From extra benefits to undesirable restrictions, here are seven questions to ask before buying insurance
Buying medical insurance can offer peace of mind and care when you need it most; but makes sure you choose the right policy
Around 5.1 million people in the UK have private health insurance, according to the Association of British Insurers, with £7.4m in claims paid out daily. Buying medical insurance can offer peace of mind and care when you need it most.
But whether you’re buying a health care policy for the first time, or looking to switch, how do you know you’re getting the right one? We asked independent experts AMII (Association of Medical Insurers and Intermediaries) what you should ask your insurer before you buy.
1. What cover is included?
Like any insurance, health policies offer various levels of cover. Most cover the costs of inpatient treatment (a hospital bed, tests and surgery). Outpatient treatment (consultants and tests) is included with many policies, but might be capped. Some will cover the cost of drugs not available on the NHS.
“Many insurers offer ‘modular’ policies, allowing you to pick and choose benefits to tailor your cover and costs to your needs,” says Michael Payne from AMII. Cancer is one area where cover can vary – some policies offer extensive heart and cancer cover, including genetic testing to make sure you get the right type of chemotherapy, and even the option of chemotherapy at home.
2. Which policy is right for me?
Cheaper policies cover fewer types of outpatient treatment and have lower caps. For example, most comprehensive policies will give you full cover for cancer and heart conditions – but the level and the length of care will vary. There are also policies that provide cover for serious conditions, or the over-55s.
“Write a list of what you want and stay focused when researching,” advises Michael. “Speak to an independent broker who can look closely at your individual needs.”
3. How much does it cost?
This depends on age, health, pre-existing conditions and what you can afford. “Budget policies will probably only provide hospital treatment and no or limited outpatient care,” says Michael.
“Check if this can be extended for outpatient costs relating to hospital treatment and, if so, what exactly this would include, such as post-treatment consultations, X-rays, or tests.”
Also, ask if the premium includes a no-claims discount and how much the cost is likely to increase if you make a claim. Think about the excess you will have to pay if you claim.
4. Are there extra benefits?
Some policies offer extras, such as free or discounted gym membership, or technology that will help you stay fit. “Only take this if the overall policy is right for you,” says Michael. Other benefits can include online or phone consultations, and specialists you can call 24/7 for help.
5. What are the restrictions?
Your policy might have restrictions on which hospital you have access to, and which consultants, clinics or surgeons.
Ask if it covers outpatient care as well as hospital stays and treatments, and if there are limits on costs. Some policies will only cover you if you have to wait longer than six weeks for NHS treatment.
Health insurance doesn’t cover longer-term treatment (such as kidney dialysis), or incurable conditions like asthma or drug abuse, normal pregnancy and non-essential cosmetic treatments.
6. How is my premium assessed?
“Insurers may ask for a detailed medical history – you must declare all your health history and check if any existing conditions may be disallowed from cover,” advises Michael.
However, some insurers may offer a moratorium policy with no detailed health questionnaire, but it places a blanket exclusion on pre-existing conditions.
“It will explain which conditions are excluded and for how long.” Ask if the quote includes a no-claims discount – and how much you would lose for each claim.
“Sometimes it’s cheaper to pay for minor treatments or consultations and not lose your no-claims,” says Michael.
7. What is the claims procedure?
Some policies require that payment for your care is authorised beforehand, known as ‘pre-authorisation’. You may also have to pay towards bills, depending on the excess.
“Insurance is there for unexpected events – you can’t expect to take out a policy when you suddenly fall ill,” says Michael. “But once you have it and start to use it, it will be hard to change insurers, especially in the middle of treatment – so it’s important to find the right policy and provider for your needs.”
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Wellbeing