Health insurance

Health insurance

Health insurance, or medical insurance, is an optional form of insurance in the United Kingdom that covers the cost of private health care and medical treatment in place of or in addition to National Health Service (NHS) treatment.

It covers acute conditions only, i.e. illnesses, diseases or injuries that respond to treatment over a short course of time and from which you will be able to recover to your previous state of health (for example a hip replacement or cancer treatment). The opposite of acute is chronic, meaning conditions that are ongoing or recurrent or become gradually more serious over time, for example asthma or irritable bowel syndrome. Chronic conditions are not covered by private medical insurance.

NHS waiting times can be long and access to the latest treatments limited, so private health insurance provides peace of mind that you will receive prompt and up-to-date care should you fall ill or have an accident. However, it can’t cover everything that the NHS covers, such as accident and emergency care, so it is therefore designed to supplement rather than replace NHS care. Also, you can’t refer yourself for treatment under your private health insurance policy – you’ll still have to go down the channel of visiting your general practitioner and receiving a referral from them.

There are various different channels through which you can purchase private medical insurance, such as direct from the insurer, through a broker or agent such as a bank or retail outlet, or through an independent financial adviser. There are also various methods of application, with many providers offering online quotes.

Various different levels of cover, from budget to wide-ranging, are offered by health insurance providers, so you can choose a policy to suit your personal requirements and financial circumstances. The majority of policies cover in-patient care (care requiring you to stay in hospital for one or more nights). Many also include day-patient care (surgery or treatment in hospital that involves close supervision but not an overnight stay) and some policies include out-patient care (clinical treatment that does not require you to be admitted as either a day patient or an in patient). Different insurers also have different terms and conditions on what hospitals you can use. Some have a limited range whereas others allow you to choose whichever hospital you desire.

Pre-existing conditions are not normally covered by private insurance. You’ll most likely have to fill out a medical questionnaire and perhaps be examined by a doctor before your policy is granted. Existing or previous illnesses or conditions must be declared. If you fail to declare your full medical history, your policy may be invalid and you may not receive any cover.

Diagnostic tests and consultations are normally included, as well as the cost of hospital accommodation. (You’ll probably have your own room with television and home comforts.)

Typical exclusions from private health care insurance policies include fertility treatment, routine maternity care, gender reassignment, HIV/AIDS, organ transplants, self-inflicted injuries or injuries resulting from dangerous activities.

You can change insurer at any time, but bear in mind that if you do, you may not be covered for the same conditions that your current policy covers.

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