"Many policies cover physical therapies such as physiotherapy and chiropractic work but some also cover mental health issues through access to counselling and psychotherapy"
And it’s not just cancer. Early diagnosis can make all the difference to a wide range of serious and not so serious illnesses, injuries and conditions. Identifying the problem and getting to the best experts and treatment quickly makes a massive difference to outcomes and quality of life.
For many, the NHS’s commitment to providing free treatment to all is enough. For others, especially those who are worried about waiting to get a diagnosis or treatment, private medical insurance could be the answer.
Quick access to healthcare solutions
PMI provides fast access to expert healthcare and could help cover the costs of private diagnosis and treatment.
Policies vary widely, and making sure buyers understand the levels and areas of cover is crucial. Broadly, though, there are two types of cover: out-patient, which provides cover for diagnosis, tests and scans and treatments which don’t require hospitalisation; and in-patient, which would typically include surgery and follow-up care.
Many policies cover physical therapies such as physiotherapy and chiropractic work but some also cover mental health issues through access to counselling and psychotherapy and a select few offer assistance in the form of common dental and optical benefits.
A major benefit in most policies is faster access to diagnosis and a range of treatment for curable conditions, through a private system that would otherwise be unaffordable to many.
PMI can radically reduce waiting times, which can be up to 18 weeks (from the date of referral to a specialist to treatment) if on the list of non-urgent cases for the NHS. The wait can be longer, in some cases, for those not on the list. It could also give patients greater choice, not only to schedule appointments and treatments to fit in with their lives, but also to choose where and by whom they’re treated, and in some cases gain access to specialist drugs and treatment not available on the NHS.
For in-patient stays in hospital, going private may mean your own room and more comfortable facilities and surroundings. In addition there’s usually more freedom on visiting times and rules.
In terms of market size, an estimated three million policies were active in 2015, covering 5.3 million lives. The average amount paid out per claimant in 2014 was £1,906, according to the ABI.
Understanding your policy
There is a vast range of products available, tailored to provide a mix of budget considerations and breadth of cover.
It’s important to note that some cover is limited; to help reduce the cost of policies insurers include a cap on the amount that can be claimed in any one year. Most also exclude chronic and pre-existing conditions. Again policies vary: They may exclude all past conditions, even if they only recur after taking out the cover, or place limitations on conditions that occurred within a set period before the start of the policy, normally the previous five years.
It’s easy to avoid any unexpected surprises, however, by taking the time to understand the product and how to make a claim. For example, most policies insist individuals get authorisation for consultations and treatment before it takes place. This protects the policyholder as much as the insurer from unexpected bills, which could result in the policyholder having to foot the bill or insurers declining the claim.
Also, just as with any other insurance product, insurance intermediaries can provide an important service by clearly explaining the features and cover during the purchase process - adding value to customers. By taking the time to educate their clients about PMI, specialist healthcare intermediaries can give them another option for their healthcare needs, offering busy workers convenient access to quality healthcare when they need it.
Without a doubt, the NHS will continue to play a critical role when it comes to the nation’s healthcare. However, with resources stretched and waiting times growing, it’s good to have options.
What is important is that insurers and intermediaries have the products available to provide this choice for their customers.
