Private Medical Insurance

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

Remember, private medical insurance is designed to cover treatment for curable, short term illness or injury (commonly known as acute conditions). Some illnesses and treatments are never covered and these are common to most schemes.

Usually included:

• Cover for treatment of short-term (acute) medical conditions
• In-patient tests
• Surgery
• Hospital accommodation and nursing

Sometimes included:

• Out-patient tests
• Out-patient consultations with a specialist
• Overseas cover
• Cash payment for treatment received as an NHS in-patient

Usually not included:

• Conditions you had before taking out the insurance (commonly known as preexisting conditions - read Section 7)
• GP services
• Cover for long-term illnesses which cannot be cured (usually referred to as chronic conditions)
• Accident and emergency admission

As well as those listed above as 'Usually not covered', the following conditions or treatments are normally outside your cover:

Drug abuse, self-inflicted injuries, out-patient drugs and dressings, HIV/AIDS, infertility, normal pregnancy, cosmetic surgery, gender reassignment (also known as sex change), preventive treatment, kidney dialysis, mobility aids, experimental treatment, experimental drugs, organ transplant, war risks, injuries arising from dangerous hobbies (often called "hazardous pursuits").

Private Medical Insurance Guide:

1. About this guide
2. What is private medical insurance?
3. How do I buy private medical insurance?
4. How do I choose the right cover?
5. What am I covered for? What does my cover not include?
6. What will affect my premiums?
7. Will I need to provide details of my health?
8. Will my cover be affected if I am disabled?
9. How do I make a claim?
10. How is private medical insurance controlled?
11. What if I want to change to a new insurance company?
12. Your private medical insurance checklist
13. Useful addresses