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Demystifying the Complexity of Private Health Insurance

Introduction

At WeCovr, we understand that navigating the world of private health insurance can be a daunting and often confusing experience. With a myriad of options, complex terminology, and varying policy structures, it's no wonder that many individuals find themselves feeling overwhelmed. However, as an independent insurance broking firm, our mission is to simplify this process and empower you with the knowledge and guidance you need to make informed decisions about your healthcare coverage.
In this comprehensive guide, we'll delve into the intricacies of private health insurance, shedding light on the factors that contribute to its complexity and providing you with the tools to navigate this intricate landscape with confidence.

The Intricacies of Policy Underwriting

One of the primary contributors to the complexity of private health insurance is the underwriting process. Underwriting is the method by which insurance providers assess the risk associated with providing coverage to an individual. In the context of health insurance, there are two main underwriting approaches:

1. Moratorium Underwriting

Moratorium underwriting is a process where the insurance policy excludes all recent pre-existing health conditions, typically within the last five years. A pre-existing condition is any illness, condition, or symptom that you've experienced, been diagnosed with, received treatment for, or sought advice for prior to obtaining the policy.
The advantage of choosing a policy with moratorium underwriting is that you won't need to complete lengthy health questionnaires during the application process, making it a quicker and more streamlined option. However, the downside is that the policy terms may not always be clear about which conditions are covered or excluded. When you make a claim, your insurer may need to review your medical history and consult with your GP, potentially leading to lengthier claims processes.

2. Full Medical Underwriting

With full medical underwriting, you'll be required to disclose your complete medical history, typically by filling out a detailed health questionnaire. In some cases, a medical examination may also be necessary. While this process can be more time-consuming, the benefit is that your policy documents will clearly outline what is and isn't covered, providing transparency and potentially covering certain pre-existing conditions, even if they've been experienced relatively recently.

Navigating Policy Features and Terminology

Another aspect that contributes to the complexity of private health insurance is the range of policy features and the terminology used by different insurance providers. Here are some key concepts to be aware of:

Acute vs. Chronic Conditions

Most private health insurance policies cover acute conditions, which are illnesses or injuries that can be successfully treated with medical care, such as broken bones, appendix surgery, cataracts, or hernias. However, chronic conditions, which are ongoing and can only be managed but not cured, are often excluded from standard coverage. Examples of chronic conditions include diabetes, hypertension, and arthritis.
It's important to note that there may be exceptions to this rule, as some insurers may cover acute flare-ups of chronic conditions or include cancer care as part of their core coverage.

Mental Health Support and Treatment

Many insurance providers advertise mental health services, but there is often a significant difference between mental health support and mental health treatment. Support may include services like wellbeing guidance or access to counselling, typically offered remotely and with limited sessions. Mental health treatment, on the other hand, is usually an optional extra that covers specialist psychiatric care, inpatient treatment for conditions like eating disorders or substance abuse, and face-to-face services.

Consultant and Hospital Lists

Insurers often use different terminology when referring to the options for choosing your healthcare provider and treatment facility. Some common terms include:
  • Guided Consultant List: This option limits your choice of consultant to a pre-approved list provided by your insurance provider. While the list may be extensive, it can help keep premiums down.
  • Non-Guided List: With this option, you have the freedom to choose your own specialist consultant, but it typically results in higher premiums.
  • Hospital Network: Similar to consultant lists, insurers may offer different hospital network options, ranging from a limited regional network to a national or unrestricted network, with the latter being the most expensive option.

Terminology Variations

It's important to note that insurers may use different names for essentially the same concepts, which can contribute to the confusion surrounding private health insurance. For example, what one insurer calls a "comprehensive policy" may not align with another insurer's definition of the same term.

Understanding How You Pay for Treatment

In addition to policy features and terminology, the way you pay for treatment can also add complexity to private health insurance. Here are some common payment options and pricing methods to be aware of:

Excess

An excess is an amount you agree to pay towards the cost of your treatment. Once you've reached the excess limit, your insurer will cover the remaining costs. Some insurers charge a single excess per policy term, while others may charge an excess per claim, so it's crucial to understand how this is applied to avoid unexpected costs.
Choosing a higher excess can often result in lower premiums, but it's essential to ensure that the excess amount is affordable for your budget.

Shared Responsibility (Co-Payment)

Some insurance providers offer a shared responsibility or co-payment option, where you share the cost of every treatment with your insurer up to an agreed percentage. For example, you may be responsible for paying 25% of the treatment cost, while your insurer covers the remaining 75%.

No Claims Discount

Unlike other types of insurance, where you start with no no-claims discount and earn it over time, health insurance policies often come with a substantial no-claims discount of around 70% initially. However, this discount can be quickly eroded if you make claims, leading to higher premiums over time.

Pooled Risk and Community-Rated Premiums

Pooled risk and community-rated premiums refer to the practice of pooling premiums among policyholders to spread the risk. This approach can help lower premiums for individuals who may be considered higher risk, as their risk is diluted by being part of a larger pool.

Choosing the Right Private Health Insurance

With so many factors to consider, selecting the right private health insurance policy can be a challenging endeavor. At WeCovr, we understand that there is no one-size-fits-all solution, and every individual's healthcare needs and circumstances are unique. To help you navigate this process, here are some key considerations:

Identify Your Priorities

Start by evaluating what features are most important to you. Do you require comprehensive outpatient coverage? Is mental health treatment a priority? Understanding your healthcare needs will help you determine which policy options and add-ons are essential.

Assess What You Can Forgo

While it's tempting to opt for the most comprehensive coverage, it's important to consider what you can realistically forgo to keep costs down. For example, if you're comfortable with being treated at a regional hospital network or by a guided consultant list, you may be able to save on premiums without compromising on the quality of care.

Consider Your Budget

Private health insurance premiums can vary significantly based on your age, health status, and the level of coverage you choose. It's crucial to establish a realistic budget and explore options like higher excesses, shared responsibility, or pooled risk premiums to find a balance between coverage and affordability.

Seek Professional Advice

At WeCovr, we understand that navigating the complexities of private health insurance can be overwhelming. That's why we strongly recommend seeking professional advice from our team of experienced brokers. As an independent firm, our sole focus is on finding the best solutions that meet your unique requirements, without any conflicts of interest.
Our brokers will take the time to understand your personal circumstances, healthcare needs, and budget constraints. We'll then leverage our extensive knowledge of the insurance market to present you with tailored recommendations and guide you through the process of selecting the right policy.

Conclusion

Private health insurance may seem complicated, but with the right knowledge and guidance, it doesn't have to be. At WeCovr, we are committed to empowering you with the understanding and support you need to make informed decisions about your healthcare coverage.
By demystifying the intricacies of policy underwriting, policy features, terminology, and payment options, we aim to equip you with the tools necessary to navigate this complex landscape with confidence. And when you work with our team of experienced brokers, you can rest assured that you'll receive personalised advice and tailored recommendations to find the perfect private health insurance policy for your unique needs.
Don't hesitate to contact us today and take the first step towards securing the healthcare coverage you deserve. Our team at WeCovr is here to be your trusted partner, guiding you every step of the way.
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Why get private health insurance?

Health insurance allows you get back on your feet quicker:


✅ Avoid long NHS waiting lists of many weeks and get treated faster with private medical insurance, which can be really important for a successful recovery
✅ Get early diagnosis so you can get the treatment you need right away done privately
✅ Business owners can save on their tax bill with private medical insurance
✅ You are free to choose your surgeon or hospital to suit your needs by place and time
✅ You often get a private room with better facilities for your treatment or surgery
✅ With private medical health insurance you gain access to advanced treatments not available on the NHS

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Benefits offered by private health insurance

Private medical health insurance is an insurance policy that covers the costs of private healthcare, from diagnosis to treatment. You just pay an affordable monthly premium that covers all or some of the cost of treatment for acute conditions that develop after your health insurance policy has begun.

Our mission is to put you in touch with not only the best, but the most suitable private medical health insurance companies. With even more risk on the rise for personal health today, it makes more sense than ever to have private medical health insurance cover.

👍 Many people are very thankful that they had their private medical health insurance cover in place before running into some serious health issues. Private medical health insurance is as important as life insurance for protecting your family's finances.

Important Fact!

Why increasing numbers of individuals and families opt for PMI insurance

👉 We insure our cars, houses, bicycles and even bags! Yet our health is one the most precious things we have.

People buy life, critical illness and private medical health insurance for a variety of reasons – easily one of the most important insurance purchases an individual or family can make in their lifetime. PMI insurance is still seen as a luxury in the UK. Indeed, only around 11% of the population has private medical insurance. However, an increasing number of people are taking out private medical insurance due to a number of reasons:
  • Avoid NHS waiting lists and be treated more quickly
  • Faster diagnosis (comprehensive cover)
  • More access to latest cancer drugs and treatments, some of which may be unavailable on the NHS
  • Greater choice over where and when your treatment takes place
  • Have a private room should you need treatment in hospital
Our experienced FCA-authorised insurance partner experts are ready to provide you with a FREE Consultation.

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Any questions?

Do I need Private Medical Insurance if I have Life Insurance?

Life Insurance and Private Medical Insurance cover you for two different purposes, so you will need to assess your needs but may wish to consider holding the two policies. Private Medical Insurance covers you if you get sick or need treatment and want or need to go privately. Life Insurance covers you in the case of death, giving a payout to family/those left behind.

Are Pre-existing Medical Conditions Covered?

Health insurance covers conditions that develop after your policy starts. Pre-existing conditions are typically not covered, and insurers may exclude related issues. Some policies may cover symptoms of pre-existing conditions under specific circumstances. Always review your policy's exclusions. Coverage for pre-existing medical conditions may be available if you currently hold a medical insurance policy or are transitioning from a company scheme. However, if you have never had medical insurance before or if your policy is not active at the moment, pre-existing conditions will not be covered. This limitation exists because health insurance is primarily intended to protect against unexpected health issues. To simplify, it's akin to getting into a car accident and then trying to obtain insurance coverage afterward to repair the vehicle — insurance companies typically do not cover such claims. Nevertheless, there is an option to gain coverage for pre-existing conditions after a two-year waiting period, subject to specific rules and conditions.

Why Do I Need Private Medical Insurance?

If you prefer to get straight into treatment in the private sector without the long waiting times with the NHS, or you just prefer the private sector anyway, without having to pay it all yourself, then you would need to have Private Medical Insurance to cover it. Sometimes treatments and drugs that are not covered by the NHS can be covered by Private Medical Insurance.

How Much Does It Really Cost?

It's free to use WeCovr to find health insurance - we never charge you for quotes. Health or private medical insurance is an investment that can pay for itself the first time you might need medical treatment.

Isn't NHS Treatment and Coverage Enough?

It depends on your personal choice and preferences. If you are prepared to limit yourself to NHS-covered treatments only and can or want to endure long waiting times to get into treatment, then yes, NHS might work for you. Your cover there is free. If you don't want to be exposed to long waiting times or if your treatment is not covered by the NHS, then you would benefit from Private Medical Insurance.

Why Do I Need to Speak to Someone?

Private Medical Insurance is an important financial product that insurance companies take a lot of care and diligence so speaking to real human beings ensures that they understand your requirements fully so that you can get the right cover.

Are Your Insurance Partners Trustworthy?

All of our partners are carefully vetted and authorised by the FCA, which means they are held to the highest standards that the FCA expects from them and treat all customers fairly!

How Do You Make Money If the Quotes Are Free to Get?

Our insurance partners give us a few pounds when you take out a policy with one of their experts.

How Much Is Private Health Insurance?

The cost of private health insurance depends on several factors, including your age, location, smoking status, and the type of policy you choose. Your health insurance policy is tailored to your needs, and the cost can vary based on the level of cover you require, such as the amount of excess and specific treatment allowances.

How Does Private Health Insurance Work?

Private health insurance covers you for conditions that arise after your policy begins. You pay a monthly fee and can make claims for private healthcare covered by your policy. One of the main benefits of private healthcare is quicker access to treatment compared to the NHS, along with access to new drugs or specialist treatments.

What Does Health Insurance Cover?

Most health insurance covers private hospital stays and may include outpatient treatments like scans, tests, or appointments. Policies vary in coverage, and exclusions often include emergency treatment, maternity care, cosmetic surgery, and ongoing conditions present before the policy started.

Can I Pay Extra to Have a Pre-existing Condition Covered?

Unfortunately, you cannot pay extra to have a pre-existing condition covered as part of your health insurance policy. However, you have access to support from a nurse or digital GP. If you have questions about what is covered under your policy, please contact us for clarification.

When Will My Health Insurance Policy Start?

Your health insurance policy begins once you've selected your policy and set up your payment. After setup, you'll receive your cover documents detailing what is and isn't covered. It's important to review these details carefully as policies differ.

Will I Need an Excess on My Private Health Insurance Policy?

An excess is the amount you contribute towards treatment when you make a claim. Choosing a higher excess can reduce your policy's monthly cost but requires a larger contribution when claiming. WeCovr's experts will offer you flexible excess options depending on your preferences.

How Can I Reduce the Cost of Health Insurance?

To reduce health insurance costs, consider choosing a higher excess, which lowers the monthly premium. However, ensure the plan still meets your needs. Other factors affecting cost include lifestyle choices like smoking and potential savings for couples or family plans.

Is There an Age Limit for Private Medical Insurance?

There is no age limit for taking out health insurance, but age influences the policy's cost. The benefits of health insurance are consistent regardless of age. If you're considering health insurance, you can get a quote from WeCovr's experts regardless of your age.

How Can I Compare Health Insurance Plans?

Let WeCovr's experts do the legwork for you and compare health insurance plans at no cost to you to find the best fit for your needs. Consider individual, couple, or family plans and review coverage details thoroughly before choosing. WeCovr provides transparent information on coverage options for easy comparison.

Can I Add Other People Onto My Health Insurance Policy?

Yes, you can add your partner (if you live at the same address) or dependents to your policy at any time. The cost of couple's or family health insurance depends on factors like location, age, health, and chosen excess. Contact WeCovr or your insurer for assistance in adding someone to your policy.

Can I Use Health Insurance Abroad?

While WeCovr's private health insurance plans are tailored for the UK, we offer global health insurance options for those living or working abroad. For holiday coverage, travel insurance is recommended.

What is Comprehensive Cover?

Comprehensive cover provides extensive benefits, including full outpatient services such as consultations, diagnostic tests, physiotherapy, and mental health therapies. Our team at WeCovr can assist in understanding the various coverage levels available.

Does Health Insurance Cover Dental Treatment?

Private health insurance typically does not cover dental treatment. However, WeCovr's experts can guide you to dental insurance policies offered by our partner insurers. Reach out to us to explore these options.

Does Health Insurance Cover Cancer?

Yes, private health insurance covers cancer treatment from diagnosis through treatment. At WeCovr, we can help you navigate the cancer cover options that suit your needs.

Can I Change My Cover Once I Have Signed Up?

At WeCovr, you have flexibility in adjusting your cover. Speak to our experts within 21 days of receiving your paperwork or at policy renewal to make changes.

How Quickly Can I Get an Appointment with a Private GP?

Accessing a private GP appointment is fast and convenient with WeCovr's services, available through your digital platform provided under your chosen insurance plan.

Can Each Person on My Policy Have Different Options of Cover?

Yes, family members on the same policy can potentially have different levels of cover tailored to their individual needs.

Are There Different Levels of Cover?

WeCovr works with insurers offering a range of cover levels to accommodate different budgets and needs. Our experts can discuss these options with you.

Where Can I Find Out More About Hospitals or Treatment Providers?

Discovering healthcare facilities and specialists is easy with WeCovr's resources. Contact us for personalised assistance by tapping one of the buttons above or below and filling in a few details for personalised assistance.

What Does Fee Assured Mean?

Fee-assured consultants provides transparency and no hidden costs for clients.

Does Health Insurance Cover Mental Health?

WeCovr prioritises mental health support with comprehensive coverage and access to specialist advice and services.

Can I Cover My Children as Well?

Children up to a certain age can be included in your policy, and we offer discounts for family coverage.

Will the Cost Go Up Every Year?

Like most health insurance plans, premiums may increase annually due to factors such as age and medical cost inflation.

How Much Does Health Insurance Cost?

The cost of health insurance varies based on several factors. Connect with our experts by tapping a button below and get your own personalised quote.

What's the Difference Between Health Insurance and NHS?

Private health insurance offers quicker access to consultations, treatments, and personalised care compared to the NHS.

Does Health Insurance Cover Physiotherapy?

Yes, WeCovr's experts can guide you which health insurance plans include coverage for physiotherapy treatments.

Can I Use My Cover Straight Away?

Immediate access to certain services like our digital GP app is available upon enrolment.

How Can I Get a Quote?

You can obtain a range of suitable quotes easily by tapping one of the buttons above or below and filling in a few details for personalised assistance.

What Does Health Insurance Cover and What Can't It Cover?

Health insurance covers new conditions that arise after the policy starts. Pre-existing conditions and certain exclusions may apply.

How Does Health Insurance Work?

WeCovr's experts help you arrange health insurance that simplifies access to private healthcare services, including consultations and treatments.

What is Outpatient Cover?

Outpatient cover includes consultations, physiotherapy, and mental health therapies outside hospital admissions.

Can I Use My Health Insurance Cover Immediately?

Yes, you can use your health insurance cover immediately. You have access to a nurse through your helpline and can consult with a GP using the digital GP app. If you need to make a claim right away, we may require a medical report from your GP. Health insurance is designed to cover new conditions that arise after the policy has started.

Does Health Insurance Cover A&E (Accident and Emergency)?

No, health insurance does not cover A&E (Accident and Emergency) visits. Private hospitals do not typically have the facilities for handling A&E cases. In case of an emergency, please dial 999 or use the NHS emergency services. However, if you require follow-up treatment after an emergency situation, your private medical insurance may be able to assist.

Are There Any Rewards for Being a PMI Plan Holder?

Yes, many insurers offer rewards in leisure, wellbeing, and health. Speak to WeCovr's experts or visit your insurer's website for more details on member rewards.

I'm Leaving My Job and Have Health Insurance with Them, What Do I Do?

You may continue your cover or get another own personal policy. If you continue your cover, existing or ongoing medical conditions might be covered depending on the level of cover you choose. Contact our friendly experts to discuss your options and find the right option for you.

How Do I Get a Quote After I've Left My Job?

You can tap one of the buttons above or below and fill in a quick form to arrange a call with us to discuss your options.

If I Continue My Health Insurance After I've Left My Job, Will My New Cover Be the Same as Before?

Your cover may be similar but not identical. We will help you find the right level of cover that suits your needs, and ongoing medical conditions may be covered. Contact our friendly advisers to explore all available options.

If I Continue My Health Insurance After I Left My Job, Will the Price for My New Cover Be the Same?

No, the price won't be the same as before since employers often contribute to the cost of employee cover. Additionally, different cover levels and medical histories may affect the price. Contact WeCovr's experts for detailed information.

How Long Do I Have After Leaving My Job to Decide to Stay with My Insurer?

You have a few weeks or months from leaving your job to decide to continue with your insurer or change to another one. Your policy may start the day after you left your work policy, and our experts can guide you through other available options.

What Do I Need Before Asking About Continuing My Cover After I've Left My Job?

After leaving your job, contact WeCovr's experts with your leave date to discuss available options.

I've Ongoing Treatment But I'm Leaving My Work Health Insurance Policy, Can I Still Have Treatment?

Yes, ongoing treatment may be covered on your new personal policy, although it could affect the price. Contact our experts for personalised advice on your options.

When And How Do I Pay My Excess?

Details on paying excess fees will be provided when you contact your insurer for treatment authorisation.

Do I Pay an Excess for Using Services Like Digital GP?

No, there is no excess fee for utilising these services.

Can I Change My Excess Partway Through the Year?

Excess adjustments can be made at specific intervals during your policy term.

What is a No Claims Discount?

No claims discounts can impact renewal costs based on claims history.

Can I Pay Extra to Have a Pre-existing Condition Covered?

Pre-existing conditions typically aren't covered but can be discussed with our healthcare specialists.

What is Full Medical Underwriting?

This involves health-related questions before policy enrolment to determine coverage.

What is Moratorium Underwriting?

Moratorium underwriting simplifies enrolment but may require health disclosures during claims.

Will My Claim Take Longer If I Have Moratorium Underwriting?

Claims may require additional information if under moratorium underwriting.

What is a Pre-existing Condition?

Pre-existing conditions refer to medical issues existing before policy inception.

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Who Are WeCovr?

WeCovr is an insurance specialist for people valuing their peace of mind and a great service.

👍 WeCovr will help you get your life insurance, critical illness insurance, private medical health insurance, over-50s funeral insurance and senior life insurance quote in no time thanks to our wonderful super-friendly expert partners ready to assist you every step of the way.

Just a quick and simple form and an easy conversation with our FCA-authorised life insurance, critical illness insurance and private medical insurance partner experts and your valuable insurance policy is in place for that needed peace of mind!
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