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
  • Surgery
  • 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.

Why might you need medical insurance?

Medical insurance in the UK, unlike life insurance, is very much a luxury, as we all have access to the NHS, which is free at the point of use in most cases. Indeed, only around 11% of the population has private medical insurance, in comparison to over 30% of adults having life insurance, which is telling in itself. 

That said, there are several reasons why you may wish to take out private medical insurance:

  1. Potentially faster diagnosis (if you have comprehensive cover)
  2. Avoid NHS waiting lists and be treated more quickly
  3. Access to groundbreaking cancer drugs and treatments, some of which not available on the NHS.
  4. Have more choice over where and when your treatment takes place
  5. Have a private room while you’re in hospital

These days medical insurance policies often come with a host of other benefits, such as discounted gym membership and even free cinema tickets, so be sure to check with your broker or in your policy terms and conditions to find out what you have access to.

Which medical insurance is the best?

Which medical insurance is the best will largely be dictated by your own preferences and of course the amount you’re willing to spend on the policy. Broadly speaking though the best health insurance policy will be comprehensive in nature, meaning it’ll cover an extensive list of illnesses and treatments, alongside having full, in, day and outpatient cover. Again, it’s always best to speak to a health insurance broker to make sure you’re getting the best deal. To get free advice from a qualified health insurance expert, please click this link and request a quote.

Who are the best providers of medical insurance in the UK?

There are a number of leading players in the market, all of them having their own strengths. In another recent article, “Best Health Insurance UK” we review these companies in detail but here is a summarised list of them for quick reference:

  • Axa PPP
  • Bupa
  • Aviva
  • Freedom Health Insurance
  • WPA
  • Vitality
  • Saga

How to reduce the cost of medical insurance

There are a number of ways you can reduce the cost of your medical insurance, all of which we’d recommend you discuss with your broker to ensure you aren’t sacrificing cover unnecessarily. The best ways to keep the cost of a policy down, as we detail in another recent article “Cheap medical insurance” are:

  1. Compare policies and providers
  2. Opt for no or reduced outpatient cover
  3. Add an excess
  4. Add a 6-week NHS wait clause
  5. Have a reduced hospital list
  6. Switch providers

The best way to reduce cost is of course by comparing and switching without reducing the amount of cover you have, so please speak to us before you start making any sacrifices.