How do I choose the right cover? - Private Health Insurance

A good place to start is to think about the type of life you lead and what diseases or illnesses you would like covered. If you are single or have children then choose a policy which is geared towards these specific needs.

If you participate in sport or are starting a family then you will find that some companies offer specialist packages which cover these particular requirements.

Some insurers will allow you to personalise your policy. This involves you picking and choosing from a range of options such as dental and optical care, health and fitness cover. This is an ideal choice for those people who want extra coverage for specific needs. So you may be offered a ‘basic package’ with the option to buy extra services as so desired. Your monthly premium will reflect these additional extras.

A personalised approach is a good option as it means that you only pay for services you need or fit in with your lifestyle rather than those which are not applicable to you.

Many companies offer a standard or ‘fixed’ package which does just that. It is a set type of cover with limited choice and restrictions on these choices. A fixed package may include some or all of the following:

  • Consultant fees
  • In-patient, day-patient and out-patient costs
  • Diagnostic tests such as x-rays and scans
  • Physiotherapy
  • Cancer treatment such as chemotherapy and radiotherapy
  • Hospital charges such as accommodation, theatre time etc

Additional extras include: home nursing, chiropody, health screening and recuperative care to name but a few. All or a combination of these can be included in a fixed package although this depends upon the insurer.

The advantage of a fixed package is that of cost: it is likely to be affordable and so appeal to people on tight budgets. However the downside of this is that it may restrict you in terms of the choice of private hospital etc.

If you don’t want a full policy or a personalised one but want cover for long term illnesses then consider ‘limited’ cover. This suits those individuals who will use the NHS for emergencies or a short term illness but want private care for a long term condition rather than going on a waiting list. It means that you get the best of both worlds – NHS and private.

Health insurance has moved from a ‘one size fits all’ approach to one in which they offer a range of packages which you can choose from, and customise if necessary. These will typically start from ‘budget’ packages with limited services through to ‘luxury’ packages which include a wide range of services.

Insurance providers may offer the following health insurance products:

  • Packages: from budget through to standard and comprehensive
  • Business
  • Self-employed
  • Specialist e.g. sport
  • Limited cover
  • Dental
  • Optical
  • Cover for the ‘mature’ customer
  • Children

Another recent innovation is that of preventative medicine: many companies have gone down the road of offering services which are designed to promote good health and avoid illness. These include discounts at health and fitness clubs, fitness advice, nutritional advice and a nurse and/or GP helpline. The rationale behind this is that promoting a healthy lifestyle means less risk of illness and so a reduced need for medical treatment. Plus this also reduces the burden on both the NHS and private healthcare.

Illness and disease do happen; however healthy you may be but a few positive changes to your lifestyle can reduce your chances of contracting an illness which is good news in the long run.

All policies contain an ‘exemption clause’ which basically means what the policy covers and what it excludes. This is discussed in more detail in the next two sections.

As a rule of thumb read the small print carefully and ensure that you fully understand what you are paying for. Ask as many questions as you need to and if you are not satisfied with anything in the policy then ask until you are.

Some insurers will ask you to pay the full amount (premium) in full whereas others will let you pay this via a series of monthly instalments. Another option is that of sharing the cost of treatment. You agree to pay half the cost and they cover the other half. They may also agree to reduce the cost of your premium although you need to check with them beforehand.

If you choose this option then find out how this works. You may be lucky in that your insurer will pay the healthcare provider, on your behalf; whereas others will expect you to pay and then apply for a refund.

Try and get the first option as the second one means that you could be put of pocket for a period of time whilst waiting for your insurer to refund the costs of treatment.

It’s worth spending some time sourcing insurance providers, policies and quotes until you find that one that suits you and your needs.

How long will my policy last for?

Generally, a policy will last until you reach the age of 65 or even 70. If you are near this age then check with your insurer to see if they will continue to offer you cover. Unfortunately, some insurers do not provide cover to anyone aged 65 or over.

Private Medical Insurance Guide:

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