Cover Levels And Medical Insurance

Summary
PMI policies vary. You need to check what is covered and what is excluded. Check terms carefully when switching provider.

Cover Levels And Medical Insurance

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Chronic asthma or on-going kidney dialysis, for example, are usually not covered, nor are normal events such as pregnancy. Unless required following an accident or injury you would find that cosmetic surgery is not covered either.

There are different levels of private medical insurance with premium, standard and budget policies available. There are also policies with specific terms such as offering cover only after six weeks on the NHS waiting list, or being over 55 years of age. Some are disease-specific.

Some insurers can offer a policy that is tailor-made for you. The basic core of the policy would cover you as a hospital in-patient and you could then add different modules specific to your needs.

In general full costs are paid for an in-patient stay or for day-case operations, including any test necessary. However, cover for out-patient treatment will vary unless you have a Comprehensive policy which would cover consultants' fees, diagnostic tests, scans, chemo or radiotherapy, physio etc.

A Standard policy may limit the cost of treatment for an out-patient. And Budget policies are even more limited in terms of the cost of treatment covered and also the types of treatment. One example is that the cost of physiotherapy may be covered if you are in hospital after a stroke, but not otherwise.

Psychiatric treatment is a grey area and insurers' views vary - is it curable (covered) or does it fall into the long-term, on-going category (not covered). You are more like to find cover under a Comprehensive policy but you would need to check the terms carefully.

As expected, the more expensive the policy the more likely it is to cover extras such as home nursing, parent stay in hospital with a sick child, a private ambulance and even complementary therapies and a 24-hour help line.

You can shop around and switch to insurers with more competitive rates, but you need to pay particular attention to the terms or you could find yourself suddenly uninsured - for example if you developed a condition while holding the first policy you may find it excluded under the new one.

You may be able to switch and still be covered for a pre-existing condition, or you may retain cover only if you remain free of the pre-existing condition for a certain period of time. You really need to check this very carefully before you sign on the dotted line because it can come as a huge shock to find you are no longer covered when you assumed you were.

If health insurance has been a perk of your job and it is ending for any reason, see whether you can take out an individual policy and keep covered.