Introduction Types of Policies Limits on cover Excesses Exclusions Underwriting Buying medical insurance
Introduction Medical insurance is designed to pay for the cost of acute medical treatment required after the policy commences. In the UK today there are around 6.5 million people with medical insurance, whether individually or through a company scheme. The reason for medical insurance’s popularity is:-.   1 Treatment when and where you want it; 2 Your choice of hospital and consultant; 3 Speed and convenience; 4 Private Room. Other types of insurance are sometimes confused with medical insurance. For example, cash plans will only pay a small amount of money if you are hospitalized, which will not be enough to fund private treatment. Income replacement will provide a monthly payment to replace your income should you be unable to work through accident or illness, critical illness provides a lump sum in the event you contract one of the named critical illnesses. Only medical insurance will actually pay for treatment that you require.
Types of Policies Medical insurance will pay for the treatment of acute episodes of illness or injury. Policies are generally split into two categories - budget or comprehensive. The level of cover provided by the different schemes provided by the different insurers will vary. Different schemes also use different hospitals. Please see our comprehensive and budget explanation.	Top
Limits on cover All insurances whether medical or general insurances will have areas where the cover is limited. This is to control the claims costs so that premiums do not rise at unsustainable levels. Limits for medical insurance generally apply to things like alternative medicine, home nursing and private ambulance etc. The cost of hospital treatment and out-patient consultations (if chosen) is generally not limited.	Top
Excesses Increasingly popular now is the addition of an excess amount to a policy of between £100 or £200 to make a saving on the monthly premiums, which can be as much as 20%. In addition much larger excesses, up to £5000, and shared cost schemes are becoming more popular as the premiums are extremely competitive.	Top
Exclusions All private medical cover excludes certain things. This is done to control costs and keep premiums down. Below is a summary of the main exclusions for each insurer.   IF YOU HAVE ANY QUERIES ABOUT THE EXCLUSIONS PLEASE CALL FOR FURTHER ADVICE AND CLARIFICATION 1 Pre-existing conditions (as covered in UNDERWRITING) 2 Temporary relief or control of chronic conditions. A chronic condition is one that is deemed incurable(i.e. Hayfever). Cancer and Heart disease are considered curable. Should you have an acute phase of a chronic illness, provided that the condition is not a pre-existing condition, then benefit is payable. 3 Normal pregnancy, infertility treatment, sterilisation (male or female), any form of assisted reproduction. 4 Termination of a pregnancy or any foetal surgery. 5 Treatment in Health Hydros 6 Experimental treatment unless authorisation given beforehand. 7 Cosmetic treatment except caused by an accident or medically necessary operation. 8 Treatment caused by war, riot or revolution or similar event. 9 Medical aids that are not part of your body, for example glasses or crutches. 10 Treatment by a GP or treatment by a dentist This is not an exhaustive list but gives an overview of the most common exclusions.	Top
Underwriting WHAT IS UNDERWRITING? Any person could not expect to insure their house if the roof had just fallen through. Similarly private medical insurance will not cover any conditions that are already existing or known about. This does not mean that insurance is not offered, just that already existing conditions will generally be excluded. Only unforeseen medical conditions can be covered. To administer this the insurance companies use one of the following:   FULL MEDICAL UNDERWRITING This is the most common form of risk management used by private medical insurance providers. Newly insured individuals answer a set of questions about their medical history. The actual questions vary from company to company. The objective is to reveal any treatment which is being received or waited for. This will then be excluded from the cover so that the insurer will not have to immediately pay claims, which will impact on the overall claims fund. Treatment which has been received from a GP, or a consultant in the past will generally be excluded although dependant on the condition an exclusion may not be added.   MORATORIUM This type of underwriting excludes all previous conditions for a continuous period of (usually) 2 years. If during the 2 years no treatment or advice is sought about the condition, nor symptoms suffered, it should then be included in the cover. The moratorium is rolling and if advice or treatment is sought then the 2 year moratorium period will start again from the date of the symptoms, advice or treatment. The exact term of a moratorium can vary from insurer to insurer and a full disclosure of the insurers moratorium should be obtained.	Top
Buying medical insurance There are now so many different policies available in the market place that it has become almost impossible for somebody who is not an expert to actually compare different types of policies available. Most commentators now recommend the use of a specialist healthcare intermediary that should be General Insurance Standards Council regulated and preferably a member of the Association of Medical Insurance Intermediaries, AMII, an association that is dedicated to continuing the high standards of service that specialist medical insurance intermediaries currently offer.   The above information does not constitute part of any contract nor should it be relied upon as specific advice.	Top