Private Medical Insurance: A Full Coverage Policy

What are the options?

Private Medical Insurance or Health Insurance in the UK can seem like a minefield, as many types of insurance often do. Insurers offer many different styles of policies, with many allowing the customer to ‘tailor make’ the policy and fine tube the level of cover to suit their budget. In this article, we aim to break down the options to help you make the right choice.

Here we will out line all the information you need to know about a Full Medical Insurance Policy. Your other options are the Diagnosis Policy or the Treatment & Care Policy. Click the links to find out more to help you make your decision.

Diagnosis Policy Treatment & Care Policy

Full Medical Insurance Policies

Whether a full Private Medical Insurance policy will be covering an individual or employees of a company, it can be as basic or as comprehensive as the policyholder chooses depending on their needs and of course budget.
All policies will cover any in or day patient treatment in full irrespective of the level of cover the customer chooses. Full Cancer Cover is often included in full aswell as major diagnostic tests such as MRI or CT scans or invasive camera’s which tend to be carried out as a day case. All of this is often referred to as the ‘Core Cover’ of a policy.

Policyholders have options to upgrade their cover which will increase the premium as well as selecting cost containment options which will bring premiums down. Let us now look at some of these options and what they include:

Options to Upgrade:

• Inpatient Mental Health cover – while the majority if policies will include some level of Mental Health cover as standard, this will only be as an Outpatient – this would include consultations or cognitive behavioural therapy as an example. To cover the policy holder in an inpatient facility, there would be an increase in premium.
• Therapies – again, most policies will cover some level of therapy to see a physiotherapist for example, but, if the policyholder wanted to include cover to see an osteopath or chiropractor the policy would need to be upgraded.
• Dental & Optical – Private Medical Insurance policies do not cover routine treatment or tests with a dentist or optician as standard – policyholders must upgrade to cover cash benefits for this.

Options to Contain Costs

• Policy Excess – policyholders can choose excess levels from £0-£1000 per annum – the higher the excess, the lower the premium will be
• 6 Week Option – a relatively new option compared to most, the 6 Week Option only applies to in or day patient treatment. When a consultant or specialist recommends in or day patient treatment, the insurer will check whether this can be carried out on the NHS within a 6 week period – if it can, the member can either use the NHS or choose to self-fund the treatment privately – if it can’t, the member can carry on and use the policy for the treatment which would be paid in full. This benefit can also bring other limitations depending on the insurer so be sure to read the full description. This benefit can often bring a healthy discount of around 15%.
• Reduce Outpatient Cover – Outpatient consultations and diagnostic tests are usually covered in full, however, policyholders have the option to downgrade this to often £1000 or £500 per person per year. Major diagnostics like MRI scans would still be covered in full, but, if a policy had a limit and the customer claimed over and above, the difference would fall to them to pay. £1000 is often considered as sufficient and is therefore used on a regular basis to keep costs down.

As mentioned above, all policies will now include some ‘extra’ benefits as standard irrelevant of the level of cover, such as Wellbeing apps which can give advice on diet and lifestyle and Digital GP apps which will allow customers to have a video call with a GP usually within 24 hours.

If a company is considering offering Private Medical Insurance to its employees then a full policy is the most common option. This will give the employer the security that if employees become unwell they should have a speedy return to work, and will also take away any stress and worry from the employee over waiting times.

Who is it right for?

This style of policy would be suited to people who do not want any risk of using the NHS at all. This policy will usually be the best option for companies covering their staff.

Monthly Premium for a 45-year-old living in Manchester – £90.46 (as of 01/09/2023 –source: Vitality Health PMI UK)

Overall, Private Medical Insurance may feel complicated, but there really are option to suit everyone. Personal Healthcare Management specialise in finding the right policy for customers and will be happy to give unbiased advice. If you would like to discuss options please email enquiries@phealthcare.co.uk or call 01829781920.