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The dos and don’ts of buying private medical insurance

Written by: Mark Todd
Funding cuts, staff shortages and other public health service factors are driving Brits to look at the benefits of private medical insurance (PMI). Here are the key points to understand.

Long gone are the days of PMI being a realm for the wealthy. In fact, the number of people looking to invest in PMI is on the up and our health insurance comparison site, ActiveQuote, has seen a 30% increase in enquiries this year alone.

As long as you realise there may be restrictions for some pre-existing conditions, securing private medical cover has never been more accessible or affordable.

With a wide range of cover available, getting the policy you require need not always be compromised by the quest for affordability either. In short, ensuring the cover you have in place meets all of your health requirements is about as personal as it gets in insurance terms.

For those taking out their first ever PMI policy this can also mean more questions than answers, so here are a few PMI dos and don’ts…


Look at private hospitals located nearby

Premiums can be reduced simply by restricting the list of hospitals you are willing to use. Savings of up to 25% can be made by specifying which providers you want access to. More often than not, a chosen hospital will already be on a discounted list, while the policy holder ends up paying to access a national list of private providers they are much less likely to use anyway.

Shop around

Most providers base premiums on the location and age of the applicant. Combine this with a host of discount deals available via different hospital groups and finding similar but cheaper cover from one provider to another becomes fairly commonplace.

Double check your ‘outpatient’ provision

Most plans involve fully comprehensive day and inpatient cover – that is the cost of care when a claimant is admitted to hospital. For everything else – consultant appointments, scans, blood tests, physiotherapy and more – outpatient cover is also provided. As the more common kind of claim, the ability to claim outpatient benefits repeatedly will be restricted by some mid-range policies, where fully comprehensive ones won’t.

Check and understand the form of underwriting provided

It is often a given that pre-existing conditions often cannot be insured (at least straight away). You may also, however, end up with some unwanted exclusions should you pick the wrong type of policy to begin with. It’s important you’re upfront about your medical circumstances to get the right policy for you and your needs.

Be clear about cancer

A cancer diagnosis is made every two minutes in the UK. Policy holders are often required to specify the level of cover they require in detail. Understanding what kind of treatment is available and being clear on your preferences is therefore advisable.

What experimental treatments would you want access to? Which advanced drugs would you like if needed? How long will the provider pay for these drugs? Would you like full palliative care? Going armed with these answers when getting a quote will help you narrow down your options.


Underestimate the excess

Excesses apply per person, per year in most cases. A family of four with a £500 excess charge could rack up a hefty bill over a year should more than one of those covered require medical treatment within that time. If you are mid-claim when your plan comes up for renewal, the excess involved then also applies to any further treatment required from the time the new policy takes effect. Make sure excesses specified are affordable, to avoid falling short of cash when you’re not well.

Pay for central London hospital coverage unless you’ll use them

The charges for treatment at these ‘elite’ hospitals can be much higher than the rest of the market. You could end up paying a lot more for something you have no intention of using or are highly unlikely to use owing to your geographical situation, for example.

Forget to check up on additional benefits

You may want to incorporate dental and optical cover in your policy, or if you’re planning a family in the future make sure complications during pregnancy are covered. Make sure to mention the specifics relevant to you and find out what’s included before committing to a chosen provider.

Wait for a condition to occur before looking for cover

The best time to insure yourself is when you are completely healthy. Most pre-existing conditions that you have suffered in the last five years, will rarely be covered for at least two years from the day you start the policy – many longer term or chronic conditions may not meet the requirements for cover either. Getting covered when you are fit is an effective way to ‘lock in’ your good health.

Assume big name providers are always the best

Just because a name isn’t familiar doesn’t mean policies aren’t watertight or generous to boot. Some of the best levels of cover in the market are provided by friendly societies operating across the UK. Their standards of customer service and cover levels are also generally excellent.

Mark Todd is private medical insurance team leader at ActiveQuote

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