Updated August 2018

Your 5 Minute Guide to Private Medical Insurance

What is Private Medical Insurance?

Private Medical Insurance (PMI), also known as Private Health Insurance, is designed to pay some, or all, of the costs of your medical or surgical treatment and expenses for acute conditions (usually defined as a disease, illness or injury) that are likely to respond quickly to treatment, allowing you to return to a fit state of health.

Basic policies normally cover essential treatment such as hospital care and surgery. More comprehensive cover may include specialist therapies and complimentary medicines such as chiropody and acupuncture. Depending on the type of cover chosen, you could pay your medical costs ‘out of pocket’ and then be reimbursed, or your insurer will make payments directly to the provider.

Is Private Medical Insurance right for me?

It’s all about choice. Choice in the level of care you get and choice of how, where and when it is provided. But it may not suitable for you. The UK’s National Health Service (NHS) delivers free treatment at the point of service, for most UK residents, although there may be some costs involved depending on the type of treatment and your circumstances. PMI is not designed to replace any NHS services. However, you may not know how long you will be on a waiting list and therefore in those circumstances opting for Private Medical Insurance could likely aid your recovery.

But there are also a number of typical policy restrictions of which you should be aware. For example, the following conditions and services, are not normally covered by PMI:

  • Pre-existing conditions
  • GP services
  • Long-term, incurable illnesses
  • Accident or emergency admission
  • Self-inflicted injuries
  • Out-patient drugs
  • HIV/AIDS
  • Infertility treatment
  • Normal pregnancy
  • Cosmetic or laser eye surgery
  • Kidney dialysis
  • Organ transplant
  • Injuries sustained from dangerous hobbies
  • Pre-existing conditions
  • GP services
  • Long-term, incurable illnesses
  • Accident or emergency admission
  • Self-inflicted injuries
  • Out-patient drugs
  • HIV/AIDS
  • Infertility treatment
  • Normal pregnancy
  • Cosmetic or laser eye surgery
  • Kidney dialysis
  • Organ transplant
  • Injuries sustained from dangerous hobbies

What does Private Medical Insurance cost?

Cost is a very important consideration. There are relatively low cost private medical schemes that offer limited cover but schemes offering comprehensive cover can be expensive. Remember that private healthcare for some serious conditions such as cancer can cost hundreds of thousands of pounds.

Initially it's worth checking to see if you're already (adequately) covered by your employer (or your partner's employer) through a company private medical scheme.

If you decide that PMI is the right choice for you, then shop around as the cost can vary considerably. And prices aren’t fixed. Be prepared for premiums to increase as you age. However there are ways to help reduce your premiums, such as:

  • Agreeing an excess on your policy
  • Not specifying a particular hospital for treatment
  • Checking whether your insurer offers discounts for paying for the whole year upfront
  • Demonstrating a healthy lifestyle
  • Paying for part of your treatment
  • Choosing a lower grade of hospital accommodation

Some insurers may also reduce premium costs if you choose a ‘six week option.’ This means that if the NHS waiting list is six weeks or under, you agree to be treated by the NHS.

Please note that this information is not fully inclusive and is intended to provide general information only. It does not constitute personal advice. Your requirements will depend on your unique personal circumstances. We recommend you talk to your Brunsdon Financial Adviser for further information and qualified advice.

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