All Inclusive Cancer Care

Cancer is the biggest cause of death in the UK and one is three people are likely to develop it but getting health insurance for cancer it is not as simple as it seems as there are great variations in the level of cover that you get from different medical insurance companies.

As outlined in Health Information Insurance cancer care is expensive and companies appreciate that not everyone can afford the premiums that need to be charged for comprehensive cover.

Do you want unlimited cover so that you do not need to stop private treatment and return to the NHS?
Most companies do not offer treatment once your cancer becomes incurable. It is then treated as a 'chronic' condition which medical insurance companies do not cover. If you then need palliative care there are even less companies that will cover your care.

Only three companies offer unlimited cover: Bupa, PruHealth and The Exeter Friendly Society.

Exeter Friendly Society
This health insurance company works on a co-payment scheme where you can agree to pay a percentage of your treatment costs (which is capped) which then means that your premiums are lower. The insurance they offer covers all health problems. What is significant about them is that they offer full cover for cancer care as well.

The Exeter Friendly Society also cover you to stay with a child in hospital up to the age of 18. If you have children this is a very important point as most companies only cover you when your child is 11 or twelve.

Costs for a 42 year old, non-smoker of average weight
No Co-payment: £ 98.45
25% Co-payment: £ 87.25
50% Co-payment: £ 70.44
75% Co-Payment: £ 42.44

There are advantages and disadvantages to co-payment schemes which need to be carefully considered.

Bupa
Bupa offer unlimited cover on a specific policy known as their Bupa Select Heart and Cancer Policy. It has no restrictions other than a £500 allowance for physiotherapy a year and £60 only per ambulance trip to take you to treatment facilities.

Bupa only give quotes to individuals and do not provide online quotes. However offering this specific cover enables them to keep the costs of this policy down.

PruHealth
Pruhealth offers the most comprehensive health insurance for cancer on the market. They even cover experimental treatments and complimentary treatments which other insurers do not cover. Their policies are general health insurance products which cover all conditions not just cancer.

Costs
40 year old female
Core: £68.13
Essential: £82.17
Comprehensive: £101.17

40 year old male
Core: £63.64
Essential: £76.82

Comprehensive: £95.33

4) Co-Payment Options

Co-payment, also known as shared responsibility, is a fairly recent development within health insurance which helps consumers reduce their monthly premiums.

Co-payment means that you agree to pay a percentage of your health care costs if you become ill. There tends to be no limits to this policy.

Advantages
Your premiums are reduced compared to other policies.

If you do not need to make a claim then you will feel that you have not wasted your money on cover that you have never used.

From an insurers point of view for non-serious cases clients normally go via the NHS and tend not to make small claims via the insurance scheme. Ultimately this helps the consumer by keeping insurance premiums down.

This kind of policy often has no upper limits which does not apply to most other policies.


Disadvantages
If your bills are high then your contribution will also be high. You need to make sure that you have enough money to cover any treatment otherwise you will have wasted your insurance premiums.

Some people think that co-payment schemes may deter people from seeking the medical attention that they might need as they may be concerned about any health care bills that they may incur if they do in fact need treatment.

This type of cover does not give peace of mind unless you are fully confident that you will be able to pay for any treatment needed.


An Example of a Co-Payment Scheme

WPA: Shared Responsibility Scheme
WPA offer a Shared Responsibility Scheme where you pay25% of treatment costs up to an annual maximum of either £500, £1,000, £3,000 or £5,000. The aim is to make customers an incentive to negotiate hospital costs and keep prices down. After you have reached your annual limit WPA will pay 100% of each claim.

The feeling in the health insurance industry is that having cover makes people feel that services are free. Well isn't it? That's why we pay our medical insurance premiums, isn't it, so that we can get the care we need without having to 'worry about anything.'?

MacEwan from WPA said:

'Most policies uncouple the patient from the insurer, which leads to uncontrolled premium inflation. Under Shared Responsibility, they work together, and last year we reduced premiums by up to 8%.'

'If they think they are likely to be ill, they will go to one of our competitors,' he added.

3) Hospital Lists: Part 2

Part 2
This is the second part of a blog which compares health insurance companies' hospital lists.

Standard Life
Standard Life have several choices.

UK Countrywide list
This gives you access to most private hospitals across the UK including several London ones and NHS private patient units.

Countrywide London upgrade
This upgrade gives you an additional seven of the more expensive and prestigious Central London hospitals, including Harley Street Clinic, Portland Hospital for Women and Children, and the Princess Grace Hospital.

Extended London upgrade
With this option you have access to three extra Central London Hospitals – Hospital of St. John and St. Elizabeth, Bupa Cromwell Hospital and The London Clinic.

Guided Option hospital list
This option gives you a 15% saving. This list contains hospitals from the Spire, BMI, Ramsay and Nuffield group. The GP refers patients to a hospital and then the hospital arranges an appropriate consultant.


WPA
WPA hospitals are separated into regions and postal districts. Depending on which plan you take out with them you may have different 'Scales of Cover' which means you have limited choices for some plans. You can choose to go to a hospital which is out of your scale of cover and then pay the extra costs yourself.

Scale 1: All hospitals. London and Provincial and scale 2 and 3 hospitals

Scale 2): All Scale 2 and Scale 3 hospitals

Scale 3): All Scale 3 hospitals

Very thorough information about the different hospitals available is given on their website.

A very interesting disclaimer which is attached to their information about the hospitals they work with:

"Please note by recognising providers of healthcare WPA is not providing any warranty or guarantee of the standard of care provided to patients, which is subject to a direct contract between the patient and the provider."

PruHealth
PruHealth have three hospital lists for you to choose from. You can add any of these when you choose your health insurance policy:

National - cover at all PruHealth private hospitals outside of London

London - cover at all PruHealth private national and London hospitals

Premier - cover at all PruHealth private national, London and premier hospitals

3) Hospital Lists: Part 1

Part 1

The third part of our series of blogs to help you understand the different health insurance covers out there looks at how different companies can offer you different hospital lists.

Hospitals are chosen carefully and must comply with strict standards of care and excellence.

Bupa
Bupa is the UK's largest medical insurance company. They have access to over 400 hospitals which is more than any other health insurance company. They used to run their own hospitals but they are now controlled by Spire Healthcare. Whichever Bupa policy you are on you can choose from their local or national hospitals.

AXA PPP Healthcare
This medical health insurance company provide over 200 general hospitals, 36 psychiatric hospitals and 5 rehabilitation centres. They also have access to almost 400 CT, MRI and PET scanning centres and additional facilities for oral surgery and cataract surgery centres. On their website they also have a facility where you can search for hospitals. According to AXA:

"Since 1996, we have led the market in introducing a quality assurance programme, being the only insurer to build a network of hospitals based on quality and value which has been endorsed by the Office of Fair Trading."

Aviva Health
Aviva help people to cut costs by having a range of hospital lists.

Standard Hospital List
In their Core policy they have a Standard (or Key) Hospital list which gives you access to 300 national hospitals. Within this list you also have access to private patient units in NHS hospitals as well as NHS pay beds. According to Aviva this gives you an overall access to 800 hospitals.

Extended Hospital List
For an additional cost you can have access to their Extended Hospital List as well which then gives you the option to choose from the more exclusive London Hospitals.

Fair+Square Hospital List
This offers a reduced hospital list of around 200 facilities. If cover is not available under any of these hospitals then Aviva will nominate another hospital for that treatment.

Trust Care Hospital List
The Trust Care Hospital List - cost saving option that uses the excellent private patient units of NHS Trust and partnership hospitals

Signature Hospital List
This is available to customers in Scotland or Northern Ireland. The list is made up of hospitals that have been approved by Aviva. If you choose this option you are also covered to use NHS pay-beds in Scotland or Northern Ireland.

2) The Six Week Option

Some private medical insurance companies provide something known as 'the six week option.' This option means that you agree to wait for up to six weeks for NHS treatment to become available. If the NHS cannot see you within this time then you can be treated privately. Six week option plans are available for individual and company medical health insurance.

Advantages
-This is a cheaper option and can reduce your premiums by 10%-30%

Disadvantages
-This is not an option if you really do not want to be treated on the NHS
-You cannot choose where, when and by whom you are treated
-You will not be covered if your treatment is urgent as obviously six weeks would be too long to wait

How does it work?
To ensure you are seen quickly outpatient appointments are arranged through your medical insurance and then the six week option applies to any treatments that you need.

The health insurance companies have access to a detailed list of waiting times for consultants and hospitals. They can search to see if there is a hospital or consultant near you that can offer you an appointment within six weeks. If there is no suitable consultant or hospital vacancy then they will provide you access to private care.

Companies that offer the six week option
Standard Life Healthcare offers a 10% reduction in their premiums if you take up this option in both of their EspritHealtcare plans.

AXA PPP Healthcare also offers a 10% reduction with the six-week option.

Aviva offer the same six week option and if you cannot be seen on the NHS within that time then you can choose from their Select Hospital List.

1) Levels of Cover

This is the first of a series of posts which explain the different options available in health insurance.

Most health insurance companies offer different levels of cover from the most basic up to the most comprehensive but between each company there are very big differences in what they cover and how much they charge you for their premiums.

It can be difficult to compare like for like as each company splits their policy up in different ways, with different treatment options. Generally the more expensive a policy then the more cover you get. It depends what you are after.

Each insurer is bound to explain their policies clearly and most of them lay out their cover in tables. To illustrate the differences between different policies we have chosen two companies, Freedom Healthnet Ltd and PruHealth.

Freedom Healthnet Ltd offers cheap medical insurance and their advantage is that you get paid directly for your treatments and then you get to choose where you are treated. You can even choose to have treatment abroad and pocket the money left over or even go with the NHS and keep the cash.

PruHealth, a traditional company, is like the Rolls Royce of the health insurance business. They offer very comprehensive cover but their premiums are much more expensive.

Freedom Healthnet Ltd, for example, offer a very simple outline for their cover options:

Inpatient Treatment
Gold: £30,000
Platinum: £50,000
Diamond: £100,000
Diamond Plus: No Limit

Outpatient Treatment
Gold: £1,000
Platinum: £1,000
Diamond: £1,250
Diamond Plus: No limit

They then tell you what is included within the inpatient and outpatient treatment options.

More expensive polices sometimes have no upper limits for most inpatient and outpatient treatments. PruHealth, for example, cover all inpatient hospital charges, specialist and consultant fees, diagnostic tests and radio and chemotherapy for their four levels of cover: Core, Essential, Comprehensive and Select. They do however have a combined limit of £600 for various other treatments depending on the level of cover you choose.

Higher Levels
Higher levels of cover tend to offer not just additional top-limits but also other types of treatments and therapies.

Psychiatric Care
The higher the levels of cover tend to offer some psychiatric care although not all companies offer it. Freedom Healthnet, for example offer it as a 'bolt-on' with their Diamond Plus policy up to a maximum of £10,000 per policy year for inpatient treatment and £1,500 per policy year. PruHealth offer limited cover in their Select policy. They will cover 14 days of hospital treatment and up to £750 of outpatient treatment per year.

Maternity Care
Some top level covers offer cash benefits for maternity which is given after the birth of a baby if you are using the NHS. PruHealth, offer it in all their policies but Freedom Healthnet do not cover pregnancy at all.

Complementary therapies
Again, top level policies will tend to offer complementary therapies. PruHealth offer it only in their Comprehensive policy and Freedom Healthnet provide it as a 'bolt on' option as part of their Diamond Plus policy.

Pricing
You pay more for top level policies as is reflected in the information below. The information given is for a 42 year old female non-smoker:

PruHealth
Core: £68.13
Essential: £82.17
Comprehensive: £101.17

Freedom Healthnet Ltd
Gold: £18.82
Platinum: £19.38
Diamond: £43.65

Genetic Testing

Genetic testing gives a picture of a person's vulnerability of developing certain inherited conditions. It would make sense from a health insurance point of view that any information which helps insures assess your risk would affect your premium costs. If you have a higher risk of developing a condition then you would expect to pay a higher premium. Health insurance usually requires full disclosure.

There are two ways in which genetic testing is used: Tests which confirm illnesses and inform treatments and predictive tests. Insurers can already ask for the results of diagnostic genetic tests but the latter has been the subject of much controversy.

As of this moment medical insurance companies are not allowed to use predictive tests when calculating your premiums. Part of the reason for this is that tests are not yet standardised nor the results conclusive. The government, alongside the Institute of British Insures and other parties are addressing these issues and have stated that genetic testing cannot be used for insurance purposes until 2011.

One of the concerns is that in the future patients may be deterred from taking tests for fear of their premiums increasing. This would could have detrimental consequences for people who could use new information to help their future health prospects.

Another argument is that the number of people that are taking genetic tests is very low therefore the loss to insurers is also low and acceptable. Once the testing becomes more sophisticated and widely available this will not be the case.

'Insurers have been prepared to bear the risks and costs of nondisclosure, which are spread across the broad pool of policyholders, because the number of policies affected by non-disclosure of predictive genetic tests is low.'

By 2011 genetic testing will have moved on a great deal but the House of Lords Science and Technology Committee have recommended that information from those who have been screened up until this date should not be used for insurance purposes not matter what new regulations have been drawn up.


So, for the moment those who have genetic testing will not be penalised with higher insurance premiums. However after 2011 the situation will be reviewed. The government remain committed to the fact that private medical insurance companies need all available information in order for them to make an accurate risk assessment.

Different Health Insurance Options

Health insurance basically covers you for unforeseen health problems. It sounds straightforward doesn't it but the problem is that there are so many different companies who offer different levels of cover and within this there are many other options that can leave you confused. It can be difficult to negotiate the industry but with a little bit of research and emersion in the topic you can be sure to get the best medical insurance policy for you.

Over the coming weeks we will be looking at the different options available.

1) Levels of Cover
Most medical insurance companies offer three levels of cover starting with a basic level. The higher the level the greater the amount of cover.

2) 6 week option
Some companies offer this. You can choose to wait for six weeks to see if your treatment/surgery becomes available on the NHS. If not, you can have private treatment. This option means that you pay less for your premiums.

3) Hospitals
Different health insurance companies operate within different hospital networks. Some have more hospitals available to them and can offer you different hospital networks and charge you accordingly. PruHealth for example have National, London and London Premier hospital options which incur different charges.

4) Co-payment
This involves paying for part of your treatment. It reduces your monthly premiums. The Exeter Friendly Society offers a policy called Shared Care where you can pay for 10%, 25%, 50% of your treatment costs.

5) Full underwriting/moratorium
Different companies offer different ways of underwriting your policy. Fully underwritten policies assess your health and lifestyle at the start. This means that any pre-existing conditions are eliminated from your cover straight away. Moratorium policies only assess you once you have made a claim. They tend to be less expensive but claims take longer to action.

6) Excess
There are many levels of excess available including companies which allow you to pay huge excesses but that then give you unlimited cover.

7) No claims bonus
Not all companies offer this. Those that do offer a no claims discount reduce your premium the following year if you have not made a claim. It is a fairly recent and contentious area which some suggest deters people from making claims and this could be detrimental to their health.

8) Rewards for Healthy Behaviour
Some companies offer you incentive to get healthy by reducing your premium if you take preventative health care measures.

9) Specific Policies
There are specific policies which provide more specialist types of cover. Child, Cancer Care and Student health insurance policies are examples of this.

10) You or the Insurance company?
Most insurance companies pay your consultant and hospital bills for you but others pay you the money and enable you to do what you want with it.

Obesity & Health Insurance

Obesity puts you at risk of developing several health problems: heart disease, diabetes, high blood pressure and, it is thought, some types of cancer. Health insurance companies take your weight into consideration when they calculate your insurance premium. If you weigh well above your health BMI it is possible that you will pay more for your insurance compared to someone who is within a lower range. You present a greater risk to the medical insurance company.

Private medical insurance companies try to encourage people to get healthy. Their websites feature ways to live a more active lifestyle and eat well balanced meals and some even reward you with cheap health insurance when you fulfil certain health enhancing criterion. PruHealth Vitality scheme is an example of this. You can increase your status from Bronze to Silver, Gold and finally Platinum if you live a healthier lifestyle.

"By taking part in our Vitality programme and making an effort to actively look after your health throughout the year, this no claims bonus could increase to 50%, 75% or even 100%"

The government also tries to improve the nations health with initiatives that have varying levels of success. The current one is Change4Life. Last month Lord Darzi who resigned as health minister said that he would like to see overweight doctors and nurses being encouraged to live a healthy lifestyle:

'I would like to see more momentum pushing how we can get health and wellbeing for our own staff in the health service — for them to be ambassadors of prevention and wellbeing and how we get that message across the NHS.

'This is not just about public health doctors, but all the hundreds of thousands of people in the NHS who deliver care. They should all be public health ambassadors.'

There is call for private medical insurance to cover obesity treatment in the form of gastric bypass and gastric banding. This would allow people to obtain a healthy weight which would mean fewer claims in the future.

Spire Healthcare's Clinical Services Director, Jean-Jacques de Gorter, has spoken up:

'There are a growing number of patients being treated with weight-loss surgery and currently they are either self-funded or paid for by the NHS.

We believe that the private healthcare industry is missing an opportunity to differentiate itself by extending PMI cover to include funding of weight loss surgery. This would have the double benefit of both extending the value of PMI to insured patients and helping manage the risk of excessive healthcare costs arising from the consequences of obesity.'