Private Medical Insurance (PMI)

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Private Medical Insurance pays for treatment you may need in the future without having to rely on the NHS.  In other words, it gives you more options if you need medical treatment and can mean avoiding NHS waiting lists.

Who Might Need Private Medical Insurance (PMI)?

Health is the most important thing we have. When we're ill, we want to be treated quickly and although every UK resident is entitled to free healthcare from the NHS, private medical insurance (PMI) allows you to skip waiting lists and arrange treatment at a time you choose.

A recent Bupa survey found that the main reasons for going private were the fear of superbugs such as MRSA and hospital cleanliness, and a desire to avoid long waiting lists. If these kind of things are important to you, you will probably want to consider PMI so that you can be treated in the more pleasant surroundings of a private hospital.

Main Benefits of Private Medical Insurance

Like all types of insurance, the cover you get varies, but basic private medical insurance usually covers the costs of most in-patient treatments (tests and surgery) and day-care surgery, and some extend to out-patient treatments (such as specialists and consultants).

Typically, private medical insurance offers the following benefits:

  • Prompt access to eligible treatment – no waiting lists
  • Access to quality treatment from consultants and specialists
  • Access to clean and comfortable recognised hospitals
  • Access to groundbreaking drugs and eligible treatments
  • Access to some kind of healthline offering medical guidance

How Can I Get Protected?

To start with, you will need to think about your lifestyle and the conditions or illnesses which concern you the most, as there are different different levels of cover that you can take out.  The one you choose needs to be right for you and fit into your medical requirements and budget.

>>> Private medical insurance questions and answers

We then recommend that you speak to an adviser to ensure you are aware of all the options available to you.  You may want to speak to some of the various insurance companies that offer PMI, but by speaking to an independent financial adviser or insurance broker, they can reseach the whole market for you and advise based on your needs.

Things To Consider When taking out PMI

Cover can be purchased on a full medical underwriting basis, which means you will be asked a number of questions about your health and based on the information you provide, the insurer will decide the conditions of your cover.

You can also apply for cover on a moratorium basis, which means you will not be asked any questions about your health, but if you have suffered from any health conditions in the last five years, these will automatically be excluded from cover initially.

Below are some points to be aware of before you take out cover.  You may want to get clarification on these points from your adviser:

  • You can't take out cover now for treatment you know you're going to need
  • If you've had health problems in the past (pre-existing conditions) the insurer may exclude these conditions from your cover. If you are asked to disclose these when applying for the insurance you must do so, or you could invalidate your policy
  • It does not cover the treatment of chronic medical conditions. There are various definitions of chronic conditions depending on the policy, but broadly it is a long-term medical condition which is likely to continue to need regular or periodic treatment
  • Some exclude certain types of treatments such as out-patient treatments, routine treatments (such as health checks), dental care or experimental treatments.  Check these with the insurance company or adviser
  • Most also exclude routine pregnancy, HIV/AIDS, fertility treatment, mental or psychiatric conditions, and elective treatments you may choose to have, such as cosmetic surgery
  • If applicable, find out if your employer provides health insurance as part of your benefits package

N.B. If you are asked, it is important that you disclose any existing medical conditions when applying for the insurance, or you could invalidate your policy, which means the insurance company won't pay out if you make a claim. Always read the paperwork and ask your adviser if you don't understand anything.

Useful Links

>>> Benefits of taking out cover through Money Advice
PMI Questions & Answers
Speak to an Insurance Adviser (quotes & enquiries)
Life Insurance Cover
Income Protection
Critical Illness Insurance
>>> Mortgage Protection Insurance


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