What You Need to Know About Private Medical Insurance

Insurance experts Engaged Solutions explore private medical insurance and explain how you can get the most out of it.

Illness and injury has a tendency to make you feel like you’re not in control but unfortunately it’s often when you need control the most (as well a lot of TLC). Private medical insurance is the first step to taking some of it back, as it gives you the ability to make important decisions about how and when you receive medical treatment.

Of course, in the UK we’re lucky enough to receive free treatment on the NHS but with private medical insurance, often known as health insurance, you’re much more able to design your own experience.

How does it work?

Private medical insurance is available as a policy for a single person and as a policy for a family, including children.

Coverage can include:

  • Reduced waiting times – you don’t have to worry about hospital waiting lists as effectively you are treated privately.
  • Choice of private hospitals – you choose which private hospital suits you best, and you will have a private room.
  • Choice of Consultants or Surgeons – make an informed decision on who will treat or operate on you.
  • Specialist scans and drug treatments – often these can be very expensive and the NHS will not fund them. Luckily some private medical insurance policies will, although not all fund drugs throughout treatment
  • After care – see a physiotherapist or have other post-operative treatments quickly to ensure a speedy recovery.

There are, of course, different providers of private medical insurance so it is always advisable to compare individual products to make sure that it has the coverage that meets your circumstances.

What’s not covered?

As with any insurance policy, there are exclusions that you should be aware of. Private medical insurance does not cover chronic medical conditions, such as diabetes, HIV or AIDS related illnesses, cosmetic surgery (to improve appearances), epilepsy or normal child birth. Pre-existing conditions and injuries sustained from dangerous sports or in a war zone are also not covered.

As with any legal document, you should always read and fully understand the terms and conditions before taking out a policy.

How do you make a claim on your Private Medical Insurance?

If you’re not well and are referred by your GP to a specialist, call your provider to advise them and to confirm any limits on your policy. Do this at every stage of the claim so you’re clear that any changes in treatment or medication are covered by your policy. It’s that simple.

However, it’s important to note that any excess on your policy will normally need to be paid by you to the hospital. You will not usually receive any bills from the specialist or the hospital for your treatment, as these will be settled by the health insurer directly.

How do I review my private medical insurance?

To get the most out of your private medical insurance you should try to review it regularly. This will ensure that the level of coverage you have actually suits your needs. What’s more, providers change their offering regularly to include new benefits and information, so by shopping around you could get a better deal. Insurance Brokers who are regulated by the FCA and have access to multiple products can help you find the most appropriate private medical insurance policy.


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