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Private medical insurance – one to add to the list?

It goes without saying that the majority of those reading this will have most, if not all, of the major insurances – life insurance, critical illness cover, buildings insurance, home insurance and car insurance. But when it comes to private medical insurance (PMI) or health insurance, as it's more commonly known there are still many that aren't convinced of its value.

The fact that the NHS ranks amongst the best healthcare systems in the world plays a significant role in this, of course, but as we all know there are limitations to free healthcare. Limitations, which may not enter highly on your list of concerns whilst healthy, but if you were to ever find yourself in a situation where you needed medical treatment, I wonder if you would feel differently?

Health insurance is there to ensure that if you need medical treatment in the future you'll be covered for private care, whether that's the bill in its entirety or a portion of it. It can help to minimise waiting times for treatment, ensure a faster diagnosis and generally grants the policyholder more flexibility and choice in terms of the preferred facility and appointment time. Together, these benefits ensure a prompter turnaround, helping in turn to minimise any discomfort, pain or anxiety that you would feel if you were unwell and facilitate your journey to recovery. Most hospitals offering private treatment will also include an en-suite with greater amenities, choice of food and privacy as part of the service to create a more relaxing and comfortable environment.

As with other insurances, the cover available very much depends on the level of care that you're insured for. So if, for instance, you were to take out basic private medical insurance, your policy would typically pay out for most inpatient treatments such as tests and surgery, day-care surgery, exclusive drugs and medication, scans and overnight stays in hospital. More extensive plans usually include outpatient treatments and appointments with specialists and consultants.

Take note, however, that there are limitations to what PMI will cover. The list invariably includes chronic or long-term illnesses such as diabetes, arthritis, HIV/AIDs, epilepsy and hypertension, and self-afflicted conditions like dangerous sports or drug and alcohol abuse. Non-essential cosmetic treatments, gender reassignment surgery, fertility treatment and organ transplants are excluded too, as are GP services, accident and emergency admission, NHS prescriptions and normal pregnancies. In regard to pre-existing conditions – which again you would not be covered against if you were to take out PMI – there are some providers that offer a 'health cash plan', whereby you can set up a monthly direct debit to pay out a cash sum when treatment is needed.

There are many different policies to choose from, but they roughly fall into three categories:

  • Standard: this type of policy gives the most comprehensive cover. There are a variety of sub-divisions within this category.

  • Budget: in return for cheaper premiums, you will get reduced cover under this sort of policy. For example, the company may pay out up to a given amount per year for a treatment, regardless of whether your treatment costs more; limit the types of treatment that are covered; only start if the NHS cannot begin to treat your condition within 6 weeks.

  • Over 60s: specifically designed for people in the 60 to 75 year age range

​When choosing a policy you should consider both how much you are willing to pay for the cover and what your own personal needs and preferences are. What's more, if you participate in a specific sport or have a history of illness this will inevitably impact upon the type of cover that will be available to you. As such, you should always take care when choosing PMI, especially if you intend to personalise your policy or bolt-on extras such as home nursing, health screening, recuperative care and so on. If you need help deciding which cover would be best for you, an Independent Financial Adviser (IFA) with dental specific experience can help you to choose PMI based on your individual circumstances.

Illness and disease can happen to anyone at any time, and when it does your critical illness cover and income protection will only subsidise you during your time off work, not help you medically. Health insurance is the only way to maximum your chances of shorter waiting times, better facilities and faster diagnosis to get you back to fighting fit in no time, so if you value your health it might be worth adding PMI to your list of insurances.

For more information please call 0845 345 5060 or 0754DENTIST.

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i. The Commonwealth Fund. Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for better U.S. Health Care. Accessed online 4 September 2017 at

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