How to Buy Health Insurance

Sometimes people ask How do I Buy Health Insurance? It can be a complicated process as there are many different medical insurance companies that sell various policies in a different number of ways. This is a brief guide on the different options available.

Who sells health insurance?

Health insurance companies
Health insurance companies can sell policies directly to consumers and businesses. Operative should have a very thorough knowledge of the policies that they sell and should therefore be able to give you good advise. Be aware that their job is to sell you a policy.

Independent Advisors
Independent Advisors earn their money by selling insurance policies to businesses and the general public and taking a commission on what they sell. They should be impartial and be able to sell you the best policy for you, your family or your business. They are regulated by the Financial Services Authority. Some health insurance policies are only sold via brokers.

Insurance Agents
Insurance Agents sell policies from standard medical insurance companies on to their clients. Examples of this include supermarkets, banks and building societies.


How can I buy health insurance?
Health cover can be purchased in a variety of ways:

Face to Face
This is the traditional method of buying medical cover. The advantage of it is the personal touch. It also enables a broker to get to know their client and ask important questions, that could help reduce non-disclosure, based on their customers facial expressions and body language. This method of buying insurance is becoming less common.

Over the Phone
Taking health insurance details over the phone is another option. Operators usually follow a paper or online questionnaire which will help them to fill in a customers application.

By Post
This is the least common way of buying health insurance although sometimes people use this method after they have been to see an advisor. If they feel they have been bombarded with lots of information they may take forms home with them and make a decision when they have a clearer head.

The Internet
This method is becoming more common. Access to health insurance via the internet is available either directly through a health insurers website or via price comparison sites such as www.comparethemarket.com or www.moneysupermarket.com

Avia's New Magazine

Aviva Healthcare is set to launch a new wellbeing magazine this month. This comes as a part of a growing national trend for health insurers to focus on improving health and wellbeing rather than just focusing on ill health.

The aim of the magazine, Your Wellbeing, is to position Aviva as a provider of health information not just medical insurance and will be available to their private health insurance and income protection customers.

Magazine will have a 48 glossy page spread full of health information as well as news about medical breakthroughs. It will also be encouraging people to engage with Aviva online. It will be sent to at least 100,000 customers.

Tiffany Pykett, customer communications and loyalty manager at Aviva UK Health, siad:

'We spoke to our customers and they told us that they’d like a regular health-focused magazine, so that’s what we’ve created.'

The development of the Your Wellbeing magazine is part of a recent move from Aviva to focus on wellbeing. It has introduced a wellbeing element to their policies. They can give you up to a 15% discount for having a more healthy lifestyle as part of their My Health Counts scheme. Sally Gunnel, a former Olympic athlete, is spearheading the My Health Counts scheme.

Companies, like Aviva, are following in the footsteps of PruHealth who added a new dimension to the health insurance market when they introduced their Vitality scheme medical insurance which has linked with partners in order to offer customers discounts to gym memberships and stop-smoking schemes. Vitality also offer discounted policy rates if customers join in the large range of health giving activities on their list.

Low Health Insurance Complaints

Health Insurance companies should have a very clear complaints procedure. If a customer is not satisfied with the response of their medical insurance company they have the right to appeal to the financial ombudsman who then arbitrates and gives a final decision by which the insurance company must abide by. Earlier on in the month the Financial Ombudsman Service (FOS) praised the health insurance industry for its low levels of complaints.

According to Melissa Collet from FOS, only 1% of insurance complaints were about private health insurance. On average 70% of complaints about insurance result in the insurance company having to back-track but for the health insurance industry only 31% of decisions result in a change of outcome. This is a remarkable difference and is testament to the fact that the health insurance industry is regulating itself well.

Last year, out of 127,471 new insurance complaint cases only 514 involved disputes over private medical insurance. However there were various areas however that Ms Collect felt needed attention because they featured high on complaints made to Financial Ombudsman Service (FOS):

• Jurisdiction
• pre-authorisation
• experimental treatment
• chronic and acute conditions
• pre-existing conditions

Collet said:

'Consumers get muddled about pre-authorisation. Particularly when they need treatment quickly. Sometimes a misleading impression can be given, over the phone, about what is and is not covered.'

FOS meet regularly with the health insurance industry in order to discuss how they make their decisions and give the industry feedback on the type of complaints that they receive and what they can do to alleviate the situation.

Help With Stress

Last week on the 4th November was Stress Awareness Day. Stress causes many problems of a psychological, physical and social nature and this is something that they health insurance companies are becoming more sensitive too.

Stress Awareness Day was sponsored by International Stress Management Association (ISMA) who want to draw attention to the harmful effects of stress. Ann McCracken, Chair of ISMA, said:

'Stress, depression and anxiety accounts for over 13.5 million workdays being lost each year, making it the single biggest cause of sickness absence in the UK. The aim, through the nationwide campaign, is to increase public awareness about the effects of stress, the treatments available and, most importantly, to help individuals suffering from stress to seek help using a team of stress experts.'

This years campaign focuses on work related stress.

The health industry as a whole is aware that stress causes mental and physical harm. What do private health insurance policies have to offer people when it comes to stress?

PruHealth consider fighting stress as an essential part of maintaining a healthy lifestyle. In their latest Vitality Index research they found that 16% of people consider stress to have the biggest impact on their health. In their Vitality scheme the health insurer discounts off monthly premiums if their customers engage in a range of health enhancing activities.

Counselling Services
Because of an awareness of the impact that stress can have some medical insurance companies offer a free telephone counselling service in an attempt to combat this:

Aviva offer a 24hr Stress Counselling Helpline
AXA PPP Healthcare Stress Counselling Helpline

Fact Sheets
Most of the private medical insurance companies offer information about stress, its effects and how to overcome it. Most of this information is available free online for everyone not just their own customers. Additionally. Bupa offer advice on stress free living as part of their online Wellness Programme.

Psychiatric Cover
As a last resort patients may need psychiatric care if they have been exposed to too much stress. It is important to note that not all health insurance policies cover psychiatric care. Those that do tend to offer it within their more 'premium' levels of cover.

NHS V Private Health Insurance

Last week the government announced that it would make it a legal requirement for patients to have to wait no longer than 18 weeks before they are treated on the NHS after which time they have to be treated at a private establishment.

This new development proves how linked the NHS and private sectors have become. However private medical insurance patients are not necessarily happy to see NHS patients treated for free within the private sector when they have been paying for their regular monthly premiums.

For private establishments the NHS desire to use them has been a godsend as their patient figures have been steadily declining. In 2007 53,000 NHS patients were seen in private hospitals. This figure had risen to 151,000 in 2008.

William Laing, chief executive of analysts Laing & Buisson said:

'The extra business, however, has been a mixed blessing for independent hospital operators since such work they take on at NHS tariff rates offers a lower profit margin than private work. If and when self-pay demand returns, and as medically insured activity grows in the future, existing independent hospitals will wish to return to their core private business.

'The big question for the future is whether the independent sector will have an appetite for investment in additional, lower cost capacity aimed specifically at servicing the NHS market. Experience with the independent sector treatment centre (ISTC) programme has dented providers' confidence in the government's long term intentions, but nevertheless the NHS is a massive market and the independent sector share of it is currently very small, at just 4%.'

For people who pay for their health insurance it might be upsetting to see NHS patients being treated in the same type of establishments as them. However, it is not just the proposed 18 week law that is causing cause for concern. Currently it is common for NHS patients to be given a list of private providers that can carry out their treatment at NHS cost.

Chris Meier, head of marketing at private health insurance (PMI) provider National Friendly said:

'It may be slightly jarring to realise that an NHS patient is being treated by the same type of consultant in the same environment, but they won’t necessarily have had the accelerated access and in all likelihood they will have spent a long time on a waiting list.'

18 Week Law

According to Health Secretary, Andy Burnham UK citizens should have a legal right to be treated within 18 weeks on the NHS. He proposes that if this is not possible then they should then have the legal right to be treated privately. This is good news for UK citizens but still a very poor effort in comparison to treatment times within private health insurance.

The reforms would come into force next April when they would become part of the NHS Constitution. A two week waiting time for cancer treatment would form part of the new laws.

Mr Burnham said: 'With this new power behind them, patients can be certain that they will receive the same high standards of care, regardless of who they are or where they live.'

Prime Minister Gordon Brown said: 'Every single person who has to go into hospital or go through the difficulty of cancer will have clear rights and real power guaranteeing them quick access to care, or the offer of going private or to another NHS provider if these standards are not met.'

The government are already hitting their 18 week waiting list targets on a regular basis so in many ways these new directives are a little meaningless. Now that these targets are being hit what is important is to set new, improved targets.

In medical insurance terms 18 weeks is a very long time. Even with the more inexpensive 'six week option' policies, as the name suggests you only have to wait six weeks. With more and more patients being treated in private establishments under the NHS one of the shining beacons for health insurance is the speed by which you can be seen. And, of course, speed is important for good mental and physical health.

9) Specific Policies: Childrens Private Medical Insurance

One way of reducing private medical insurance costs is taking out a very specific policy. The health insurance market is coming up with more and more ways to reduce costs but still enable people to get the kind of care that they want.

Children's Medical Insurance
There are specific policies available now that only cover your children.

AXA PPP offers First Healthcare. This is a health cover plan for children which works under their six week option. This means that if a child cannot be treated within six weeks for their day or outpatient treatment then they will be covered by the insurance.

Ben Faulkner, speaking for AXA PPP, says:

'Regardless of waiting times, the policy covers immediate access to private outpatient tests and costly MRI and CT scans. It also pays – again irrespective of NHS waits – for the child to see an experienced consultant privately at a convenient time for both child and parent, helping to relieve the worry of not knowing what’s wrong.'

Medical cover from First Healthcare costs £9.99 per month for the first child and then £8.99 for each additional child.

Child Health Solutions from Child Health Cover was launched in September and provides paediatric health insurance for children from birth to 18 years old. This policy costs £13.50 for a first child with discounts for additional children. It includes dental cover and speech therapy. It also provides access to specialist paediatric hospitals and a 24hr GP helpline.

Rebecca Freebody, head of propositions management and market development at Aviva UK Health, says that the research they carried out showed that people who maybe could not afford full health insurance cover were keen to still have protection for their children:

'When we first conceived the product there wasn’t a child-only product available in the market. Our product has core cover similar to adult PMI, but it also covers physiotherapy, chiropody, dental and speech therapy which often have long NHS waits. Our policy is comprehensive in that as soon as the child needs treatment they can access it straightaway.'

Back Pain Dilema

Back pain is a big problem in the workplace. It causes a great deal of work absenteeism and reduction in productivity. On the other hand if you are the one with the back pain the last thing you want is to be at work.

GP's have the job of deciding whether to give someone a 'sick note' or not. They are in the middle. Statistics show that keeping active is one the best forms of advice for back pain and GPs are encouraged by government guidelines to get people to keep their bodies moving and go back to work. On the other hand they are under pressure to comply with a patients demands for authorised time off work.

Recent research by Arthritis Research Campaign shows that GP's feel under pressure from both sides and that they feel that negotiating between the two camps requires 'effective negotiation of mutual perceptions and expectations.'

The workplace has responsibility to provide an environment which minimises the risk of health problems including back pain. One of the recommendations made by the Health and Safety Executive (HSE) is for companies to give their employees access to private health insurance with the idea that they have access to early help and advice which in turn will reduce absenteeism and speed up recovery. Often by the time people go to their GP the back problems they have are chronic. The aim is to get to people before this happens.

Medical health insurance provider Aviva have recently launched a product, Back-Up which aims to help people deal with their back and neck problems with the veiw that they can return back to work as quickly and safely as possible.

According to the statistics Back-up has seen a 37.5% reduction in the number of physiotherapy sessions needed by people and 50% of employees said that the scheme 'prevented them going absent or restricted their duties.'

Clinical development manager for Aviva's UK Health business, Mark Sharpe said:

'Musculoskeletal conditions are one of the top causes of private health insurance claims, yet they have traditionally been treated with a broad brush '6-10 sessions of physiotherapy' approach which gives little consideration to the customer's exact circumstances. Our Back-Up service bucks this trend.

'Evidence now shows that tailoring treatment plans to the individual's personal needs, has a far better out-come for all parties - the individual recovers quicker, employers benefit from reduced sickness absence costs and our medical insurance claims costs, and therefore future premium increases, are controlled.

We are extremely proud of our Back-Up service which has already delivered numerous benefits for our customers. The feedback we've received is absolutely fantastic and we're delighted more of our customers can now benefit from this highly valued service.'

Back-up has meant that Aviva have won the Employer Rehabilitation Initiative of the Year category at the 2009 Rehabilitation First Awards.

Best of Both Worlds

Private health care is expensive but there are many reasons why people chose to be treated privately instead of going with the NHS. One of the reasons for taking out medical insurance is that it is a good way to budget for the unexpected.

Below is a list of typical procedures and the costs that they could incur if you paid upfront for your medical treatment:

Colonoscopy: £1,500 - £1,500
Cataract Removal: £1,500 - £2,950
Gall Bladder Removal: £3,500 - £5,800
Hip Replacement: £7,500 - £9,400
Inguinal Hernia: £1,500 - £2,450

Taking out medical health insurance means that if you become unexpectedly ill you will not have to find the money for expensive procedures and surgeries.

For some people paying upfront for medical insurance is not a problem and recent evidence suggests that individuals can get a much better deal from health providers than health insurance companies do. As an individual you can negotiate on the cost of treatment with some providers.

There is an alternative option which resides somewhere between the two options. Freedom Healthnet are a health insurance company that provide cover in the form of cash for outpatient procedures. This means that you have the best of both worlds: the security and budgeting benefits of traditional health insurance and the purchasing power of an individual patient in the independent sector. Freedom provide the added benefit that they also offer one of the cheapest health insurance options available.

Additionally, with Freedom you also have the option of having treatment abroad or staying with the NHS to have your procedure and keeping the money for other things.

Breast Cancer Screening

Leading health insurance company Bupa are trying to encourage women over the age of 40 to have breast cancer screening in order to detect the early signs of breast cancer.

Early detection of breast cancer is vital. It can save lives and also reduce the risk of the need for full mastectomies or reconstructive surgery. The NHS provides free breast screening every three years for women between the ages of 50 and 70 but the statistics show that more than 50% of breast cancers were found in women under 50. The government plan to extend the screening to 47 and 73 by 2012. Bupa have been offering breast cancer screening for the last 30 years.

Dr Janet Donaldson, lead physician at Bupa Wellness said:

'It is important for all women to be breast aware. We all lead incredibly busy lives and it is only too easy to ignore minor changes, when a simple check could make a difference. Breast screening from the age of 40 gives women the best opportunity to detect any abnormalities early and offers a much greater chance of successful treatment if any are detected.'

Screening takes the form of a mammogram which is an x-ray of the breast tissue. Mammographies can detect early abnormalities in the breast, before any changes can be felt manually. According to Cancer Research UK two pictures are taken during a mammogram and this increases the rate of detection by 25% - 40%.

The general advice is for women to regularly check their breasts for any changes. The Cancer Research Website suggest that you look out for the following:

• A lump or thickening the breast area
• A change in the shape or size of a breast
• Dimpling of the skin
• A change in the shape of the nipple
• A bloody discharge from the nipple
• A rash on the nipple or surrounding area
• A swelling or lump in the armpit

Prevention and early detection are the most important factors in dealing with cancer but comprehensive health insurance for cancer is offered by some health insurance companies including Bupa who offer cover under their Bupa Select Heart and Cancer Policy.