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What isn’t covered under health insurance?

There are some common policy exclusions when it comes to health insurance. Generally you would not receive cover for the following:

• A&E visits. Unfortunately, if you’re rushed to Accident and Emergency and treated, you won’t be able to claim on your health insurance.
• Chronic conditions. Health insurance does not cover conditions that are long term or cannot be cured, for example asthma or diabetes.
• Pre-existing conditions. Your health insurance won’t cover you for conditions that you had previously developed before your policy began.
• Organ transplants. You’re not likely to find health insurance cover for organ transplants.
• Cosmetic surgery to improve your appearance. This is also not something that health insurance usually covers, however many insurers will pay for ‘eligible’ surgery required to restore appearance following an accident or cancer surgery.
• Pregnancy or childbirth costs. Complications during pregnancy or childbirth may be covered by your insurer but delivery costs are normally exlcluded.

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Frequently asked questions

Purchasing your policy

• What is the best type of health insurance to purchase?

  There’s no single “best” policy, although there some handy tips that are useful in most situations. For example, to keep the cost down it’s best to opt for a cheap policy that specifically covers treatments you think you may need, rather than a more expensive comprehensive policy. For example, choosing a policy that covers physiotherapy and hospital stays, but not dentistry or homeopathy, may be a better option if you think that those are treatments you’re likely to need.

• Do I need health insurance?

  No-one in the UK needs health insurance as we are lucky enough to have free health care under the NHS. However, health insurance gives you access to the benefits of private medical care.

  Benefits of private medical care include quicker diagnosis, shorter waiting times and potentially better facilities. With health insurance you can also enjoy:

  • The ability to choose the hospital where you are treated.
  • The ability to choose the doctor or specialist who treats you.
  • Access to a private or shared room in a private hospital.

• How do I choose a policy?

  The first step is to consider what illnesses or injuries you want to insure yourself against, and then consider the types of treatment you want to cover. Once you’ve worked this out, you can then start to get quotes from a health insurance broker or browse online. You can then compare these quotes to find the best deal. When doing so, make sure the policy offers the cover you need, is affordable, whether there’s any limits on how much or how often you can claim and if there’s a qualifying period. That last one is a period of time that you must wait before you can make a claim – so it’s important to check this before accepting a policy!

• What are the different types of health insurance policy?

  There are three main types of health insurance policy – budget, mid-range and comprehensive. Budget, unsurprisingly, is the cheapest of these and will normally only cover day-patient and in-patient treatment, and they’ll likely be limits on what you can claim. Mid-range policies will cover the same treatments while also covering some outpatient treatments. A comprehensive policy meanwhile will provide full cover for in-patient, outpatient and day-patient cover while also covering psychiatric and therapeutic cover.

• Is it worth it?

  If you’re happy with NHS treatment, then private health insurance simply isn’t worth it. If you want or need private treatment, however, then an insurance policy may be the most straightforward way to pay for it.

• Are there any alternatives?

  In addition to NHS treatment, there’s also healthcare cash plans. These are schemes that you pay into each month. They allow you to claim back the cost of some types of medical treatment after you’ve paid the initial bill.

Adjusting your policy

• Can I lower the cost?

  Yes, the cost of health insurance can be made cheaper by a variety of means. Chief among these is a no claims discount: this is when you’ve had health insurance for a while and, during that time, you haven’t made any claims. As a result, your premiums become cheaper. Other ways include an excess, which is the amount you pay towards treatment yourself when you make a claim. A higher excess will normally make your premium lower, but will make claiming on your policy more expensive.You can also get cheaper cover by using nominated hospitals, and some insurers will also reduce your premiums if you keep in good health.

• Will my health affect the cost?

  Yes, it’s possible your health could affect the cost of your insurance. If you have a pre-existing condition, for example, then insurance is likely to cost you more. Some policies, however, may only charge more if you need to cover treatment for a condition.

• Can I still use the NHS if I have health insurance?

  Having private health insurance cover won’t prohibit you from receiving treatment free of charge on the NHS. Alternatively, you could use your insurance cover to pay for treatment.

• Will my health insurance cover me abroad?

  It’s relatively uncommon for health insurance to cover you both at home and abroad – it’s likely that you’ll need two separate policies for this. Many travel insurance providers also offer medical cover for your trip overseas, for example.

• Can I use any hospital?

  No, unlike the NHS, most private insurance plans will specify which hospitals you can use for your treatment. When you’re referred for treatment, you’re likely to be given a list of hospitals by your insurance company.

• Can I get health insurance for my family?

  Yes, you can. The ways to this are to either take out individual policies for each family member, or to get a single family policy that covers the whole family.

• Can I get health insurance if I'm disabled?

  Yes, you can. It’s important that you check that your policy covers treatments related to your disability though, as some providers won’t cover these.