Top 5 FAQs About Health Insurance

Our team loves a challenge. But sometimes you might have a very simple question about health insurance. These are some of the most common questions we’re asked. If there’s something else you’d like to know, why not contact us today? We’re happy to help!

1) How does health insurance underwriting work?

Every insurer assesses risks in a different way. Health insurance is no different. Your premiums are based on a combination of things – your age, post code, lifestyle, previous health etc.

Before quoting on a policy, a health insurer needs to know more about your current health and any pre-existing medical conditions you might have. Depending on your situation, you’ll be offered a policy that has one type of underwriting or another.

We’ve talked about these in more detail in our full How Does Health Insurance Underwriting Work guide – but here’s a very brief summary:

Full Medical Underwriting

This type of underwriting involves giving detailed information about any historical, current and pending medical conditions, plus any associated treatment and/or medication.

Medical History Disregarded

If an insurer says they’ll underwrite your policy on a ‘Medical History Disregarded’ basis, it means they’re not going to take pre-existing conditions into account.

Moratorium Underwriting

This type of underwriting works on the basis you’ll need to prove you’re eligible to make a claim, if or when you make a claim. There are caveats around previous medical conditions.

Continued Personal Medical Exclusions (CPME)

Where possible, this type of underwriting lets you switch from one insurer to another by transferring all the exclusions you have in place already.

Continued Moratorium Underwriting

This means that instead of starting a new Moratorium we can back date the new insurers Moratorium to the start date of your current policy.

If you’d like to know more, our expert Healthcare Consultants are very happy to talk through underwriting options with you over the phone.
You’ll find our contact details here.

2) How does health insurance work?

Health insurance helps you to get prompt, private medical treatment when you’re suffering from illness or injury. Health insurance doesn’t cover medical emergencies. If you need emergency treatment, the NHS will treat you in an Accident and Emergency department.

Most policies start with core or basic cover. This includes the charges at specific hospitals; specialists’ fees (up to a fee limit); consultations with approved specialists and diagnostic tests such as blood tests and X-rays. Treatment for cancer is usually included at this level, too.

  • If you’ve noticed a change in health, the first step is to talk to a medical professional. This might be your local GP, or your policy might offer an over-the-phone service.
  • Then, if you need treatment or more diagnosis, that professional can refer you to a specialist and a private hospital – one that’s covered by your policy.
  • At this point, if not before, you’ll let the insurer know that you might be making a claim. It’s a good opportunity to confirm what you’re covered for – the insurer will have all of your details.

Then, while you go ahead with your appointment, the insurer will start the paperwork to make sure all eligible bills get paid – which means you can focus on getting better.

If you’d like to know more, our expert Healthcare Consultants are very happy to talk through type of cover you have, or could get, and explain how to claim. You’ll find our contact details here.

3) Can I choose which hospital or specialist I see?

Health insurance policies always come with information showing where you can expect and will be expected to get treatment if you need to make a claim.

When you’re referred for a diagnosis or treatment, you’ll be sent to a specialist who’s known to the insurer. If there’s someone you’ve heard of who you’d like to see, you can always ring your insurer to find out if that’s okay. Most insurers will say yes, providing the consultant’s fees aren’t higher than their fee guidelines.

Although each health insurer uses a different network of facilities, we can talk through the hospital list that’s associated with your policy. We might be able to offer alternatives too.

4) Can I get health insurance for an illness or injury I already have?

It’s possible. Insurers won’t cover you for most illnesses that you have now or that you’ve had before – pre-existing conditions that are not already covered by a health insurance policy. This includes any illness, disease or injury that you’ve had medication, advice or treatment for – whether or not the condition was diagnosed. It also includes any illness, disease or injury giving you symptoms that haven’t been diagnosed yet. If you all ready have a pre-existing condition covered or you have a condition that is minor or not been treated for a while it is possible to continue cover with a new insurer.

If you’re worried about switching policy due to pre-existing conditions, our expert Healthcare Consultants are very happy to talk through some of the options with you over the phone.You’ll find our contact details here.

5) Is private medical insurance better than getting treated on the NHS?

Health insurance gives you peace of mind. In some cases, you might choose not to use your policy – for a low-cost diagnosis, for example – and in others, you might decide to see a specialist working in an NHS hospital instead of claiming on your policy.

But health insurance (sometimes it’s called private medical insurance) does guarantee prompt treatment. It also offers the reassurance that there’s a team of medical experts, making sure you’re getting the right treatment and the insurers we work with have teams who’ll be reviewing your recommended treatment plan. If there’s something that’s not been considered, and they know it’s a better option, they’ll speak directly to your specialist – making sure you get the best care.

Your health insurance may also pay for drugs and care that’s not available on the NHS. Each policy is different, but in general, there’s a broader quality of care involved too. You’re likely to have a private room, and some health insurance policies offer alternative therapies too.

If you’re unsure about value for money, give us a call. Our expert Healthcare Consultants can explain the benefits of private care to you over the phone. You’ll find our contact details here.

Overall, the best way to make sure you‘re getting the best value for money is to review your health insurance policy regularly. Everyone’s situation is slightly different, so, before we make a recommendation, we’ll ask you questions about what level of cover is important to you.

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