Private Business Intermediaries

Health Insurance - A Short Guide

Health InsuranceEstablished in 2003, Freedom Health Insurance is a successful private medical insurance (PMI) provider bringing its clients innovative UK and international health insurance products at competitive premiums. 

As a customer-focused company with a genuine passion for health insurance, we understand how important it is to continuously provide exceptional levels of service to all our customers.  With our experienced teams based in Poole, Dorset, Freedom is a professional business giving the personal service you would expect. Freedom’s UK policies are reinsured by A-rated reinsurers giving you the all-important peace of mind that you are dealing with a secure and professional insurer.

Choosing a health insurance policy can be daunting with a large range of options and levels of cover available. Freedom Health Insurance aims to be open, honest and clear about our cover and costs. We simplify the process of choosing health insurance cover with an easy-to-use online quote tool where you can build a policy that is tailored to your budget and needs and review actual premiums with no obligation.

In this guide we aim to explain the key things to consider in an open and transparent way. Before buying any policy it is vital that you read the policy wording, key facts and Association of British Insurers (ABI) Guide to Private Medical Insurance, as they give more specific information about the policy you plan to buy.

At Freedom Health Insurance, we are happy to talk you through any aspect of private health insurance you don’t understand. Just give us a call on 0800 999 2013.

Introduction

This guide to health insurance in the UK is, we hope, an open and informative review of the key choices currently available. Private medical insurance can be a complex purchase so it is important you understand what you are buying. If you have any questions, your provider will be happy to explain anything you don’t understand. It is VITAL when buying any insurance product that you read and compare the  Health Insurance - Key FactsThis guide can only generalise so please ensure that you understand in detail what your needs are so that you can judge how well any product meets your individual requirements.

Private Medical Insurance (PMI) is not for everyone, and individuals’ needs can vary enormously, so it is good to understand the options before deciding what sort of cover, if any, will suit your needs and budget.

Freedom Your Choice

Cover to use your money your way

  • Flexible insurance plan that pays you a cash lump sum for eligible private treatment or gives you 50% of the cash benefit when choosing NHS treatment instead
  • Freedom pays you directly for the cost of all eligible in-patient and day-patient treatment (when you are admitted in a hospital)
  • You choose when and where you're treated, in any private hospital either in the UK or abroad
  • All eligible out-patient charges (when you are not admitted in a hospital) are paid directly to the hospital, saving you time and hassle
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Freedom Elite

Health Insurance Created by You

  • Elite is a conventional plan - similar to the famous name plans you will know, but without the overheads of huge advertising budgets. We set out to offer you great value year after year
  • Wide range of options so you can choose only the cover that you want to fit your needs and your budget
  • A solid, traditional policy recommended by experts nationwide
  • Contact us for a quote to see just how competitive we can be for your new policy or at renewal
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Your Choice & Elite

Quality Cover

  • Unlike some companies, we don’t give you a big no claim discount to make our premiums seem good value at the start – we try to provide you with value for money every year you are insured with us
  • Important cancer cover is included with all of our policies
  • The real test of any insurance policy is when you need to claim.  Our experienced claims team are friendly, helpful and knowledgeable, with a passion for ensuring that all our customers feel valued and supported at all times.
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Types of Health Insurance

Here is a list of the main types of cover available. You will find more detailed information on each one below, together with some things you may wish to think about.

Traditional Medical Insurance or PMI (Private Medical Insurance)

PMI was made famous by BUPA. This type of conventional medical insurance is available in many different forms, with cover levels varying from minimal to extremely comprehensive (often with premiums that match). This type of insurance usually pays the hospital and consultant directly for your private treatment. Some insurers offer a large no claim discount on joining that can result in greatly increased premiums after a claim. For more information see below. Freedom’s traditional medical insurance product is called Elite, and is one of the few not to start with artificially discounted premiums that can go up significantly after a claim. At Freedom Health Insurance, we aim to offer you great value every year, not just at the start of your policy.

Freedom Elite is comparable against the famous name insurers mainstream cover, yet offers outstanding value.

Company Medical Insurance

Company Medical Insurance is similar to traditional medical insurance but provided by a company to their employees, often as a taxable benefit. Large company schemes have the advantage of spreading the risk over a number of people and can often benefit from very competitive premiums as a result. The bigger schemes can also benefit from a type of underwriting called ‘medical history disregarded’ (MHD) – this means that new employees can be added to the insurance and all their pre-existing medical conditions can be covered immediately irrespective of their previous medical conditions or claims.  Smaller company schemes and individual policies are usually unable to cover pre-existing conditions.

Freedom Health Insurance offers our traditional Elite plan, our self-pay Your Choice plan and our international plan, Freedom Worldwide, to businesses large and small.
 

Cash Plans

Cash plans can be a lower cost option for medical insurance but don’t usually give the same range of benefits that a traditional PMI plan can offer. Some cash plans offer little more than token sums of money when the policyholder becomes unwell, while many offer no access or funding for private treatment whatsoever. Cash plans can be useful however to help cover living expenses whilst unwell or contribute towards a large dental bill for example.

Freedom does not offer cash plans, as we believe they offer little real cover for the costs of serious illness. Cash plans should not be confused with quality self-pay cover, such as Freedom’s Your Choice policy.

Self Pay

Self-pay is an innovative type of health insurance that is becoming more popular. The leading products such as Freedom’s Your Choice policy, offer a real alternative to a conventional policy. Whilst relatively new to the UK, self-pay plans are well established in the USA as a primary way of reducing the costs of private health care. A good quality self-pay policy will pay a cash lump sum for private medical treatment or pay a (usually smaller) cash lump sum if NHS treatment is more convenient for you.

The Freedom Your Choice plan is, we believe, one of the most attractively priced and generous self-pay plans available in the UK.


Travel/International

Leaving the UK for work or pleasure also leaves behind the NHS and most private medical insurance cover. It is vital that anyone travelling outside the UK ensures they have health cover in place whether they are leaving for a holiday, longer trip or if working abroad. In European Economic Area (EEA) countries, the European Health Insurance Card (EHIC) provides access to state-provided health cover at a reduced cost or sometimes for free. Whilst the EHIC card is worthwhile, it won’t help if you need to be flown home for specialist treatment or allow you to access to private cover where the state funded health care is poor.

We do offer travel insurance if requested by our clients, however our real focus is our international plan, Freedom Worldwide, for those who live and work internationally and need good levels of healthcare cover wherever they are.

 

Private Medical Insurance in Depth

It was once easy to buy a comprehensive health insurance policy and almost opt out of the NHS altogether except for primary/GP care. However this was only affordable to the very well off or those lucky enough to have a company pay for the cover.

With health costs spiralling, the costs of cover generally rose over time and became out of reach to many. To help reduce premiums, the private health insurance industry has produced a long list of options to help reduce the cost of cover and bring it back within the reach of more of us.

Freedom’s Elite policy aims to deliver a quality range of cover with options to customise to your needs at an attractive price.
 

No Claims Discount

This is one way that some providers reduce premiums at the start of the policy to encourage customers to take out their cover.  It is often not clear exactly what impact this ‘discount’ will have over the term of your policy though, and you may only discover the true premium when you have made a claim and your costs go up significantly. Often, the premiums don’t come back down again until you have been ‘claim free’ for an extended period of time. This type of policy may discourage the insured person from claiming, making the whole point of having the cover questionable. You never know when you may need treatment and the time following a serious illness is not the best time to be facing escalating health insurance costs.

Freedom Health Insurance doesn’t offer a no claims discounts as we try to ensure fair premiums at the start of your policy and at every renewal.
 

Excess

Adding an excess to your policy is a good way of keeping costs down. An excess is the sum of money the insured party will pay towards their claim (either per person per year or per claim) – it can range from zero (making your premiums higher) to several hundreds of pounds (making your premiums lower).

For example, imagine you had a policy excess of £250. It’s not uncommon for an out-patient appointment with some simple tests, to cost in the region of £200. Many specialist consultations result in no further treatment or investigations. In this example, the insured person with a £250 excess per claim, would pay for this initial consultation themselves if they chose to have the consultation privately. Under these circumstances, there is generally a smaller chance of the insured person to see a series of private consultants for a range of issues just because they are insured. This enables the insurance company to keep the premiums lower. The benefit to the insured person of taking out an excess is that premiums will be lower, whilst ensuring private medical insurance cover is in place to allow private treatment for any significant claim, such as an MRI scan or a surgical procedure.

Using our Online Quote Tool, you can change your excess and see instantly what impact changing your excess level has on premiums for both our Elite and Your Choice products with no obligation.

 

Six Week Option

The idea behind these plans is to provide cover in the event that the NHS cannot provide the treatment you need within six weeks. Central government targets place a great deal of pressure on the NHS to keep waiting lists as short as possible, so in reality these plans sometimes don’t need to pay out. If the NHS should really struggle going forward, waiting times could grow and this type of plan could come into its own, but for now they probably don’t represent good value as you may not get any real benefit.

Freedom Health Insurance doesn’t offer a Six Week Option policy as we don’t consider they presently provide worthwhile cover.  We believe that if you pay your premiums for private medical cover, you should be entitled to private treatment regardless of whether the NHS is able to meet its targets for treatment. When you are unwell, uncertain treatment dates is one stress that you just don’t need.

Hospital Lists/Trust Care

A great way of keeping costs down is to restrict the hospital list. These are the hospitals that the policyholder can access using their plan.

The most extreme version of this option is to restrict the insured person to have treatment in private wings of NHS hospitals only. This can suit some policyholders. Having a private medical plan with out-patient cover and an NHS Hospital-only restriction, will allow rapid access to a consultant and should an in-hospital stay be required, this will be in the private patient wing or ward of an NHS hospital, usually with private rooms.

One note of caution though,  if your chosen consultant does not practice at the hospital on your list, you probably won’t be able to use them. Whilst many consultants work in the NHS, not as many treat their private patients in NHS private beds. So choose with care, especially in London where an extended hospital list may be a good investment.

Freedom’s Elite policy has a good range of hospitals on its most basic list with only a few of the very highest price facilities listed separately as an option.  None of Freedom’s plans are restricted to NHS-only pay beds, but automatically cover every NHS pay bed in addition. Our Your Choice policy pays a set cash sum for treatment so you are free to choose better value hospitals (NHS pay bed or rural private hospital) and keep any left-over benefit to spend yourself if that is your preference.  If you choose to use a more expensive facility, you can simply pay the difference.

In-Patient Only

This is an effective way to keep your costs down whilst ensuring cover for the major, and often more expensive, in-patient treatments. If you choose only to be insured for in-patient cover, you won’t have cover for out-patient consultations (i.e. any treatment in the hospital that doesn’t require you to be admitted for the day or overnight).

Your GP can refer you to an NHS consultant for your diagnosis, or if you prefer, you can pay to see a consultant privately. You might choose to pay (typically a few hundred pounds) for a couple of immediate private consultations with the consultant of your choice, knowing that if expensive in-patient or day-patient hospital treatment is required (typically costing thousands of pounds), you will be covered for the major expenditure.

Freedom Health Insurance offers in-patient only cover as an option, but we recommend taking out-patient cover too where this is affordable. We try and keep premiums as low as possible to allow this. Some insurers will increase premiums after a single small claim, which again, we try to avoid.
 

Out-Patient Only

This is a new option and one that you may choose to avoid. This type of policy, often offered to tempt buyers with low premiums, only pays for out-patient consultation appointments and tests. If you need any type of treatment in hospital, you will not be covered. The main issue with this type of policy, occurs when you are diagnosed by a private consultant. That consultant cannot then move you to the top of their NHS waiting list, meaning that although you may have received fast access to a diagnosis, you will then join the same NHS waiting list as those with no insurance cover. In fact some NHS trusts prevent people with a private diagnosis from joining the waiting list for treatment, without first being recommended for treatment by an NHS consultant which could delay treatment even further.

Freedom Health Insurance does not offer out-patient only cover; we think it is full of pitfalls and does not cover the main costs associated with healthcare, i.e. day-patient and in-patient hospital treatment. We do however offer Your Choice, our affordable self-pay cover which pays cash sums per condition with an out-patient option that supplements the core in-patient benefits.
 

Pre-Existing Conditions

It can be very difficult to get cover for any condition for which you have experienced symptoms, received medication, medical advice or treatment for several years (usually five years), whether the conditions has been diagnosed or not. A new insurer will usually exclude further treatment for a condition that is pre-existing, until a number of treatment and symptom free years have passed. Never try and get cover for a condition you think or know you have. Not being 100% honest and open with your insurer will simply lead to any claim being denied. If you make a claim where there is any doubt, your medical record will be examined and if your condition is found to be pre-existing, your cover will be void.

The best rule is to declare everything you can remember. You can ask your GP for a copy of your records so you can accurately declare all your previous conditions. If you declare that you had asthma as a child but are now symptom free, that may be accepted, so if you get a respiratory condition whilst insured, you would be covered, whereas if you had not declared the illness, your claim could be declined.
 

Chronic Conditions

To find out more about what chronic conditions are click here

This subject can be a complex area. Thankfully, cancer has been excluded from most chronic conditions lists, with reputable insurers covering cancer for as long as treatment is required. However, health insurance policies do not often cover other chronic conditions. Once all attempts to cure an illness or injury have been exhausted (usually excluding cancer) private cover will cease. Why is this the case? Simply put, once there is no more that can be done to cure a condition, and that medical support is aimed at relieving long term effects, UK Medical Insurance cover ends for that condition so that costs of insurance is not out of reach to all but the most well off. However whilst cover for the chronic aspects of a condition may not be covered, any changes that do require intervention may well be covered. This is one area where you need to read the key facts and small print of the policy as cover is varied. Suffice to say that quality insurers will cover the acute phase of an illness and significant changes, whilst they usually will not cover the day to day ongoing maintenance treatment. An example is asthma; if you are newly diagnosed and require investigations and treatment these would be covered as per the level of cover selected, however once diagnosed and stable, the routine checks that will probably last the rest of the patients life, will not be covered privately. Yet if a sudden change in the condition were to occur or a new treatment option became available, this may be covered depending on the nature of the cover selected.

Freedom Health follows industry best practice to cover acute but not chronic stages of treatment. Look at the policy summar and policy document for more information.

Just because you have a chronic or long term condition should not put you off medical insurance, whilst that condition, that hopefully you have well under control thanks to care from the NHS, other conditions not excluded by your chronic condition, will be covered. You may wish to take out cover whilst young and fit to ensure you're covered for any conditions that occur in later life.

Freedom Health's policy on pre-existing conditions is in line with other insurers and we work to best practice to reduce abuse of insurance which pushes up costs for all.
 

Switching Insurers

This is often difficult for reasons that we will explore, so it’s key to try and select the insurers and policy that is best for you from the outset. Many people find themselves 'locked in' to a policy having made a claim, as once you have made a claim any new insurer would usually exclude cover for that condition until you have been symptom free for two years.