Five Things to Know About Private Medical Insurance


Private Medical Insurance could get you off a waiting list and back into good health allowing you to get back to work and to enjoying your life.

Our health is important to us, most of us want to rely on the NHS for everything we need but we are becoming increasingly frustrated at the time it takes to access our health services, be it for a GP appointment or to get an operation done or a consultant appointment in a timely manner.  For those that can afford it the top level of Private Medical Insurance (International or Private Client Private Medical Insurance) replaces everything the NHS does. For most, and it still costs a lot, a UK based Private Medical Insurance Policy tops up the NHS so we can get treatment for many conditions more quickly. For accident and emergency, cancer, strokes and heart attacks you can’t beat the NHS , indeed for these health conditions and any chronic illnesses we normally have to rely on the NHS as the Private Medical Insurance doesn’t provide cover for them (but may give access to cancer drugs not available on the NHS).

Here are five important things you need to know about Private Medical Insurance

1. It is expensive and will get more expensive each year

Private Medical Insurance is expensive to start with as it is an insurance cover that people claim on.

It gets more expensive as you get older as the probability of you making a claim increases as you get older. So much so that often those fortunate enough to be covered by a Group Scheme, paid for by their employer, find they can not afford to pay for it themselves when they get to retirement, the very time in their lives that they are most likely to make use of it. Expect increases in cost of double figure each year, a fair chunk of the increase is also down to high levels of inflation in the healthcare market.

Group Schemes paid for by an employer are normally much better value than individual policies, however still expect increases particularly if you have a stable workforce as everyone will be getting older every year.

Some insurers policies are individually claims related, that means if you make claims the cost of your insurance next year will go up. Some insurers have no claims discounts that you will lose if you claim.

2. Read the ABI Guide ‘Are you buying private medical insurance’

This is for individuals but if you are new to Private Medical Insurance and you are arranging cover for your business it will be well worth reading to help with your understanding. Written by the Association of British Insurers (last updated in 2017) it explains how Private Medical Insurance works

3. It won’t normally cover you for a condition you already have

You’d be surprised at how many people enquire about cover only when they have already suffered an illness, they then want the Private Medical Insurance to cover them.  It won’t. If you are in that situation, you can still pay for private healthcare from your own pocket.

When you apply for cover you will be offered different types of underwriting. If you want full certainty of cover then go through the Full Medical Underwriting Option. However, expect any existing condition and related conditions to be excluded. Moratorium Underwriting is a bit more difficult to get your head around. You don’t have to complete an in-depth medical questionnaire so it can be a convenient way of getting cover. With Moratorium underwriting the insurer won’t cover for conditions you have had medical advice for or treatment for in a period of time before the insurance starts, the advantage of this form of underwriting is that some conditions may well be covered after you have had the insurance for a period of years (normally two). So a condition for which you receive ongoing treatment or consultations is never likely to be covered but a one off condition, say an operation on a knee, could mean (rather than having any conditions relating to your knees excluded in the fully underwritten option) you knees could become covered at a later point.

4. It can be tailored to your situation and budget

Many of the insurers offer modular cover allowing you to add and take off blocks of the cover depending on the cover levels you need. This allows you to get the cover you need that suits you and your budget. Examples would be providing for mental health or not, or having access to all the top hospitals in London or not. Costs can also be managed by have an excess or a shared responsibility limit. This means you either pay the first part of any claims in a year, or a percentage contribution to any claims up to a limit in any one year. The larger the excess or shared responsibility limit the less you will pay for your insurance.

As an intermediary we spend a lot of time researching these options when customers first come to us as their Private Medical Insurance is getting expensive. Of course, as a whole of market insurance broker for private medical insurance, we can also check cost with other insurers and where appropriate recommend a change.

5. It is difficult to compare the products from different insurers

An old saying but it can be like comparing apples with pears. One insurer will have multiple options, then looking at multiple insurance companies can expand the choices to a point of not being able to compare and make decisions without then expertise of an intermediary.  You might expect me to say that this will come at a cost to you, however the great news for Private Medical Insurance is that the insurance companies normally charge the same to you as the consumer regardless of going direct or through an intermediary. This is certainly something that business is awake to but individual consumers often don’t know.

If you approach us about Private Medical Insurance we will give you advice. We will carefully review your needs and situation to find the best value cover for you. If you already have Private Medical Insurance, we will be happy to review your cover and where appropriate become your intermediary to assist you in the future with your existing insurer or where appropriate a switch to a new insurer.