Health insurance faqs

Use our guide to learn more about health insurance and compare quotes today.

How does health insurance work?

If you have health insurance, you can arrange for prompt private treatment in a few simple steps:

  1. If you think something is wrong with your health, see your GP and tell them you have private health insurance.

  2. If you need treatment, your GP will be able to refer you immediately to a leading specialist and a private hospital of your choice.

  3. You must tell your insurance company that you want to make a claim on your policy and confirm your coverage.

  4. When your health insurance company agrees, your GP will make your appointment with the specialist. This will be taken care of by your insurer.

Health insurance does not cover medical emergencies. If you need emergency treatment you will need to visit the NHS Accident and Emergency site as usual.

However, once your health has stabilized, your health insurance will cover the continuation of your private treatment.

What types of health insurance policies are available?

Budget. Budget policies are the cheapest form of health insurance, but they normally only cover inpatient and outpatient treatment with limits on how much you can claim.

Midrange. Most mid-range health insurance policies cover all inpatient and outpatient care and some outpatient treatment. Mid-range policies are a good option if you want to enjoy the benefits of private health at an affordable price.

Full. Comprehensive health insurance policies are the more expensive option, but they offer comprehensive coverage for inpatients, day patients, and outpatient care, with benefits such as psychiatric coverage and additional therapy included.

However, not all insurers use these terms to classify their health insurance products, which is why Uswitch’s comparison service shows you full details of each policy online to help you compare them.

Can I switch to another policy without losing coverage?

Yes you can. The Switch / CPME (continuous personal medical exclusion) subscription allows you to change contracts without losing coverage for conditions that arose while you were covered by your original contract. You can compare “switch policies” online with Uswitch or by calling 0800 862 0360 *.

Which hospitals can I use with my health insurance coverage?

Each health insurance policy comes with a list of approved hospitals which may vary depending on the amount you pay. For example, not all policies will cover premium hospitals in London. Make sure you are happy with your list of hospitals before purchasing your health insurance policy, especially if there is a particular private hospital that you want to use.

What factors will affect the cost of my health insurance?

Health insurance premiums are determined by different factors which can increase or decrease the monthly cost. Naturally, your current health and medical history is a big factor for insurers, and some providers will offer reduced premiums and cash back rewards if you exercise regularly and eat a healthy diet.

If you smoke, you may incur higher premiums than non-smokers, and your age will also affect the cost of your policy.

Can I reduce my health insurance premiums?

There are a range of discount programs that can be applied to your health insurance policy to make it more affordable without sacrificing the coverage you need. These include:

Six week option: If the NHS is able to provide treatment within six weeks, you will be treated on the NHS. However, if the NHS cannot guarantee treatment within six weeks, you can use your health insurance policy to be treated immediately.

Excess: You can volunteer to pay the first part of any claim, which will be agreed upon when purchasing the policy. The higher your policy deductible, the lower your premiums.

Co-payment: You can volunteer to pay a percentage of any claim that will reduce your premium.

Reduced list of hospitals: By choosing this option, you will not be paying for hospitals that you do not need.

You can usually apply as many or as few of these plans to your policy as you want to reduce premiums.

What does health insurance not cover?

Health insurance is not designed to cover emergency medical care, but it will cover your treatment once your condition has stabilized.

Generally, Medicare does not cover the following; pregnancy, fertility treatment, cosmetic treatment, sex change or any other voluntary medical treatment.

Health insurance does not generally cover treatment for chronic illnesses, but it can provide health care to stabilize chronic illness in the event of a severe disease flare.

Can I cover pre-existing conditions?

Health insurance is designed to cover conditions that you develop after purchasing your policy. However, the type of subscription you choose will determine whether your pre-existing conditions will be covered in the future. There are three main types of subscription:

Moratorium: Moratorium policies will normally exclude coverage for any condition you have experienced in the past 5 years. However, if you do not receive any symptoms, treatment or advice for this condition within the first two years of the policy, you will be covered again.

Full Medical Underwriting (FMU): UMF policies require that you provide your complete medical history when applying. Usually, your insurer will exclude coverage for pre-existing conditions, but you will be advised of these exclusions before committing to purchase the policy.

Change: Changing your subscription allows you to change insurer without losing coverage for the ailments you have suffered since taking out your old contract. Will my health insurance payments change?

Your health insurance premiums may increase as you get older because you are more likely to claim your policy. The level of increase will vary depending on your insurer and your policy. It’s worth reviewing your policy every year to make sure you’re getting the right level of coverage at the lowest price.

About Wendy Hall

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