What is health insurance and why do you need it?

Shorter waiting times, faster diagnosis, better facilities

Rachel Hosie
Tuesday 23 May 2017 11:35 BST

Insuring your home or car is a no-brainer, but some people aren’t sure why health insurance can be a good idea.

Why get health insurance?

Health insurance, also known as private medical insurance, is designed to ensure that if you need medical treatment in future, you won’t need to worry about NHS waiting lists or paying for the cost of the treatment.

If you’re treated privately, health insurance will pay all or some of your bills.

It should get you diagnosed and treated quickly, as well as offer you a prompt referral to a consultant and admission to a private hospital at a time and place that is convenient for you.

With health insurance, you’ll have a choice of private hospital from an agreed list provided by your insurer - most hospitals offer a private en-suite room, TV and a choice of food, which you wouldn’t necessarily get as a normal patient.

In short, the main benefits of private health insurance are:

  1. Shorter waiting times for treatment on the NHS
  2. Better facilities
  3. Faster diagnosis
  4. Choose from a range of private facilities
  5. Choose a convenient time for appointments and treatments

What it does - and doesn’t - cover

Health insurance covers an array of things, including exclusive drugs, hospital stays, scans and surgical procedures.

Inpatient treatment is when you require a hospital bed, and is covered with most plans.

Outpatient treatment means you visiting external specialists or consultants, and is usually available on more expensive policies. Different plans will offer different options.

Not usually covered, however, are any existing, chronic problems, A&E visits, drug abuse, organ transplants, normal pregnancy and non-essential cosmetic treatments.

What are the different types of health insurance?

When considering private medical insurance, there are typically two types of cover: moratorium underwriting and full medical underwriting.

With moratorium underwriting, you only need to give limited information to your provider. The insurer will not cover you initially for any conditions that have affected you in the past few years; they will let you know how long for.

This may be a condition that you have received treatment for, taken medication for or even asked your GP for advice about. After a period of time, an insurer may then cover this medical condition subject to the terms and conditions of the plan you take out.

With full medical underwriting, you are required to give full details of your medical history as part of the application process. You’re likely to get wider coverage but it will probably be more expensive too.

The insurer may write to your doctor, with your consent, to obtain further information if required. For customers over the age of 75, most insurers would offer full medical underwriting only.

There are also various specialist policies available, such as those for over-55s or ones that focus on particular diseases. Others only provide cover if you are forced to wait longer than six weeks to receive treatment from the NHS.

What are the alternatives to health insurance?

Whilst most people would generally only consider the NHS as an alternative to taking out a health insurance plan, there are actually other options.

Critical illness cover can be used to claim back for treatments against specific serious health problems.

Healthcare cash plans, which spreads the cost of you or your family’s healthcare expenses into a monthly plan. These often come with other benefits such as regular check-ups and money back from dental treatments.

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