What is medical insurance?
Medical insurance or Private Medical Insurance (PMI) to give it its full name, is a policy taken out to cover the cost of private healthcare treatments should you suffer from an eligible condition after the policy starts.
Private medical insurance is available at a variety of levels of cover, with different premiums designed to meet the needs of various customers. For example, when configuring your policy you’ll have the choice over the type of treatment covered, what level of cover will apply to those treatments and the location where the treatments will take place.
What does medical insurance cover?
All Private Medical Insurance policies will cover the cost of private treatment of eligible acute illnesses. Private Medical Insurance doesn’t cover costs relating to the treatment of long term acute conditions. Typically all PMI policies will cover the cost of inpatient treatments, where a hospital bed is required overnight. Many will also cover the cost of treatments where a bed is required only for part of a day (day patient), with only the best health insurance covering outpatient treatments where a hospital bed isn’t required at all.
Private medical insurance usually includes:
- The cost of hospital admission
- Diagnostic tests, such as MRI and CT scans
- The cost of seeing a consultant
- Cancer drugs and treatments (some of which won’t be available on the NHS)
How medical insurance works
Depending on the level of cover you have, medical insurance will work in one of a couple of ways. In all cases though, when you’re unwell, you start by seeing your NHS GP.
How it works with only basic cover
If you’ve opted for a cheap medical insurance policy where the cover is limited to inpatient treatments only, then you will first need to be diagnosed through the NHS. As is the case with all levels of cover, you’ll start by seeing your NHS GP, he or she will then refer you to an NHS specialist who will be able to perform further tests and diagnose the condition you’re suffering from. At this point, and assuming the illness you have been diagnosed with is covered under your PMI, you will be referred to a private hospital for treatment.
How it works with comprehensive cover
If you have a comprehensive private medical insurance policy then you will be assessed and diagnosed privately rather than through the NHS. Just as with a basic policy, you’ll start by seeing your NHS GP. He or she will then refer you to your private healthcare provider and the rest of your experience will be completed privately. This is by far the fastest route to treatment, as you’ll be diagnosed and treated privately, but having comprehensive cover does come at a cost.