What's Covered?
Health insurance policies come in all shapes and sizes.
Most companies offer several different levels of cover and a range of optional extras, all of which can affect the cost of your premium and the treatments and services covered by your policy.
We cannot provide a comprehensive guide to what is covered by different medical insurance companies here - there are too many factors to consider. What we have done instead is to list some of the things you will need to think about when choosing medical insurance.
We've divided these into two categories:
What Can Be Covered?
Health insurance policy cover can be as comprehensive or as minimal as you want, within certain restrictions (see below).
Here are some examples of categories of cover you might need to choose from:
- In-patient treatment (you are admitted to hospital and stay overnight)
- Day-patient (you are admitted to hospital but do not stay overnight)
- Outpatient (you are not admitted, you just attend appointments for treatment)
- Consultations & diagnostic tests
- Cancer & heart disease
- Psychiatric care
- Sports cover
- Road traffic accident cover
- Complementary/alternative therapies
- Limits in duration and cost of treatment
- Overseas cover
As with other types of insurance, the cost of your cover can also be affected by the size of your excess. Choosing a larger excess payment may enable you to reduce your premium a little - as with car insurance.
What Is Usually Not Covered?
Private medical insurance is only designed to provide cover for acute conditions. These are conditions that are curable and will respond readily to treatment, enabling you to get better.
The following types of conditions are excluded from most health insurance policies.
(Please note that this is not a definitive or exhaustive list - just a typical example):
- Chronic conditions (conditions that cannot be cured)
- HIV/AIDS
- Self-inflicted injuries
- Drug abuse
- Routine out-patient treatment - e.g. changing dressings
- Pregnancy or fertility treatment
- Sex changes
- Cosmetic surgery
- Injuries/problems resulting from military conflict or dangerous hobbies
- Kidney dialysis / organ transplants
- Preventative care
- Experimental treatment or drugs
- Accident & Emergency treatment - this is usually NHS only