Private Health Insurance

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What is health insurance?

Private medical insurance (PMI) gives you quick access to private facilities and treatments. It helps pay for any high, unexpected private medical bills you may need covered. This could be anything from physiotherapy sessions, to major heart surgery. PMI also plays an important role in funding the early diagnosis of critical conditions.

What does health insurance cover?

Private medical insurance is designed to cover the cost of private medical treatment for acute conditions. An acute condition is a disease, illness or injury that is likely to respond quickly to treatment and return someone to the state of health they were in before, or lead to a full recovery.

For the majority of claims, medical treatment begins with a GP referral for specialist treatment. This can either be your NHS GP or a private GP. Any onward treatment is managed by working closely with your private medical insurer, to ensure that you have quick and easy access to the right medical treatment.

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How does private medical insurance work?

For the majority of claims, medical treatment begins with a GP referral for specialist treatment. This can either be your NHS GP or a private GP. Any onward treatment is managed by working closely with your private medical insurer, to ensure that you have quick and easy access to the right medical treatment.

How is private medical insurance different from the NHS?

Private medical insurance is designed to work alongside all the services offered by the NHS, but focuses on providing quicker access to treatment for acute medical conditions. PMI members can still use all services offered by the NHS. But with pressures on the NHS to meet healthcare demands growing rapidly, compounded by increasingly stretched resources, PMI can play a complementary role.

Private Health Insurance - FAQ's

It’s what you pay in order to be covered by a plan - e.g. health insurance. You’ll normally pay for your insurance premium by monthly or annual direct debit. Your premium is reviewed once a year and changes depending on your age, if you make a claim and medical information.

As in home insurance, for example, the excess in health insurance is a contribution you agree to make towards any claims. The larger the excess you agree to, the lower your premiums will be. You can choose to pay the excess on each claim you make, or only on the first claim you make in each plan year.

Private medical insurance doesn't normally cover pre-existing conditions, but you can still take out cover for conditions that may affect you in future.

It doesn’t usually cover treatment of long-term (chronic) conditions, where the main aim is to keep the symptoms under control – that would make premiums much more expensive. Private medical insurance also won’t cover any pre-existing conditions you may have when you take out a plan.

There are some standard treatments and conditions that we don't cover. These are:

  • Any regular monitoring or treatment of long- term (chronic) conditions, like diabetes or allergies
  • Any treatment you receive outside the UK
  • Emergency treatment or visits to your NHS GP
  • Pregnancy, childbirth and most related conditions
  • Cosmetic treatment
  • Organ transplants
  • Any treatments or practices that are experimental, unproven or unregistered
  • Any treatment for learning difficulties, delayed speech disorders and other developmental problems

For full details on what’s covered in your plan, check your welcome pack or our terms and conditions.

Waiting Lists - Private Medical Insurance takes away the uncertainty of NHS waiting lists, by giving you access to the very best medical care, at a time and place that suits you.

Fast Diagnostic Tests - With waiting times being a major cause of anxiety in many health events, Private Medical Insurance offers the reassurance of a quick and full diagnosis. However, you’ll need to make sure the plan you choose includes Out-patient Cover.

Choice Of Hospital - PMI offers easy access to hundreds of private hospitals in the UK, as well as the freedom for you to choose where and when you’re treated.

Drugs & Treatment - PMI provides access to a wider range of drugs and treatment, including those which might not yet be approved for use or paid for by the NHS.

Choice Of Consultant - PMI gives you the freedom to choose a consultant for a specific claim.

Privacy - Private healthcare offers you the comfort and privacy of your own room in a nationwide network of private hospitals,with no worries about shared wards.

If you have no pre-existing conditions when you join, there’s no need. Just pick your level of cover and answer some basic questions about your medical history.

If you do have a pre-existing condition, we may need to ask you more questions about your health, or contact your GP. We’ll always tell you if that’s the case.

Call us and we’ll let you know if we need any more information before giving you a quote.

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