There are 4.4m people on NHS waiting lists, according to NHS England

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Private Medical Insurance (PMI) covers you in a wide variety of situations, and knowing your options is the first step to get the coverage you need.

Comparing quotes with Healthplan not only will give you the best available prices, also our experienced advisors can tailor a list of quotes to your requirements. All you need to do is to call us on 020 3966 3735 or request a quote through our website and tell us about yourself, medical history and level of cover you want.

With us, you will find all options suitable for you laid out clearly — and you will not be left in the dark about costs, coverage options or anything else. Your appointed PMI Advisor will be able to compare deals, add extras to your policy and negotiate your renewal price directly with the insurers to ensure that you receive the right level of protection for the best possible price.

What is classified as a pre-existing condition?

Normally PMI policies are in place for individuals who develop a disease after they have taken out a policy. Any health-related disorders known or showing signs before acquiring a policy, considered as pre-existing conditions. Normally, it relates to a condition where you are already receiving treatment or care, or when the symptoms have already been identified.

Some insurers might even set the yearly premium higher or lower, and this is where your personal PMI advisor will thoroughly explain your options and help to read your policy documents before buying.

Will I be covered for pre-existing conditions?

With a growing NHS waiting list for treatments, many people feel motivated to take out private medical insurance protection for their pre-existing conditions.

Unfortunately, it is unlikely, but not always impossible, that they will be able to cover the same condition under their policy. Insurers usually do not cover you for a condition that you have received advice or treatment for in the last five years. It is common for insurers to cover a condition after a two-year period if you have not sought advice or treatment for it and you have a policy in place for those two years.

How does PMI work and how do you claim?

Health insurance covers the cost of PMI and usually people buy it to receive faster consultations and private treatments which take place in a private or NHS hospital.

To claim follow these simple steps:

  • First, visit your GP and find out if you need to be referred to the specialist
  • Let your GP know you have a PMI policy and get a referral letter
  • With the referral letter contact your insurance provider and give your policy number alongside with any details your GP provided.
  • Once all have been approved you will be able to book your treatments, scans or tests in desired hospital from your Hospital List.
  • All bills will go to your insurer for payment after your treatments

Any optional extras with PMI?

Some insurance providers may include these extras as standard while some may be excluded entirely. However, you’ll usually be able to choose to add them to your policy:

  • Dental cover
  • Optical cover
  • Physiotherapy
  • Psychiatric Consultations
  • Worldwide travel
  • Homeopathy
  • Mental health support

What isn’t covered by PMI?

Before you take out policy, it is very important that you have a comprehensive understanding of what is and isn’t covered. This normally depends on the type of cover you take out, however there are some things that are generally not covered on most policies and you will not be able to claim treatment costs:

  • Cosmetic treatment
  • Pre-existing conditions
  • Chronic conditions
  • Organ transplants
  • Self-inflicted injuries
  • Injuries related to dangerous sports or activities
  • Mobility aids
  • Substance abuse
  • Routine pregnancy

How to reduce the cost of your policy?

Your PMI policy cost can be reduced if you could consider:

Comparing insurers and policies: You should always compare providers and policies to make sure you are getting the best deal. We would recommend having a personal PMI advisor like ours who will get you the best quote for your budget.

Adding an excess: an amount that you agree to pay towards any treatments you receive is called an excess- the larger the excess the lower your annual premium will be. Of course, it is an optional and it can start at £100 and go up to £5000. Please make sure that the excess is affordable.

Taking a 6-week NHS wait option: a 6-week NHS wait option on your policy means that the waiting time on the NHS should be six weeks or less, then you will be treated via NHS not privately. By adding a 6-week option to your policy you can save significantly on your premium, sometimes by as much as 20% per month. It’s very important to understand the limitation you are applying to your policy.

Reducing the hospital list: by excluding from your list you can reduce the cost of your premium, as they are among the most expensive in the country to be treated at.

Switching providers: as mentioned earlier, comparing providers is one of the best ways to bring the cost of your premium down. By having a personal PMI advisor, you can have your policy automatically reviewed every year to see if there is a better deal available for you. Having our advice is the best way to keep your costs within your budget and most importantly, it is free of charge.

Do I have to renew my cover every year?

If you are approaching the end of your cover, it is very beneficial to start considering whether you are staying with your current policy provider or compare options elsewhere. Normally, insurance policies renew annually, and premiums change accordingly, it is important to ensure your cover is still meeting your needs and is affordable for you. Here at Healthplan, our experienced and professional advisors will tailor a specific policy to your requirements, ensuring you are paying the right amount for your chosen cover.

Can I add my partner and/or my children to my PMI policy?

Yes, you can add your partner and your children as dependents on your existing policy. Families save up to 10% by adding a child to their policy and up to 5% by adding a partner.

What is the age limit for health insurance policy?

In order to take a policy for yourself, you must be over 18, however, individuals under 18 can usually be added to their parent’s or guardian’s policies – again, it is better to check in advance than to assume. Some service providers may have higher age limits, but even if they don’t, you are most likely to pay more the older you are when you get your policy.

Should I pay monthly or annually for PMI?

You can decide to pay the insurance premiums on a monthly or annual basis, depending on your personal circumstances. Most insurance providers offer both payment options and will inform you of the cheapest one.

Will I have to do a medical to get PMI?

In most cases, it will be sufficient to fill out a medical history form, as insurers do not usually require a full medical examination for the cover to start.

PMI jargon buster

We simplified some of the insurance jargon and put together a list of the most common terms to make it easier for you to understand the information on these pages:

Certificate of insurance: This is a document provided by your insurer that gives a quick summary of your cover. It will contain your membership number that you will need to provide when making a claim.

Excess: This is the amount that you will need to pay as agreed before your insurer starts to pay out. You can reduce your monthly premium by choosing higher excess.

Exclusion: Specific conditions, treatments or selection of hospitals sometimes will not be covered by the insurance company and it’s called an exclusion.

Financial Conduct Authority (FCA): UK financial regulatory authority which regulates the financial markets to ensure that firms treat their clients equally and fairly, act with integrity.

Financial Ombudsman Service (FOS): is an independent official body for settling disputes between UK based financial companies and their customers.

Insurance premium tax (IPT): Normally it’s charged on general insurance premiums for people living in the UK

Underwriting: it’s a process used by all insurance companies to try to find out your health condition when you are applying for health insurance policy to determine whether to offer you a cover, what will be the price and what exclusions or limits will be applied.

Full Medical Underwriting (FMU): by choosing this option, you will need to complete a medical history declaration for you and your dependents you wish to cover. Policy provider will then speak to your doctor if necessary.

Moratorium Underwriting: by choosing this method you do not need to declare your medical history. Your policy provider will simply exclude treatment for any pre-existing medical condition and certain conditions you or your dependant has experienced or had symptoms prior to joining.

Day patient: Typically, you will receive a treatment during the day, without staying in the hospital overnight

In-patient: You must have been admitted to hospital and spent at least a night in hospital to qualify as an in-patient

Out-patient: if you are visiting a hospital typically for a diagnostic test or consultation it is considered as out-patient.

Self-pay: if you decide to receive private medical treatment and pay yourself for bill directly without claiming from your insurer considered as self-pay healthcare.

No-claim discount (NCD): a discount applied to your premium when no claim has been made.

Questions? Speak to a real person

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