Private Medical Insurance



Private Medical Insurance – it will give you peace of mind that you will get medical treatment promptly if you become ill or injured in the future. You won’t need to worry about NHS waiting lists and you don’t have to pay for the cost of the treatment. You will get a prompt referral to a consultant. It will also offer you an admission to a private hospital at a time and place that is convenient for you. You will have a choice of specialist consultants and surgeons. This will ensure that professionals that might not be available on the NHS will attend to you quickly. You will have access to some of the best hospitals available. It also includes your own room, TV and changing rooms, as well as en-suite facilities and quality meals.

Although the NHS can provide you with the medical treatment that you need, it is still important to have PMI. In many ways, people with PMI get the best of both worlds. Even if you have PMI, you will still have access to NHS facilities. At the same time, you can enjoy superior standard of care that comes with Private Medical Insurance. With PMI you won’t have restricted visitation hours. You will also have a greater choice of food. You are also more likely to be seen by the same consultant. It takes longer for the NHS to approve new treatments. Private facilities are quick to adopt these advances. It ensures that you will always get the care you need whenever you need it.

Benefits of PMI (Private Medical Insurance)

  • Avoidance of long NHS waiting lists
  • You can choose the hospital
  • Specialist of your choice
  • Choice in timing of treatment
  • Higher nurse to patient ratio
  • Highly professional medical staff
  • Guaranteed privacy that a private hospital can provide
  • More flexible visiting hours.

What treatments are available?

There are three different types of treatment that are available: out-patient treatment, day patient treatment and in-patient treatment.

  • Out-patient – when you receive a referral from your GP for a consultation with a specialist or consultant before you get admitted to a hospital.
  • A day patient – you spend a couple of hours in the hospital to recover from either a diagnostic test or a series of tests.
  • In-patient treatment involves you staying in the hospital for one or more days. Different policies of health insurance offer different levels of care, but they typically have different premium levels. The premium levels depend on the level of cover required.

Are there any exclusions?

There might be some exclusions, such as existing medical conditions or chronic conditions that have no known cure. Each policy is different and will have a list of exclusions that is not listed above. Private Medical Insurance might not cover a permanent medical condition, long-term medical care, and rehabilitation. In most cases, Private Medical Insurance will never cover accident and emergency services. It also won’t cover conditions relating to drug abuse as well as HIV/AIDS. Most likely it will also not cover war and riot health related issues. It usually does not cover cosmetic surgery for vanity purposes. The cost of the insurance premium depends on a large number of factors and individual circumstances. However, it would be advisable to speak to a qualified adviser to get the best advice.

What are Diagnostic Tests?

These include: MRI; CT Scans; PET Scans; X-rays, blood tests, etc. These are all covered as part of your treatment.

  • Inpatient/day patient – full cover
  • Outpatient – the level of cover depends on your limit e.g. £1,000. £750, £500. This varies from insurer to insurer and terms and conditions apply.

Patient insurance 1024x681Type of Medical Underwriting

  • Full medical underwriting requires you to complete a medical application. This includes declaring any past health conditions or treatment you may have had and conditions you are currently suffering or treated for. The insurer will make a decision based on your medical history and then decide what they will and will not cover under the policy.
  • Moratorium underwriting means you do not have to submit any details about your past health. Instead, the insurer will exclude treatment for any conditions you have suffered in the past 5 years. Any conditions you suffered during this period are defined as preexisting.

However, PMI can still cover these preexisting conditions at a later date. Your Private Medical, Insurance can cover your preexisting conditions if you do not show symptoms of those conditions within two years. You should also not be receiving any treatment, medication, or professional medical advice for it. There is a the 2 years cooling off period. If the condition reoccurs within this period, you will start another 2-year period before the condition can be covered.

***It is important to note that moratorium definitions can vary from insurer to insurer. You should confirm the definition in your policy terms. (Moratoriums can vary from 1 to 2 or 5 years.)

  • Continued Personal Medical Exclusion (CPME) – This applies if you switch your health insurance policy. It means the new insurer agrees to cover you on the same basis as your original insurer, rather than on a clean slate. The insurer will ask you to answer a switch questionnaire in order to give you a continuation option.


  • Medical History Disregarded. It is available mostly on a Group insurance scheme with a minimum number of members. It varies from insurer to insurer. This covers all preexisting conditions and normally requires a higher premium.


NHS Cash Benefits – varies from insurer to insurer. You will get a cash back payment per night or per day if you choose to use the NHS rather than claim on your PMI Therapies. Therapies such as: Physiotherapy, Chiropractor, Osteopathy, Acupuncture, Homeopathy, Podiatry, and Chiropody are all available depending on the insurer.

Dental Cover – also available at an extra cost depending on the insurer. Not all providers offer this benefit.

Psychiatric cover – available at an extra cost and it depends on the insurer. Some automatically include this benefit.

Worldwide or Overseas Cover – This will cover you abroad. It is available at an extra cost and it depends on the insurer. Some automatically include this benefit.

Parental Accommodation – This covers parents to stay overnight in the hospital if their children are admitted. It depends on the insurer and the maximum age of children varies.

Home Nursing – covers assistance should you need help while recuperating at home.

GP Helpline – This telephone service is available 24/7.  It varies according to the insurer.  Some can prescribe medication or refer you straight to a consultant.

Virtual GP – varies depending on the insurer. Some offer this for free.  Some can prescribe medicine or refer you straight to a consultant.

Pregnancy complication – covers ectopic pregnancy, miscarriage, stillbirth etc.  The cover varies across insurers.  It does not cover planned treatment e.g. fertility treatments.

How much does it cost?

Costs depend on your individual circumstances and of course, your health. Having said that, there are a few ways to keep your costs down.

  • No claims discounts – it helps cut costs. This means that if you do not make a claim, you can build up a discount. You can also build a discount, if the cost of your claim is lower than your premium. But be careful, some of these no claims discounts can put people who are seeking vital treatment off in order to save their discount. Thus, it negates the whole purpose or point of Private Medical Insurance. For this reason, some providers DO NOT offer a no claims discount on the policy.
  • Excess – is a monetary amount that you wish to pay towards any treatment to help reduce the premium. It can be paid per claim or per year. You can claim regardless of the number of claims made.
  • The discount available is based on the amount chosen. For example, from £100 to £1,500 alongside your chosen option, whether it is on a per claim or per year basis.
  • 4-week or 6-week option – Another way to cut costs is to delay treatment. Use your Private Medical Insurance only if the NHS can’t see you quickly enough. You can choose between either a 4-week or 6-week delay.

Chances are, your finances will be greatly affected when you get sick. You can easily lose all your savings paying for your medical bills. That is why it is important for you to have a plan. You can speak with one of our qualified advisers to know more about Private Medical Insurance. We can help you choose the plan that suits your needs. Just click on the “Get a free quote” button and we will get in touch with you.

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