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Private Medical Insurance – what does it all mean?

Private Medical Insurance – what does it all mean?

private medical insuranceIf you’ve ever looked into private health cover yourself, you may well have found yourself bemused by the sheer quantity of jargon involved.

Insurance is a tricky business, and the technicalities of underwriting and individual cover can be mindboggling.  That’s why we offer our independent service free of charge, and with no obligation to buy.  Sometimes you just need an expert to help you work things out.

However, I am well aware that many people like to price compare or research the market on their own, before approaching a broker.  So if you’re interested in private medical insurance, here are a few things you might need to know, when applying for cover.

The type of underwriting you go for makes all the difference

Underwriting is basically a term used for how your insurer will use your medical history.  There in enough to be said on this subject to fill an encyclopaedia so I shall just touch on the three main terms.  A moratorium is a common, and cost effective option.  This means you will not be covered for all conditions affecting you within the past 5 years but, once you have been free of all treatment or consultation for two years after your plan starts, they may then be included.

You could also choose a Fully Medically Underwritten policy which also requires you to declare all previous conditions but the insurer will then decide upfront whether to cover it or to exclude it, either completely or for a period of time.

Finally, if you are buying a corporate policy for your employees, and have more than 20 to cover, you can choose Medical Health Disregarded which simply means everyone is covered regardless of individual medical histories.

Watch your excesses

As with any insurance policy, you will be able to choose an excess.  This can dramatically alter the cost of a policy as you can opt for as little as £50 or as much as several thousand.  However, do check how an insurer applies the excess.  It will normally only be applied to the first claim of each year, but some providers apply the excess to each and every claim.

For affordability – consider co-payments

This is a policy in which you establish a co-payment amount.  This is a sum of money you agree to contribute towards the cost of treatment.  For each claim you will only pay a percentage of the cost, until your co-payment amount is exhausted – at which point, the provider takes on the remaining cost.

Check Provider Partnerships

Some providers establish partnerships with specific clinics which offer them cut price services.  This is fine if the partnership organisations are nearby and ones you favour but if not, and you need to claim, you will find your provider insists you are treated with their partners and it could be restrictive.

Beware of shortfall

Many policies have a maximum amount the will pay out on a consultation or procedure and if you have chosen a consultant or clinic with higher fees than your policy’s maximum, you will be liable for the shortfall.  You can always choose a cheaper service, of course, but it’s good to be aware from the start.

I hope this makes sense of some of the terms you might have seen when searching for policies, and, once again, please don’t hesitate to contact me directly should you have any other questions.

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