Private Medical Insurance

Private Medical Insurance is designed to provide the best specialist care

by granting access to private hospitals and bypassing NHS waiting lists.

What is Private Medical Insurance?

Private Medical Insurance (PMI), also known as Private Health Insurance, provides coverage for the cost of private medical treatments for acute conditions that arise after your policy begins. It gives policyholders access to faster medical care, choice of specialist and hospital, and tailored treatment options.

PMI is flexible and can be customized based on individual needs and preferences, with various levels of coverage and costs to suit different customers.

Private Medical Insurance Coverage Includes:

Hospital Admission Costs

Diagnostic Tests (e.g., MRI and CT scans)

Surgery Expenses

Consultant Fees

Hospital Accommodation and Nursing Care

Cancer Drugs (including some not available on the NHS)

Additional Coverage Options Include:

Outpatient Consultations (Partial or in Full)

Therapy Cover (Partial or in Full)

Mental Health Cover

Physiotherapy and Chiropody

Dental Care

Audio & Optical Cover

Why Buy Private Medical Insurance?

Private Medical Insurance (PMI) can serve as a valuable supplement to the NHS by providing faster access to private treatment and coverage for services, including certain cancer drugs and treatments that may not be available through the NHS.

Key Points About PMI Coverage:

Acute Conditions: PMI is primarily designed to cover acute conditions that occur after your policy starts. These are short-term illnesses, injuries, or diseases that respond quickly to treatment and aim to return you to full health.

Exclusions for Chronic Conditions: Insurers typically exclude chronic conditions, which are long-term illnesses or diseases that require ongoing management or have no known cure. These conditions often need continuous monitoring, control of symptoms, or rehabilitation.

Pre-existing Conditions: Most insurers will not cover pre-existing medical conditions, meaning any illnesses or conditions you have experienced before the policy begins. However, some insurers offer limited cover for pre-existing conditions if you pay an additional premium or meet specific eligibility criteria.

PMI is a flexible solution that provides quicker access to healthcare services for acute issues, offering peace of mind and convenience, while still allowing patients to rely on the NHS for long-term, chronic conditions.

Types of Policy

Individual or Family Policy

When applying for an individual or family Private Medical Insurance (PMI) policy, you will need to provide specific information to the insurer. It’s essential to answer all questions fully and accurately to the best of your knowledge. Insurers will only request information that is relevant to the coverage you are applying for.

There are two primary methods that insurers use to underwrite your PMI application: Full Medical Underwriting or Moratorium.

Full Medical Underwriting

Full Medical Underwriting (FMU)

requires you to disclose your medical history at the time of application for health insurance. When applying, you will answer a series of questions regarding any current or past medical conditions.

Typically, any pre-existing medical conditions will be excluded from coverage; however, you will be covered for new, unrelated medical conditions that arise after your policy begins.

It is crucial to answer all questions truthfully and thoroughly, as inaccuracies can affect future claims and may result in your policy being canceled. If you're uncertain about whether to mention something, it’s best to include it for added reassurance.

By choosing FMU, you gain a clear understanding of what is covered from the start date of your policy, providing certainty about your health insurance. However, this process may be more time-consuming than moratorium underwriting, as it involves completing a health questionnaire and possibly contacting your GP for additional information.

Moratorium Underwriting

With moratorium underwriting, your health insurance policy automatically excludes all pre-existing medical conditions experienced in the past five years. You don't need to disclose this information when applying, but it will be required when making a claim.

You may qualify for coverage of a pre-existing condition if you remain symptom-free and receive no medical treatment or advice for a full, unbroken two-year period after your policy starts. This is known as the moratorium period.

It's important to note that conditions requiring regular treatment, such as chronic illnesses, will never be covered, as they are unlikely to go without recurrence for two years.

Moratorium underwriting is a popular option because it eliminates the need for a health questionnaire, making the application process quick and often leading to immediate acceptance. Additionally, if your pre-existing conditions do not recur within two years, you may become eligible for coverage related to those conditions.

Group Policy

Your employer may provide access to a group Private Medical Insurance (PMI) scheme, which typically does not require employees to declare their medical history. Instead, the scheme is underwritten based on factors such as the average age of the workforce, the company's location, and other non-personal criteria.

Basic group PMI schemes usually cover essential treatments, including hospital admissions and diagnostic tests. More comprehensive schemes may offer additional benefits.

Check with your employer to find out what coverage is available to you. This benefit may be funded as part of your employment package, or your employer might assist you in accessing individual coverage.