Private Medical Insurance: what you need to know

Established in 1948, the National Health Service (NHS) is the largest and oldest single-payer healthcare system in the world.  It is the envy of many countries and is undoubtedly one of the UK’s most prized assets, with millions depending upon it every year. However, in recent times it is has become a system under strain, facing unprecedented financial and operational challenges.  This is resulting in long wait times in A&E, a shortage of GP appointments and some healthcare services in crisis.
 

Many believe the NHS is simply underfunded and overstretched.

These challenges are compounded by our ageing population and the changing patterns of disease, with more people living with multiple long-term conditions than ever before.

As a result, some people are now considering Private Medical Insurance (PMI) as an alternative option to manage their healthcare needs.

What is Private Medical Insurance (PMI)?

Private Medical Insurance is a policy that provides quick access to leading UK medical care and hospitals. PMI has changed in recent years in order that policies work to complement and improve the NHS rather than acting as a replacement.

This provides consumers with greater flexibility and choice when selecting the right level of PMI cover. For example, many policies include access to a Private GP so that initial period of worry from feeling unwell and waiting to see your GP is eliminated and you are referred to a specialist, if required, more quickly.  Some medical policies can also provide the ability to get second opinions and in some cases will offer access to the most expensive cancer drugs.

Do you need to buy PMI?

The short answer is no. There is no legal requirement to buy medical insurance as the National Health Service (NHS) exists to provide UK residents with free medical advice and treatment, regardless of wealth and personal circumstances

But, with the NHS coming under increasing pressure to provide its services, growing numbers of people are looking to PMI to provide them with peace of mind and faster access to medical treatment if they need it.

The benefits of PMI

Some of the main reasons you may choose to buy medical insurance include:

• Reduced waiting times – In the UK the NHS can have lengthy waiting times for many treatments.  Having medical insurance often allows you to get treatment quicker, particularly for non–urgent treatment.
• Convenience and peace of mind – Being able to plan your treatment to suit your busy life and commitments is important.
• Greater choice – Having the ability to choose your hospital and the treating consultant that you prefer is highly valued.
• Control over your treatment – In the private sector your consultant will be able to prescribe the latest drugs without worrying about NHS funding and postcode lotteries. Often treatment not available through the NHS can be funded privately as can second opinions.
• Privacy & Quality care – In the Private sector not only can you choose your hospital but many policies offer you the choice of a private room with en-suite facilities and far more freedom on visiting hours than is possible in the NH

How much will PMI cost?

There are a number of factors which are taken into account which determine the cost of your medical insurance:

• Age – this is the biggest single factor when pricing policies. The older you are the higher the premium. 
• Location – If you are based in London or the South East premiums will be higher as hospital and treatment costs in these locations are greater.
• The range of benefits – More comprehensive policies that include in-patient, out-patient and full cancer cover will cost more than more restrictive policies

Access to private cover can be expensive but there are ways that you may be able to reduce the cost of medical insurance. You could choose a scheme that offers full inpatient treatment but only limited outpatient care, and no extras. Alternatively, you could opt for a voluntary excess on claims, just as you would with your car insurance, which reduces your premium without cutting the cover. Another option is to take out a policy that will treat you only if the NHS waiting list for your condition is more than six weeks.

Choosing the right policy

If you’re considering PMI for the first time, you may choose to arrange cover yourself and there are plenty of websites out there which can help. If you take this approach, it’s important to check:

• the terms and conditions offered;
• the type of cover you’re buying;
• any limitations of the policy; and
• the cost of the insurance premium.

With so many options available to you, you may prefer to get professional advice. Medical insurance brokers are experienced and know all the different providers and understand the product in all its complex intricacies.  They’ll be able to research the market on your behalf and give you information about the most suitable cover to meet your individual health needs.

Richard Gould, Director of Commercial, RK Harrison