FAQ

FAQs

1. What is Health Insurance?

UK Health Insurance covers the cost of private health treatment for short term illness. Short term illness is essentially any illness, injury or disease that you have suffered that, once treated, leads to a full recovery or returns you to the health state you were at before you had the problem. This alleviates the stress and worries that if something bad happens suddenly you are able to pay for and treat the problem quickly. Private health insurance allows you to choose when and where the treatment takes place, who treats you and where you get treated (hospital). Some things are covered like long term illness, GP costs and emergency admission to the hospital. Private health Insurance doesn’t replace the NHS, it just covers you for any private treatment that may be required. The cover that you receive can be classified in three ways: Budget Insurance – Normally only included in-patient treatment. This does not include tests, consultations and after surgery costs. This best suits people that can cover tests and consults and let the insurance company cover the cost of operations. Standard Insurance – This covers most hospital costs such as operations and consulting costs (blood work, X-rays, Scans and Chemotherapy) as well as normal therapies like osteotheripts, Chiropractors, Physiotherapists and Acupuncture. However these may vary between different insurers. Make sure you read the product disclosure agreement. Comprehensive Insurance – Provide top of the line benefits. They usually cover everything from in hospital cover to external treatments and consultations. Also general benefits sicj as travel, dental and general elective care. If you want to have no worries this is the polic that you should choose.

2. How do I buy Health Insurance?

When you are considering purchasing Health Insurance there are a number of avenues you can go to get the right policy to suit you. The main three choices open to you are as follows: 1. Go direct to the Insurer 2. Seek the advise of an Independent Health Advisor or Broker online or offline 3. Insurance Agents ( Banks, Building Societies, Retail Outlets) You can acquire quotes either over the phone, post, internet or face to face should you be happy to either visit or receive a visit from and a Health Insurance Specialist. Once you have decided what the best policy is for you the Insurer on receiving your application will process it and then send out your certification of membership. From the moment you receive this you are into what is termed “a cooling off period”. From the moment you receive your documentation you will normally have 14 days in which to change your mind if you so wish. If you do, any premiums that would have been taken will be returned and your policy cancelled. Some Insurers may arrange cover differently from above like over the phone. However cover will normally be provisional until they receive a completed application form.

3. How do I choose the right cover?

When looking at cover, it is useful to know that treatment is categorised in the following way. In-patient treatment: Treatment which, for medical reasons, means you have to stay in hospital overnight or for longer. Day-patient treatment: Treatment which, for medical reasons, means you have to go into a hospital or day-patient unit because you need a period of clinically-supervised recovery. However, you do not have to stay overnight. Out-patient treatment: Treatment given at a hospital, consulting room or out-patient clinic where you do not go in for day-patient or in-patient treatment. There is a large variety of schemes available-from low cost schemes offering limited cover, to those which offer wide-ranging cover and benefits. Most schemes offer cover for in-patient and day-patient treatment, but not always out-patient treatment. You will need to decide what sort of cover you want. There are a number of things you will have to consider. Here are just two examples: 1. Do you want your cover to include seeing a specialist as an out-patient? 2. Do you want a choice of hospitals, or would you be satisfied to receive any treatment that you might need in a hospital available from a limited range chosen by the Insurance Company? The answers you give to questions such as these could have a significant effect on the premium that you pay.

4. What am I covered for? What does my cover not include?

Private Health Insurance specifically covers any short term illness or injury that you sustain. Here is an explanation of what is and isn’t covered by health insurance. Normally Covered – Short term illness. Tests, surgery, hospital accommodation and nursing costs. Sometimes Covered – Diagnostics tests after surgery. International cover, payments for treatment under the NHS. Not Covered – Long term illness before starting health insurance. GP costs. Non curable disease and emergency admissions to hospital. Drug problems, HIV/AIDS, infertility, cosmetic surgery, organ transplant, sex change and war. Most insurers will provide your with their private health insurance policy summary sheet giving you a full outline of what and what isn’t covered.

5. Will my premiums go up?

Premiums may rise above inflation. Costs are increasing for healthcare; this is why premiums go up. Also the technology of treating and diagnosing illness is also rising. Here are som options you may have.
  • Choice of cover affects the amount you pay
  • Treatment at specified location
  • Paying a higher excess
  • Paying some of the claim
  • Being treated under the NHS
  • Choosing a different hospital
All of these things can affect the level of premium you pay. Also things like discounts, payment method or no claims bonus can affect the cost.

6. Will my premiums increase with age?

As people get older they are more likely to need and receive medical treatment, which means that health insurance premiums will usually increase with age to reflect this.

7. Will I need to provide details of my health?

There are some things you can’t get health insurance cover for. These included past illnesses and anything you have had before. There are two ways you get check for details of your health. Medical Underwriting – You have to provide your full medical history. Be sure to not lie as the insurer may not pay or take away you cover permanently.  If you are unsure write it down. If your condition will re-occur, there may be conditions on the cover and the level of cover you receive. Moratorium – This is where you don’t receive cover for anything you had in the last 5 years. Any recurring conditions will receive cover but only if you have not had any symptoms for two years after your policy has started.

8. What if I want to change to a new Insurer?

You may change Insurer. However, it is important to remember that your new insurer may not cover any previous, or existing conditions, which your current insurer may cover. You may also lose any premiums you have paid up front. It is best to check with your new insurer or whoever is selling or arranging a new policy for you, how the change may affect your cover.

9. Will my cover be affected if I am disabled?

Insurers will not refuse to cover you because you are disabled. As with other pre-existing conditions, your insurer may exclude cover for treatment arising directly from your disability. However, it must be reasonable and fair for them to do this. If you sign a medical declaration you must reveal all relevant information about your disability. If your policy does not cover pre-existing conditions, then an existing medical condition causing disability, or arising from it, will not be covered.

10. How do I make a claim?

Make sure you call the insurance company before undergoing any private operation. This will make sure that you are covered and can get compensated for your costs. Most insurers will give you guidance if you call them in regards to what the process is and if you are covered. Most doctors or specialists get paid directly by the insurer, so make sure you have all your forms completed, the specialist is aware of the situation and the insurance company is aware of the situation. Then you won’t have any problems.

11. How is private health insurance regulated?

Financial Services Authority: As from January 14th, 2005, the Financial Services Authority (FSA) regulate the sales and administration of private health insurance. The FSA set out rules which regulate the sale and administration of general insurance which must be followed by those dealing with you. There is more information about the FSA at www.fsa.gov.uk Your application form or any declaration you make to your insurer forms the basis of your contract with the insurer. Answer questions accurately. By law all insurers have to treat personal information especially medical details with absolute confidentiality. All insurers and anyone else advising on health insurance must have their own complaints procedure in place and be covered by the financial ombudsman. If you have a problem speak to your advisor or insurer first. If you are not satisfied with the way your complaint was handled, there is an independent dispute resolution procedure through the Insurance ombudsman service which your insurer or advisor must give you details of. The service is free.