As a business owner, your health has the potential to threaten the success of your business, and with the overburdened NHS often restricted from providing comprehensive care, what is Private Medical Insurance, and how can it benefit you and your dependants or employees?
As healthcare needs have continued to grow and evolve, the NHS waiting lists for vital procedures have grown. For this reason, both individuals and businesses have turned to private medical insurance (PMI) to satisfy their health and wellness needs.
What is PMI?
With PMI, individuals have quicker access to treatments and a wider selection of care environments, specialists and treatment facilities. This insurance is capable of going hand in hand with the services and care that the NHS provides, which can benefit both individuals and businesses.
Depending on whether you have medical insurance as an individual or a business, there are three types of PMI schemes:
Individual Plans
This typically covers a single person, but can extend to the entire family. Such plans help business owners ensure that any personal or family medical issues do not affect their businesses, by way of navigating around lengthy NHS wait times.
Company-Paid Plans
These plans require employers to cover the cost of a policy, but they can designate their amounts of cover. For example, a business may choose to provide its employees with a major medical expenses policy that would cover only surgery.
Group Plans
Group plans involve a collective of individuals that belong to a shared organisation, such as a trade union, that pool their resources and purchase a policy for everyone in the group.
Tailoring your Plan to Suit You
So now that we know the different types of PMI Insurance, let’s looks at how you can tailor each of these to provide bespoke cover which suits your individual requirements.
Premier or Comprehensive Plans
These offer the broadest range of cover and have the fewest restrictions on how large of an amount can be claimed. The policyholder has the option of including often-excluded items, such as:
- Dental, optical, and mental health
- Traditional pregnancy and childbirth
- Home nursing
This policy can be further tailored to include private consultations with a GP and limited cover to receive treatment abroad.
Standard Plans
Standard plans are less expensive than the premier plans, but impose limitations on what can be claimed. These limits can be placed on:
- The annual amount that can be claimed
- A predetermined amount of days that can be used for treatment
- The choice of hospital
Budget or Six-Week Plans
These plans represent the cheapest plans and provide policyholders with limited cover dictated by exceptions. They typically restrict cover to the more important or expensive types of treatment. Additional limitations include:
- Not covering the cost of the initial consultation and diagnosis
- Only covering limited types of illnesses
- Restricting the insured from using a private hospital
What Does PMI Cover?
The purpose of PMI is to provide the policyholder with a method to pay for the customised treatment of short-term, curable conditions.
In general, most policies cover neither chronic illness (such as diabetes and multiple sclerosis), nor medical expenses for routine procedures (such as pregnancy and childbirth). However, if complications should arise during routine procedures, those expenses should be covered.
In addition to complications with routine procedures, PMI policies may also provide cover for:
- Inpatient hospital charges
- Inpatient specialists’ fees
- Outpatient charges
- Home-nursing charges
- Cash benefits if the received treatment is free of charge under the NHS
- Minor surgery carried out by the policyholder’s GP
- Private ambulance
Whilst this list is not comprehensive, it does highlight the most common treatments and services that may be covered.
What Does PMI Exclude?
PMI was not designed to address all of a policyholder’s illnesses. Instead, there is a specific structure to identify what is covered. Here are some exclusions that are typically present in all PMI policies:
- Pre-existing conditions
- Superfluous cosmetic surgery
- Long-term hospital or nursing care
- Treatment not recommended by the policyholder’s GP
- Palliative treatment
- Drug or alcohol abuse treatment
- Hormone replacement therapy and gender reassignment
- Elective termination of pregnancy and vasectomy/sterilisation
Whilst this list is not reflective of all treatments and services that are generally covered, it does highlight the most commonly excluded.
https://www.turnerinsurance.co.uk/financial-advice/healthcare/
