best suited to you.

There are such a multitude of policies available in today’s marketplace that seeking professional advice is essential to ensure that you are making an informed decision. The Private Health Partnership are able to provide independent impartial advice whether you are looking at private medical insurance for the first time, or would simply like reassurance that the current scheme you have is the best one for you.

Q: I like to concept of medical insurance, but it is an expense I can’t afford at the moment. Are there any alternatives?

A: Private medical insurance is not the only option available for those looking to invest in their health. There are a number of progressive services available that can wither stand alone or complement traditional health policies. One such example is a cash plan. Starting from just £2.00 per week they are designed to provide financial assistance for a wide range of everyday healthcare costs such as dental; optical; private consultations and therapy treatment, health screening and personal accident cover.

Cash Plans have been around for over 100 years and have a continued presence in today’s market offering an affordable way of providing you with a range of benefits that will enable you to access private treatment.

If you are considering investing in a cash plan, The Private Health Partnership can advise on a competitive scheme choice to match your individual need.

Q: Can I reduce my premiums?

A: There are options available to you if you would like to reduce your premiums. You could choose from:

• A reduced level of benefits, such as limited outpatient cover;
• A specific range of hospitals
• An excess on your policy, where you pay the first part of each claim
• A policy with ’co-insurance’ where you agree to pay a set percentage of any claim and the insurer pays the balance until you have paid an agreed yearly amount (after this the insurer pays 100%)
• A policy that offers a no-claims discount or a discount that depends on your commitment to health, including exercising regularly and not smoking
• Having treatment on the NHS , if this is available within 6 to 12 weeks of being diagnosed, rather than in a private hospital; and
• Receiving a discount by changing how you pay

Q: Can I decide which hospital I would like to use?

A: Schemes tend to have their own defined list of hospitals that are available to you as part of your cover. Many insurers will also apply A, B and C bandings to their hospitals lists and may apply these differing scales to different policies (see Glossary for banding clarification). If being able to use a particular hospital is particularly relevant for you then you need to ensure this hospital is featured on the insurers list prior to purchase.

Q: What are the common exclusions on medical insurance policies?

A: Private medical insurance (PMI) is designed to cover treatment for curable, short-term illness or injury - these are known as acute conditions. It is not designed to cover the long-term treatment of chronic conditions. The table below demonstrates what is usually covered, what is sometimes covered and then some common exclusions.

You will be provided with a summary of the key features of your policy from your insurer. This will set out any important or unusual limits of the policy, as well as the main monetary limits.