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Private Medical Insurance FAQs

Private Medical Insurance FAQs

What is private medical insurance?

When you receive medical care privately, the cost of your care could be covered by private health insurance (PHI), also known as private medical insurance (PMI). It may be a good idea to compare the available options so you can obtain the best coverage for you. This is because there are different levels of PHI that cover a variety of different requirements.

How much does medical insurance cost?

There is no one-size-fits-all response to this. This is because the price of private health insurance will vary depending on the individual and the degree of coverage needed. According to research about eight of the top health insurance companies in 10 UK locations, the average cost of private health insurance in the UK is £86.07 per month or £1,032.84 per year. Compare your options if you’re searching for a more precise figure. You’ll get a quote that is unique to you and your individual situation.

What can be covered by private medical insurance?

Depending on your specific needs, different health insurance plans offer varying levels of coverage. However, generally speaking, most policies could cover care received in private hospitals, private consultations, outpatient care, and digital GP sessions. Comparing your options and getting a customised quote to your needs may be a smart idea since more comprehensive policies may offer more benefits like mental health coverage if needed.

What is core cover?

Depending on the insurer, core coverage for health insurance usually refers to the basic coverage that applies to the majority of people. For instance, it might include physiotherapy, integrated primary care, inpatient day treatment, and outpatient consultations. If you purchase core cover, your insurer will be able to provide precise information about your plan.

What is outpatient cover?

Diagnostic procedures, consultations, and other appointments that don’t require a hospital bed overnight may be covered under outpatient coverage. Outpatient cover may also apply to minor treatments that can be finished and you are discharged the same day.

What is cancer cover?

Cancer coverage is a common feature of many private health insurance plans. It can be included as a standard benefit or an optional extra. You might be covered for diagnostic testing, surgery, radiotherapy, chemotherapy, and in-patient care, though different providers will offer different services. Cancer coverage is typically only eligible if you receive a diagnosis after enrolling in a health insurance plan.

Can I get cover for my pre-existing conditions? 

​​In general, organ transplants, routine pregnancy and birth appointments, cosmetic surgery and chronic or pre-existing illnesses are not covered by private health insurance in the UK. Depending on your particular insurer and policy of choice, you may or may not be covered for certain things.

What is moratorium underwriting?

Moratorium underwriting automatically excludes coverage for pre-existing illnesses from the previous five years. It only pays for illnesses that appear after the policy’s commencement date. If you had a pre-existing condition in the five years before obtaining coverage, you may be eligible for coverage. This is usually only if you have gone two consecutive years without using any medication, treatment, diagnostic procedures, or guidance. This might not apply to all providers. Therefore, it could be a good idea to inquire with them directly about your specific situation. Due to the nature of this underwriting process, no health history form or medical examination is likely necessary.

What is full medical underwriting?

Full medical underwriting usually requires a medical declaration about your past health including pre-existing conditions. While it is possible to negotiate inclusion for minor illnesses, excluded conditions are often excluded permanent. They often do not have a two-year window to pass before they can be covered. You would need to get in touch with your specific provider to learn this information regarding your unique situation. If you haven’t bought private health insurance yet, you can evaluate your alternatives and get a quote that’s specific to your situation here.

Is dental care covered by private health insurance?

Regular dental treatment is not often covered by basic private health insurance coverage. It may be possible to add it for an additional fee. However, certain private health insurance companies occasionally pay for hospital surgical dental care.

Is optical care covered by private health insurance?

Depending on the specifics of your policy, private health insurance may or may not cover optical care. Some insurers may offer coverage as part of your plan only up to a specified amount. Others may not offer any coverage at all. You might be able to add optical care as an add-on with some insurers for an additional fee as well. Compare your options if you’re looking for private health insurance that includes vision care so that you can get a quotation that is specific to your needs.

Is cosmetic surgery covered by private health insurance?

Private health insurance is made to partially or fully cover the expense of essential medical care, not elective cosmetic procedures. As a result, it is unlikely that insurance companies will pay for elective cosmetic surgery. This includes any corrective surgery to rectify a prior procedure.

Is fertility treatment covered by private health insurance?

Numerous private health insurance providers in the UK do not pay for the expense of infertility tests, IVF, or reverse sterilisation. This is likely because insurers classify it as a “lifestyle choice” and do not consider it to be medically required. In any case, talk to your healthcare provider to explore what may be done for you specifically to include fertility treatment as part of your healthcare plan.

Is pregnancy covered by private health insurance?

Many private health insurance providers in the UK won’t cover routine care and treatment, such as ultrasounds and antenatal care, but they will likely cover complications and emergencies. What this means for your particular cover will depend on your specific policy and insurer.

Is physiotherapy covered by private health insurance?

The majority of private health insurance plans cover physiotherapy by default. However, some still require you to add it as an added benefit. If you need physiotherapy for a pre-existing illness, this probably won’t apply. However, it’s important to double check with your specific policy.

Is Covid-19 covered by private health insurance?

The NHS was the only organisation providing Covid-19 testing and vaccinations at the height of the coronavirus pandemic. This is so that the UK government could keep an eye on things and make assessments. Even while the NHS and Public Health England continue to oversee all cases and resources, there are specific circumstances in which Covid-19-related illnesses may be covered by private health insurance. Depending on the insurer, some might cover the cost of PCR tests. As well as antibody tests, and mental health care for problems brought on by Covid-19.

What isn’t covered by private health insurance? 

Generally speaking, organ transplants, routine pregnancy and birth costs, cosmetic surgery and chronic or pre-existing illnesses are not covered by private health insurance in the UK. What is or is not covered for you will change depending on your particular insurer and policy choice.

What is joint health insurance?

Joint health insurance, commonly referred to as couples insurance, is a sort of private health insurance made to pay for some or all of your partner’s and your medical expenses if you receive private care.

Can private health insurance cover couples therapy?

Although some private health insurers cover mental health treatments for individuals, not many of them do so for group therapies, such as relationship counselling. If this is something you need, it is crucial to review the specifics of your policy.

What is family health insurance? 

Similar to individual health insurance, family health insurance works by having one policy that might cover you, your partner, and your children. This is rather than purchasing multiple plans for each member of your family. Depending on your situation and the insurer, a family health insurance policy may cover different things, but in general, it will cover medically essential inpatient, outpatient, and day-patient procedures. Pre-existing diseases, childbirth, and cosmetic surgery are frequently not covered by private health insurance.

What is child health insurance?

Child health insurance, like many other types of health insurance, is intended to pay all or part of the cost of private medical care if your child becomes ill. This could result in your child receiving treatment more efficiently, in private hospitals and clinics, and with support for the parents while your child is receiving care.

Can special needs children get private health insurance?

Yes, a lot of health insurance providers have policies for kids with special needs. However, these plans frequently don’t cover chronic conditions related to their additional needs that appeared before the policy started. It is recommended to check with your insurance company directly for specific information.

What is over 50s health insurance?

Over-50s private health insurance is a type of coverage only offered to those who are 50 years old or older. Inpatient, outpatient, and day-patient operations that are medically essential are typically covered, though coverage varies based on your situation and the provider as with other types of insurance. It is likely that cosmetic procedures and pre-existing conditions are not covered.

What is company health insurance? 

Employers may purchase company health insurance, a sort of business health insurance, to pay all or part of their workers’ medical expenses when they receive private care for conditions that appeared after the policy’s start date. In order to give their staff access to quicker care and maybe reduce the number of sick days, many firms often do provide workplace health insurance.

What is international health insurance? 

International health insurance often could cover both emergency and routine medical care when studying or working abroad for a prolonged period of time, usually more than a year. International health insurance is a long-term kind of protection, unlike travel insurance, which is meant to be a temporary measure for holidays.

Does private health insurance cover mental health treatment?

Like physical health conditions, mental illnesses are typically only covered by many private health insurance providers if they developed after you purchased the policy. When buying insurance, it is crucial to confirm that the insurer will cover any mental health issues you may have. If you have existing coverage and are unsure, contact your provider.

Does private health insurance cover preexisting mental health conditions?

Your health insurance policy’s method of underwriting will determine whether or not your pre-existing mental health disorders are covered. People with pre-existing mental health issues can generally still purchase private health insurance. Although it is common for them to be excluded from coverage, leaving only psychological illnesses that arise after the policy’s start date covered.

What is Continued Personal Medical Exclusions (CMPE)?

Continuing Personal Medical Exclusions is a sort of underwriting available to those looking to change their current private health insurance plan. It indicates that your new insurer will agree to insure you at the same level of risk as your previous insurer, maintaining any conditions already covered rather than having to start again.

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