EHIC Cards

British schools have broken up and thousands of people are heading to Europe for a family holiday. One of the things they need to take with them are their European Health Insurance Cards which provides free or (please note) reduced cost, health care in all 27 EU countries as well as Switzerland, Norway and Iceland. It is not designed to replace travel or health insurance but is very convenient to use when travelling in most European destinatins .

Martin Lewis, consumer expert said:

Martin Lewis, consumer champion, says, 'Everyone travelling to Europe should ensure they've got an EHIC. It's a no-brainer. It's totally free, and entitles you to the same treatment in any EU or Swiss hospital as a local would get, at the same price. So if they would get free or discounted medical cover so do you.

Though don't see it as an alternative to travel insurance, as it doesn't provide baggage cover, cancellation cover, and you may need to pay some costs, but it's a strong addition to it.'

It is important to understand that each country has different rules regarding what is provided in their country which then affects how you can use your EHIC card. For example, in Switzerland you will have to pay the full amount for your treatment but then you can claim for a refund. In Malta on the other hand you can access free or sometimes reduced cost care and again, claim a refund later. The NHS provide a comprehensive list of all the differences so it would be worth checking that out before you travel to your destination.

The most important thing to bear in mind is that you can only use your EHIC card when you visit a public health facility. Some countries have very little state-funded health care so it may take a little longer to locate a suitable hospital or GP. This is one of the reasons that it is important that you also have travel insurance. If you have an emergency medical problem and have to go to the a private hospital then you will still be covered even if you cannot use your EHIC card.

Some travel insurance companies insist that you have an EHIC card and will waiver any excess should you need to make a claim.

If you still don't have an EHIC card you can apply for one online and you will receive it within a week: www.ehic.org.uk , or alternatively call 0845 605 0707

What are Exclusions?

Exclusions to your health care insurance are things that are not part of the terms of your policy. Things that you will not be covered for. When choosing health cover it is just as important to find out about exclusions as it is to know what you will be covered for. Additionally all policies vary in what they do and do not cover so it is important to read the small print.

Typical exclusions
Pre-existing conditions: this is very important. Sometimes even previous symptoms of an undiagnosed condition will be treated as an exclusion.

Chronic conditions: private medical insurance is only designed to treat short term illness or infection.

Emergency treatment: private hospitals are not geared to look after emergency cases.

Routine pregnancy care: this is hardly ever covered with any policy although some companies, for example, Norwich Union Healthcare, offer you a cash lump sum with each child you have. An exception to this is Standard Life who do cover normal pregnancy as long as you have been on their Primecare Gold policy for at least two years. Complications of pregancy are covered by several companies however.

Cosmetic surgery
Infertility
Addictive conditions
HIV/AIDS related conditions
Drugs or Alcohol related conditions
Illness or treatment resulting from terrorism, criminal activity or war
Out-patient drugs and dressings
Professional sports related injury
Self-inflicted injury
Gender Reassignment
Dangerous Sports
Radioactive accidents

Sometimes Covered
Psychiatric care: Mental illness is not part of all standard policies but can usually be added as part of an extended policy.

Alternative therapies: Some policies cover alternative and complimentary therapies and others do not. Usually the more expensive policies include it.

Experimental Treatments: Normally experimental treatments are not included within your medical cover. However, as part of their comprehensive cancer treatment PruHealth will in some cases allow their customers to have experimental treatments 'provided it is within the context of a properly controlled trial.'

Ambulance cover: Very few medical insurance companies cover private ambulances to take you from your home to your treatment destination. Tesco health insurance, which is underwritten by AXA PPP, does however.

Organ transplants: Most companies do not cover organ transplants.
Bupa's Select Heart and Cancer Policy however does provide cover for transplant of either of these organs.

Prohibitive Cancer Care Costs

Cancer care is very expensive and is set to become more so in the next five years when new drugs which are currently undergoing rigorous testing will be available. This is a problem not just for the NHS but also for the private health insurance companies.

Only three health insurance companies offer comprehensive cover for cancer: Bupa, PruHealth and Exeter Friendly Society. All these companies offer palliative care as part of their insurance cover.

Professor Karol Sikora, medical director at Cancer-PartnersUK said:

'Insurers, and the NHS, do face the problem that the cost of cancer care is going to explode in the next five years.

'There are 40 drugs ready to be licensed plus other new treatments. But they also know that cancer is the main reason people keep buying their cover, so they must tell them upfront what is and isn't covered.

'I've had two patients in the past year who have suddenly been faced with their medical insurer stopping funding treatment. Luckily, I was able to convince the insurers to continue cover.'

The problem arises because health insurance is designed to cover acute health problems where the patient can be treated and then sent home with a clean bill of health. Any recurrent chronic illness is not covered. There are many cancers which respond quickly to treatment but the grey area arises when a person becomes terminally ill. In this situation medical treatment can only prolong life, not save it and on the whole this is not something that is covered on an insurance policy. In some cases cancer can be treated and then re-occur and not all policies cover for this.

The NHS has had similar problems with very expensive drugs which are designed to prolong life. Herceptin and Avastin, for example slow cancer down but they are vastly expensive and not all NHS Trusts offer it to their patients. This has caused a consumer uproar with patients demanding to be treated with these drugs.

In order to provide consumers with accurate information medical insurance companies need to be very clear what they do and do not provide. Policy documents can be difficult to understand so the onus must be on the insurance companies to make their cancer policies clear. However unless consumers are prepared to pay higher premiums for excellent cancer cover then they are unlikely to receive the kind of care that they desire.

Infection Rates Not Properly Recorded

Healthcare Associated Infections (HAI) are those that occur in hospitals or healthcare establishments and are secondary to any infections the patient was admitted with. According to a Bupa research paper earlier this year, concern over cleanliness and fear over these infections is the greatest reason why people would consider taking out health insurance rather than going via the NHS for their medical care.

The NHS have been recording their rates of healthcare associated infections (HCAIs) in a consistent manner for some time. The private health sector, on the other hand, have been slow to share information and until recently have not been obliged to do so. Comparative figures out this month call into question the reliability of the private health sector results.

In the private sector there were 35 cases of C. Difficile and three recorded cases of MRSA and between January 2008 and May 2009. The NHS has been using a Department of Health system to help NHS trusts report infection rates but the private establishments do not all use this system.

The Department of Health (DCS) currently has a total of 165 independent sector hospitals that are able to report to them and 85 that have still not fully implemented the recording system.

Additionally as people are often treated in both the NHS and the private sector it is possible for a duplication of figures to occur.

The independent sector is not currently obligated to provide details of HCAI's for all their patients although they do have to report NHS cases. According to Health Insurance and Protection:

'It is anticipated that by October 2010 they will be covered by the infection control code under the Health and Social Care Act 2008. From April 2010 IS hospitals will be registered with the Care Quality Commission, which will monitor compliance with infection control requirements.'

Recording figures helps NHS Trusts and private hospitals to set targets for the reduction of infections. The move to include the private sector fully into this system will be welcomed by groups who want to see more transparency in all aspects of health care provision.

New Standard Life Policy

Standard Life has introduced a new flexible product for those who have company medical insurance. The idea is that you can choose what suits you and your employees from a series of modules whilst still having a good basic level of cover.

The basis of the cover is their Core Healthcare Module which covers the following:

• Full cover for all your hospital stays
• MRI, CT, PET scans
• Comprehensive cancer cover
• Physiotherapy
• Consultant and specialist fees
• An online health and wellbeing service
• A private ambulance

The Core Healthcare Module can be extended with all or any of the following six options.:

Core Enhancement module
Additional cover for pregnancy complications, fertility investigations, oral surgery and home nursing

Out-patient Treatment module
Adds cover for physiotherapy, specialist consultations and diagnostic tests (including pathology and radiology).

Psychiatric Treatment module
Adds cover for in-patient & out-patient treatment, accommodation and specialist fees.

Additional Therapies module
Adds cover for chiropractic therapies, osteopathy and acupuncture.

Private GP module
Adds £300 of cover for GP services

Having these different modules increases flexibility and reduces the overall cost of an 'all in' policy. Recent research by has shown that corporate health insurance has risen in cost by 9% and that some companies are interested in finding out how they can reduce these costs.

Additionally different types of workplace may necessitate different kinds of health insurance. Computer operators, for example, are often at risk of musculo/skeletal problem which may make the Additional Therapies module useful and the Psychiatric module may be valuable in areas where there is a very high level of stress in the work environment.

Most Popular Health Insurance Companies

There are hundreds of private health insurance companies in the UK. This is a list of the most popular ones and the proportion of the market they hold.

1. 42% Bupa
2. 24.5% AXA PPP Healthcare
3. 10% Norwich Union Healthcare
4. 7.5% Standard Life Healthcare
5. 3% WPA
6. 2% PruHealth
7. 8% Other

Each company has a selection of policies and these vary in the levels of cover that they provide. They vary in cost depending on what level of cover they provide. It is important to read health insurance policy documents very carefully so that you choose the right one for you. If you should become ill and find that you are not covered to the level that you need it may be very distressing for you and your family.

Some variations in health insurance policies:

-The amount of cover you receive - this is measured in monetary terms
-The type of cover you receive - whether psychiatric and alternative treatments are included
-The amount of excess you have to pay
-How long you have to wait - some policies are less expensive if you take the six-week option. If you are prepared to wait for up to six weeks to have NHS treatment and then go privately only if your waiting time is over this, then you can save up to 10% on your premiums.

Pros and Cons of Medical Insurance

The Cons

It can be expensive
Its worth shopping around if you are over 50, a woman, a smoker or a moderate to heavy drinker. If you fall into any of these categories you will often have to pay higher premiums for health insurance.

Pre-existing conditions will be excluded from your policy
If you already have a medical condition, or even symptoms that later lead to a medical condition, you will not be covered under a new health insurance policy for this condition until two symptom-free years have passed.

Unintentional Non-disclosure can invalidate your claim
When you apply for health insurance you will be asked a series of medical questions. If you do not reveal everything in your medical history when you come to make a claim it may be invalidated. This is called non-disclosure. Even though the industry (Institute of British Insurers) has put measures in place to protect customers and make sure that insurers are being fair, care must be taken when filling out health insurance forms, which are actually legally binding documents.

If you never use your policy
If you remain in good health you may never or hardly ever have reason to use your health insurance. This can be a frustrating experience if you think about the money you could have saved instead.

Choosing can be complicated
Health insurance policies vary in what they offer. It can be complicated to choose the right policy for you without doing an awful lot of research. Some policies for example offer psychiatric treatment, others do not, some insurers, such as PruHealth offer discounts if you maintain a healthy life style. The main advise is to seek out as much private health insurance information as you can before committing yourself to any particular policy.


The Pros

Saving Money as you go
Many people want the benefits of private medical care but are unable to lay their hands on the cash when they do get ill. Having a medical insurance plan enables you to pay in instalments and reap the rewards if you do become ill. It helps you to manage your money and allows you to get the best care if the time comes.

Getting seen quickly
The NHS has reduced its waiting times but they are still very long compared to private health care (18 weeks). When you are ill you want to be seen as quickly as possible, it reduces your stress and very importantly enables things to be nipped in the bud before they become more serious.

Get back to work quicker
If you become ill your job will be affected. Statutory sick pay will only cover you for a certain number of weeks and company schemes vary. If your illness is protracted then you may develop money problems. Being able to receive quicker treatment means you will be able to get back to work quicker and maintain your standard of living.

Security for your family
Very often people are happy to wait on NHS waiting lists until their children become ill and then they feel very differently. There are even health insurance policies which are just for children. Axa PPP, for example have, First Healthcare which is just for children.

A safe and comfortable environment
Private health care institutions provide a safe and comfortable environment. High standards of hygiene in private hospitals was the top reason why people preferred to have medical insurance. Additionally the comfort of a private room and the good catering services make private hospital care a more psychologically positive experience.

Swine Flu & Health Insurance

Swine flu is now spreading in the UK at a fast rate. We have moved from 'prevention' status to 'treatment' status and yesterday the first person to have no underlying health conditions died from complications of swine flu. Your local GP and NHS Direct will be able to advise you about the best course of action should you contract the virus but if you have health insurance how will you be treated if you contract swine flu?

For most people swine flu will be treatable at home with the usual cold and flu remedies and plenty of rest. Most people across the world who have become seriously ill with swine flu have had underlying health problems. Vulnerable groups include those with respiratory complaints, heart, liver and kidney conditions. If you have a chronic, already existing health problem, the most likely situation is that you will not be covered for this condition anyway by your medical insurance and if this becomes exacerbated by swine flu you will not be able to receive private medical care unless you pay for it.

Additionally if you are taken ill and need to have emergency treatment then you will have to go to an NHS emergency department as emergency treatment is not covered under any health insurance policy. In fact private hospitals are not set up for emergency medical care at all. They tend to only cater for pre-planned hospital and out-patient consultations and treatments.

However, if you have been generally in good health and become seriously ill as a result of swine flu and are then stabilised in an NHS emergency department it is possible that you could then be transferred to a private hospital under your health cover.

New cases of swine flu are expected to rise to 100,000 a day in August. This will no doubt put a strain on the NHS which will overspill into the private sector. We will be monitoring the situation and reporting on any new developments and their effect on the private health care sector.