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Private medical insurance: five points to consider before buying

Paloma Kubiak
Written By:
Paloma Kubiak

There are a number of different options for those looking to take out private medical insurance (PMI). Here are some key points to consider before taking out a policy.

1) Look at the underwriting

There are two main ways individuals can be underwritten for PMI: on a moratorium basis or on a full medical underwriting basis. Which is best for you depends on your medical history and what you need the cover for.

Full medical underwriting will typically examine your whole medical history and potentially exclude serious health issues you’ve had in your life, but may be more lenient for less serious illnesses or injuries.

Moratorium underwriting will simply look back and exclude any medical condition you’ve had recently, usually within five years, no matter how serious or minor.

2) What additional benefits will I get?

Some insurers now offer very good additional benefits alongside the policies, such as remote private GP services available over the phone or through an app. Others will allow you to skip the need for an NHS GP referral for cancer symptoms and musculoskeletal conditions.

3) Benefits or a discount for using the NHS (where appropriate)

Some policies offer a NHS cash benefit, where you’ll receive a payment for each night you spend in an NHS hospital if you decide to use the NHS for treatment rather than going private if you’re happy to do so. Others offer a six-week NHS wait option, which can lower the cost of cover if you’re willing to use the NHS for any treatment for which the waiting list is under six weeks. For anything where the waiting list is more than six weeks, you automatically get to use your PMI.

4) Check the core benefits you’re entitled to

While additional benefits are great extras, and the NHS can be used to supplement your private medical treatment, most people buy PMI essentially so they have access to private healthcare should anything go wrong.

For that you need to check the core benefits, such as the level of outpatient cover (how much your insurer will pay out for outpatient treatment such as tests and scans), and hospital lists, which determines which UK hospitals you’re entitled to receive treatment in. Some are more expensive than others and so they’re typically listed by ‘tiers’, with all the top central London hospitals being the most expensive.

5) Use an independent adviser

We recommend using an independent expert as some companies only offer access via intermediaries, so you may not be getting access to the whole market if you look yourself. Plus  experts know the market inside out, so are well-placed to build a policy suited to your needs in what can be the complicated world of PMI.

Nadeem Farid is head of employee benefits at Drewberry