When it comes to private health insurance, one size doesn’t fit all and choosing the health plan that is right for you and your family is not always easy, especially with the number of plans available on the market.
From health insurance excess and policy costs to medical underwriting and what you’ll be covered for, there are so many factors to consider when looking to buy a private medical insurance policy that best suits your individual needs. This is why we have put together 7 elements to look for when buying private medical insurance.
1. How to choose the right health insurance cover for you
When buying a private medical insurance plan, you usually have the option to choose from a range of benefits and different levels of cover. For example, your options may include:
The type of cover you choose will not only impact your premium, but also what you can later claim for on your health insurance plan. Therefore, it’s important to take the time to understand the cover available to make sure you are choosing the best options for you because you won’t usually be able to change these mid-contract.
Find out more about how health insurance works.
2. Understanding the health insurance excess
A health insurance excess is the contribution you are responsible for paying towards the cost of your medical treatment. Just like the level of cover, you can usually decide how much you want your excess to be, although a mandatory excess may apply. Your excess may be between £0 and £1,000 and what you choose will directly influence your premium. The higher the excess amount is, the lower your premium will be and the greater your personal contribution towards the cost of settling a claim. It’s important to factor in the health insurance excess when looking at your options for providers as this will be another expense to account for.
How does health insurance excess work?
Depending on the health provider you choose, your excess may have to be paid every time you claim or you may just have to pay it once during each policy year. The excess will usually have to be paid by each person who makes a claim on the policy.
When making a claim, the health insurance company will take your excess from the amount they have to pay for your treatment. They will let you know whether you need to pay your excess directly to the healthcare provider or if your excess will be deducted from any amount you are due to be reimbursed. You should therefore consider which type of excess payment method would best suit you.
3. Factors affecting your health insurance premium
Apart from cover level and excess, other factors can influence the price of your private health insurance too. Every health insurance company has its own criteria for calculating premiums, but the most important consideration is usually your age. The older you are, the more expensive your premium is, because the likelihood of requiring medical attention increases with age.
Some companies can also price your private health insurance based on where you live (charging you more if you live in expensive areas or bigger cities), your medical history or your lifestyle (such as smoking and drinking).This is why it’s worth doing your research and getting quotes from a number of health insurance providers. The cheapest option may not necessarily be the best for you so it's worth considering your personal needs and the plan that covers what is most important to you.
4. Cancer cover
Cancer, as long as it is not a pre-existing condition, is usually covered by most health insurance policies, although some policies may allow you to select a more comprehensive cancer cover if desired. Cancer cover will usually give you access to the most up to date private cancer treatment, including drugs and procedures that may not be available through the NHS.
However, during cancer treatment, you can use the NHS in tandem with private healthcare as some health insurance policies give you an NHS cash benefit if you choose to take treatment through the NHS rather than in a private hospital.
As the level of cancer cover and the cancer-related benefits vary across insurance providers and policies, it is important to always check the cancer cover of your health insurance plan before buying.
5. Health insurance underwriting
Medical underwriting is a term used by medical insurance providers to describe the way your medical history is used to evaluate your application for health insurance in relation to pre-existing medical conditions. The most common forms of underwriting are moratorium underwriting and full medical underwriting.
With moratorium underwriting, you won’t be asked questions about your medical history when you take out the policy. Instead, the insurer will automatically exclude your pre-existing medical conditions for which you have experienced symptoms, received medical advice, treatment, or medication in the previous five years. You may be able to cover a pre-existing medical condition if you do not experience a recurrence of that condition for a full and unbroken two-year period. Read more about moratorium underwriting.
Full medical underwriting
With full medical underwriting, you are asked to give details of your medical history when applying for cover. The information you give must be complete and accurate to the best of your knowledge and belief. Based on this, the health insurance company will decide if you have any pre-existing conditions it wishes to exclude from your policy which will then be shown on your insurance certificate. This means you will not be able to claim for treatment for any of these conditions or connected conditions. With this form of underwriting, you will know exactly what will and won’t be covered from the moment your policy starts. Read more about full medical underwriting.
6. Understanding your private health insurance policy’s exclusions
Each private health insurance plan has some medical conditions and treatments which won’t be covered by the policy. These exclusions can vary based on your health insurance provider, the type of policy or your underwriting method.
A full list of health insurance policy exclusions and other terms and conditions of your policy should be made available to you when purchasing the cover. Here are some of the more common general exclusions of private health insurance:
It’s important for you to understand what will and what won’t be covered so that you are prepared and happy with your private health insurance plan.
7. Your protection and rights as a consumer
If you have purchased a private health insurance policy in the UK, you have certain consumer rights you should be aware of:
The cooling-off period
As with any goods or services purchased at a distance, health insurance comes with the right to a cooling-off period. This is the period during which you can change your mind about your purchase. The minimum cooling-off period you should get is 14 days, but some companies may offer you longer. If you decide to cancel your policy during the cooling-off period, you have the right to a full refund as long as you have not used the policy to make a claim.
Because your health insurance company collects personal information including medical details from you, they must treat it confidentially and tell you what it will be used for, who it may be given to and in what circumstances. You can also ask to see any personal information an insurer has about you.
The private medical insurance market in the UK is regulated and authorised by the Financial Conduct Authority (FCA) so you can expect a high standard of medical care. That said, you may have a negative experience that you wish to address, in which case all health insurance companies should have a complaints procedure in place and details on how to complain should be included in their policy documents. If you are unhappy with any aspect of your health insurance policy or the company’s customer support service, you can make a complaint directly to the insurer, following their procedure.
If you are not happy with the insurer's response, you may have the right to refer to an Alternative Dispute Resolution (ADR) service which in the UK is usually the Financial Ombudsman Service (FOS). This information will normally be provided by your insurance company.
Switching to another health insurance provider
If you are thinking about switching insurance providers, it’s better to wait until the end of your current insurance contract (usually 12 months) to avoid incurring any early cancellation fees from your current provider. It’s important to check the benefits, terms and conditions, and cover limits from different policies in order to choose the cover that is right for you. Moreover, you should always check if all illnesses you are currently covered for will also be covered by your new insurer as this is not always the case.
What are good questions to ask health insurance companies?
When shopping around for your private medical insurance, it’s worth having a list of questions at the ready to ask each provider. Some typical questions might include:
- How much do your health insurance policies cost? – It’s important to clarify the total cost, inclusive of any optional extras you choose.
- What treatments are covered in the policy? – An essential question, particularly if your healthcare needs or medical background aren’t straightforward.
- What treatments are not covered in the policy? – While most providers have standard exclusions that apply to every policy, there will be some differences across all health insurance companies, so it’s important to get clarity on this from each provider you speak to.
- Can I receive treatment at a medical facility of my choosing? - Some health insurance policies may not cover care in all private medical facilities.
- How do I contact you if I need to make a claim or have any queries? – The provider should provide details of their customer service process, along with turnaround times for handling claims or complaints.
We hope we’ve answered all your queries relating to what to look for in private health insurance and you’re feeling more confident about the type of cover you might need. If you have any further questions, please do not hesitate to contact us and a member of our friendly team will be happy to help.
Looking for a private health insurance quote?
If you’re ready to apply for your UK private health insurance cover, get a free no-obligation online health insurance quote for you and your family or get in touch today if you’re looking for business health insurance.
Disclaimer: The information contained on this page is for general information purposes only and should not be taken as advice or a recommendation. If you require specific health insurance advice you can talk to an independent insurance broker. Click here for a list of health insurance brokers available in your area.