Conservative Drugs Access

In the run up to the general elections all the main parties are letting us know what they intend to do about the National Health Service should they get elected. One issue which has been of concern for both medical insurance companies and the NHS is how much can feasibly be spent on cancer treatments.

The conservatives state that they intend to raise £200m for cancer drugs by increasing the threshold for employers national insurance contributions. The extra money would make more drugs available for cancer.

According to a recent report by an independent health think-tank, The Kings Fund, the UK has widespread differences in how cancer is treated across different health trusts. The conservatives plan to change this by implementing a policy which will not deny patients any drug which has been licensed since 2005. Currently the National Institute for Health and Clinical Excellence (NICE) decide which treatments are available depending on their cost effectiveness. Currently even if NICE have sanctioned a drug a health trust may deny its use if it considers the treatment too expensive.

The cost of drug treatments is a concern not just to governments but also to companies that supply health insurance for cancer. Some companies only cover drugs that are passed by NICE and compared to the rest of Europe the UK uses only 60% of drug treatments available for cancer.

NICE has its critics who say that many drugs that are used to prolong life may be expensive but that to deny patients treatment that may prolong their lives is inhumane. Despite its critics the Kings Fund report says that NICE is one the NHS success stories. NICE is there to assess cost effectiveness. Some of the more expensive drugs it has declined only prolonged life by a couple of months.

International Health Insurance Costs

The rising costs of international medical insurance may lead to a service which is completely unaffordable according to the medical director of Bupa International, Dr Sneh Khemka.

International medical insurance covers expatriates or people who holiday or travel extensively abroad but according to Dr Khemka rising costs are proving problematic:

'This is something the entire healthcare community needs to address, but we are in a prime position to facilitate a strategy. We have to contain costs. Otherwise, private care will become uninsurable. The golden goose gets shot.'

There are several ways in which the issue can be addressed:

• Encouraging good health. This is something that private medical insurance companies are all doing in an attempt to help keep health cover down.
• Looking at corruption. Over time there have been many cases of medical insurance companies being charged more than they should have by unscrupulous health providers.
• Getting doctors to look at the treatments they are prescribing which in some cases can be replaces adequately by alternative, cheaper treatments. According to Dr Khemka, who spoke to The Telegraph: 'There are lots of treatments and doctors will continue to try them because they like to do something, and they make money out of it.'
• Choosing the best hospitals and sending more patients there, thereby driving down costs by the scale of economy.
• Keeping policyholders informed. Dr Khemka said: 'This is where we are trying to win customers over. Rather than using treatments willy-nilly, we are trying to get the right treatment, which will help the patient, and save cost.'

Mental Health Action Week

This week is Mental Health Action Week where The Mental Health Foundation is trying to raise awareness of what can be done to promote good mental health. Health insurance companies vary greatly in their offerings for mental health. Some offer no psychiatric cover at all whereas others offer limited amounts.

The problem for medical insurance companies is that mental health problems are more common that the general public realise. According to the statistics one third of patients visits GPs in relation to mental health concerns, in particular for mild depression and anxiety related complaints. What this means for us is that most companies cannot offer psychiatric cover because too many people would use it and this would force up the price of premiums accross the board.

Who Offers Psychiatric Cover?

• Pruhealth offers cover in both their midrange and comprehensive policies up to £7,000 and £20,000 respectively for inpatient psychiatry in any one year and £750 in inpatient care.
• Standard Life offers psychiatric cover in their comprehensive policy with an excess of £250
• CS Healthcare offer cover up to £1000 in any one year with an excess of 15% of treatment cost
• Aviva offer cover in their comprehensive policy of up to £1,000 a year for inpatient care and £500 for outpatient psychiatric care with the psychiatry element as an optional extra
• Bupa offer 28 days of outpatient care and up to £1,000 of outpatient care per anum
• The National Friendly Society offer up to 28 days of outpatient cover
• The Permanent Health Company offer up to 28 days of outpatient cover and up to £1,00o per year in outpatient cover.
  

Who Does not Offer Psychiatric Cover?
Budget policies hardly never include psychiatric cover however Health-on-line do offer a psychiatric add on option on their policies.

Self Help Steps
According to the Mental Health Foundation there are many steps that we can take to help us stay mentally well and reduce the likelihood that we will need medical intervention:

1. Talk about your feelings
2. Keep active
3. Eat well
4. Drink sensibly
5. Keep in touch
6. Ask for help
7. Take a break
8. Do something you are good at
9. Accept who you are
10. Care for others

Bowel Cancer Awareness Month

April is Bowel Cancer Awareness Month. Bowel Cancer UK is trying to increase awareness in an attempt to help people understand that bowel cancer is a serious condition that can in part be prevented by leading a healthier life. Its the same message that government bodies and health insurance companies are trying to promote.

According to the campaign someone is diagnosed with bowel cancer every 15 minutes in the UK. The symptoms of the disease are:

• A change in your normal bowel habit lasting four weeks or more
• Blood in your stools (poo) and/or bleeding from the bottom
• Unexplained unexplained weight loss and/or extreme tiredness
• A lump or pain in your abdomen (belly)

Reducing Risk
Living a healthier life helps to prevent many cancers and diseases. Like Bowel Cancer UK, most medical insurance companies are promoting healthy lifestyles in an attempt to improve the nation's health. Comprehensive insurance for cancer is expensive because treatments and drugs have improved so much over the last ten years. Some factors that can help you reduce the risk of bowel cancer are:

• Get to know your bowel pattern, so that you know what's normal for you
• Exercise regularly to help maintain a balanced weight
• Drink lots of water
• Eat a high fibre diet made up of at least five portions a day of fruit and vegetables
• Limit your consumption of red and processed meat to a maximum of one portion (approximately 80g) per day
• Do not drink more than the recommended alcohol limits of 14 units per week for women and 21 for men
• Increase unsaturated fats and avoid saturated fats
• Don't smoke
• Take part in the Bowel Cancer Screening Programmes when they roll out in your area and you are invited to do so
• Have a bowel screening if their is a history of bowel cancer in your family

Being Treated Privately

The latest figures from the NHS show that they have not quite hit their targets for single sex wards in hospitals. Being comfortable when you are in hospital is something which greatly helps aid recovery and the private single rooms given to health insurance patients are part of that whole package of care.

Like most things that are in the public arena at the moment in the UK this has been turned into a political argument. The Department of Health gave NHS trusts £100m in January in order to speed the final process along although it initially pledged in 2001 to abolish mixed sex wards by the end of 2002.

However, Shadow Health Secretary Andrew Lansley believes that the way forward is more single rooms. He said:

'Too many of their reforms are on piecemeal issues like curtains, screens and signs anyway. Patients needs to be given the dignity they deserve. That's why we've set out plans for a massive overhaul of hospital buildings so that every patient who wants one can be given a single room when they go into hospital for planned care.'

Single rooms that were usually the prerogative of private health hospitals are now on the increase in the NHS. Initially the conservatives promised an increase of 45,000 single NHS rooms but this does not appear in their manifesto. With the UK in financial debt it is unlikely that the NHS will see the increases in the level of spending that it has had over the last few years.

In the health insurance arena single rooms are still a priority, allowing for private consultations, treatment and recuperation. However occasionally some patients that are treated privately in NHS hospitals may have to stay in wards. If single rooms are a priority for you then check the details of which hospitals are covered by your medical insurance policy and what type of accommodation they offer.

University Health Insurance Fraud Course

As consumers we want affordable medical insurance that covers us when we are in need. For health insurance companies it has become an uphill struggle to provide this. Health care is becoming more expensive and consumers are not prepared to spend as they once were. One way in which they can save money is to route out fraud.

Fraud has been on the increase in the health cover market and ultimately consumers bare the brunt of the deficit. This year the Health Insurance Counter Fraud Group (HICFG) will be launching the first university-accredited qualification in healthcare fraud investigation. The qualification will cover the standard fraud investigation modules but will also include additional elements that are relevant to health.

The development of this course is as a result of the HICFG opening its doors to cash plan providers. HICFG chairman Dr Simon Peck says:

'I am delighted to announce this development. We believe there is significant cross-over between the problems experienced by cash plan providers and those we see in private medical insurance and this is a great opportunity to pool our resources in a way which will benefit all of us.'

Saving on Company PMI

Just as the country is coming out of recession many companies are struggling with cash flow problems. This in turn can lead to reviews cuts in pay and perks. One way to keep health insurance for your staff is to review the provisions you have in place.

According to Hewitt Associates, an HR consulting company, reviewing health cover should be an annual thing as it can help to reduce costs. Colin Bullen, head of health and risk benefits from Hewitt said:

'Companies are losing out by not reassessing their current contracts. Shrinking budgets, coupled with the effects of the recession, have presented an opportunity to review and reset priorities. In many instances, benefit providers have become extremely competitive on price and are willing to adjust their rates to attract and retain business - a situation that is unlikely to last indefinitely. Savings are realistically achievable if companies act now.

'By seizing this opportunity, more advantageous terms for the next two to three years may be on the table; meaning that companies can lock in significant savings without damaging employee morale.'

In other words, private health insurance companies need your corporate business and they might be willing to negotiate on your current terms. That's great news for business and great news for your employees who won't have to miss out on medical insurance cover. Bullen warned against reducing cover. He said:

'Blanket benefit cuts do not lead to enduring business advantages. We are urging companies to start 2010 by acting with an eye to the longer term. A well-structured benefits policy that is valued by employees typically results in more engaged employees and is proven to boost workforce motivation. Rather than just taking an axe to current benefit structures to control costs, employers should reshape their benefits to meet member needs and demand the best value for money from their providers.'

Health Insurance for Cancer Glossary

Health insurance policies can be complicated and they vary a great deal from one to the other. When it comes to health insurance for cancer there are even more complications. Different policies offer varying degrees of cover. Becoming savy with the terminology of medical insurance policies will help you to choose the best cover for you.

The Association of British Insurers (ABI) which regulates the health insurance industry has a set of common definitions which I have replicated here. This is a good starting point but of course is not exhaustive. Each company will have refined definitions of their own.

Acute condition
'A disease, illness or injury that is likely to respond quickly to treatment which aims to return you to the state of health you were in immediately before suffering the disease, illness or injury, or which leads to your full recovery.'

Cancer
'A malignant tumour, tissues or cells, characterised by the uncontrolled growth and spread of malignant cells and invasion of tissue.'

Chronic condition
‘A disease, illness, or injury that has one or more of the following characteristics:

• it needs ongoing or long-term monitoring through consultations, examinations, check-ups, and/or tests
• it needs ongoing or long-term control or relief of symptoms
• it requires your rehabilitation or for you to be specially trained to cope with it
• it continues indefinitely
• it has no known cure
• it comes back or is likely to come back.’

Day patient
'A patient who is admitted to a hospital or day patient unit because they need a period of medically supervised recovery but does not occupy a bed overnight.'

Diagnostic tests
'Investigations, such as x-rays or blood tests, to find or to help to
find the cause of your symptoms.'

Inpatient
'A patient who is admitted to hospital and who occupies a bed overnight or longer, for medical reasons.'

Outpatient
'A patient who attends a hospital, consulting room, or outpatient clinic and is not admitted as a day patient or an inpatient.'

Pre-existing condition
'Any disease, illness or injury for which:

• you have received medication, advice or treatment; or
• you have experienced symptoms;

Whether the condition has been diagnosed or not in the XX* years before the start of your cover.'

(*this time scale varied between insurers)

Take Vitamin D says Bupa

According to Bupa, the health insurance company, people should be taking vitamin D supplements during the winter to reduce their chances of getting certain cancers.

According to Bupa research taking supplements of Vitamin D can reduce your risk of cancer by up to 25%. The recommended dosage is at least 1,500 - 2000 international units (IU) a day, which equates to 3-4 high strength capsules (12.5 micrograms/capsule).

Vitamin D can be obtained naturally from sunlight and foods but according to Bupa the British sun during winter is insufficient to provide us with what we need. Taking good doses of the vitamin is thought to reduce the onset of bowel, breast, colon and prostrate cancers.

Bupa’s assistant medical director, Dr Virginia Warren said:

'Natural ways to get enough vitamin D aren’t realistic because our skin cannot make vitamin D from winter sunlight in the UK as it is too weak. In the summer, people are rightly concerned about risks of skin cancer. And nobody wants to eat four tins of mackerel every day to get their vitamin D from oily fish.

'People have to act now to take preventative measures against cancer for their future long-term health. The old-fashioned view was to take a low daily dose of vitamin D for healthy bones. Cancer is today’s biggest killer and we need to protect our bodies from it as much as we can. Taking vitamin D supplements are an effective, inexpensive and easy way of doing that.'

Medical insurance for cancer in the UK is a subject of much debate at the moment. Bupa provides specific cancer cover in their Bupa Select Heart and Cancer policy but there is a great impetus at the moment on the prevention of the disease.

All the major private health insurance companies have been focusing on health prevention over the last few years. Obesity, lack of exercise, smoking and drinking as well as a poor diet are all linked with increased risk of cancer.

10 Disadvantages of Medical Insurance

1. Chronic conditions are not covered
Health insurance is designed to cover you for an acute illness and restore you to the health you enjoyed prior to the illness or injury. Should you be left with chronic symptoms after this they will not be covered by the insurance.

2. Your current health issues will not be covered
Any illness or even symptom of an illness that you had five years prior to taking out a policy will not be covered should you become ill from this. Even symptoms that do not seem related to any illness you have had can be included in this.

3. Health insurance can be complicated to purchase
There are many private health insurance providers and their policies can vary greatly from one another. Even within a company there can be several types of health insurance available with a variety of options to choose from. Because policy documents are legally binding agreements it is very important to read the small print so that you know what your rights are. Getting the help of a financial advisor is recommended when you are choosing a private health insurance policy.

4. Cancer is not well covered on all policies
Cancer cover is very varied. Some companies do not cover cancer at all and others provide fully comprehensive policies that cover palliative care should it be needed. As cancer is a one the main causes of death in the UK this is a factor which you need to consider carefully when looking into health insurance.

5. Comprehensive cover can be expensive
The most comprehensive policies are the most expensive. Most are also weighted depending on your age, sex and lifestyle. Its important to shop around and get the best deals.

6. There are many exclusions
Health insurance exclusions are great in number. Most are standard and are related to obvious risk factors for example alcoholism or drug use, dangerous occupations or hobbies, HIV. Others are less obvious - some policies will not cover mental health or pregnancy.

7. Mental Health is poorly covered
The statistics show that at any one time one out of ten UK citizens are suffering from a mental health condition at any one time. Some policies cover mental health others do not. Usually it is the top-of-the-range policies which include mental health cover.

8. Health insurance companies can be very stringent in following their rules
The health insurance industry has a reputation for repudiating claims on very minor details. Even though they have tried to remedy this reputation by providing guidelines which means that consumers are treated more fairly you still need to keep on your toes. If you have a claim that is rejected do not give up. Go back over the small print and see if there have been misunderstandings that can be rectified. You are within your legal rights to complain.

9. The NHS is improving
Some believe that the NHS has improved dramatically over last ten years and that therefore the private sector no longer has the pull it once had. The NHS has improved but it still lags far behind in the speed at which it can provide treatment compared to the private sector.

10. There are no official statistics for private health establishments
NHS statistics are published all the time. It enables the public to see what's going on. This does not apply to the private health insurance industry which is notoriously bad at transparency.

10 Advantages of Health Insurance

Taking out private medical insurance gives people peace of mind. Here are some of the benefits it offers.

1) A preliminary consultation is available quickly
Of course there are variations depending on where and by whom you want to be treated. As in all areas there will be consultants and hospitals that are more in demand than others. What is certain is that you won't have to wait anywhere near as long as you do with the NHS

2) A choice over which specialist or hospital treats you
Your GP will refer you to a consultant and hospital of your choice. However you do need to check the details of this with your provider. Different providers offer access to different hospital networks.

3) A single room with gives you greater privacy and confidentiality
Having said this,, some policies include treatment in an NHS facility under private health care terms. Its important to check the details.

4) Spreading your health care costs via the payment of a monthly premium
For people who always go for private health care, medical insurance is a way to budget monthly for unforseen illness or injury.

5) Being in an environment which pays a very great deal of attention to infection control
Bupa studies have found that better cleanliness and infection control is the main reason why people prefer to opt for private health insurance over the NHS.

6) Lower stress levels
High stress levels have been shown to increase recovery times. A patients' stress levels are lowered throughout. Quicker specialist referrals, quicker treatment times and a more private environment are all factors which lower stress and help with recovery.

7) You get back to work quicker
The longer you are out of work the more it affects your rights to sick pay. Being seen quickly enables you to retain your income levels. The financial impact of illhealth is an important factor.

8) Helps your employees get back to work quicker
Losing key employees to ill health affects productivity as well as morale in the workplace.

9) Short waiting time should you need an operation
This is not only a more pleasant result of medical insurance but can also improve your overall health over time. Leaving illness untreated can lead to complications and can worsen your condition which will then make it harder to treat.

10) With some companies you will get 24hr counselling helpline.
Different companies offer varying levels of 'extras' as part of their health insurance policy. This can include reduced rates and gyms as well as online and telephone help.

Health Spending Cuts

The UK Government has large debts which have to be paid for over the next few years. Public spending cuts are inevitable and the NHS is likely to suffer. But what kind of impact will this have on the private health insurance market?

According to the Windmill Report the NHS will have to plan for a 20-30% reduction in spending until 2011. Healthcare and the standards that the public expect are both advancing quickly that in real terms spending needs to rise. The Government aims to increase efficiency in order to make up the difference but according to the Windmill Report the funding gap could range between £21bn - £40bn by 2017.

One of the proposals in the drive towards greater efficiency is the move towards greater private involvement in the NHS. The report states:

'Both the culture of the NHS and input-focused procurement conspire to preclude effective engagement of the independent sector. There is still a great deal of wariness, if not reluctance, over using the expertise of independent sector providers - even when they may have proven solutions to the financial and demand pressures ahead - for example, in managed care, property and estate management, and in the expertise and technology to support care closer to home.'

If the government balance the needs of the NHS well the impact on the private sector could be great.

If the use of private companies increases in the NHS then the private sector will benefit. They will have larger volumes of work and less need to target the individual and business customers.

The economic climate has seen a decline in people taking out health insurance. This has been exacerbated by our perception that the NHS is improving.

This scenario is not so rosy for the health insurance market. As consumers we are less likely to take out medical insurance if we are satisfied with standards and waiting times in the NHS.

If the government cannot achieve their aims then the medical insurance market will benefit. In theory we will become dissatisfied with the NHS and move towards the security of health insurance cover.

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.

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.'

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.

Bupa HM Forces Health Insurance

There are many specialist medical insurance products which are tailored to suit groups that have particular needs. Bupa, the UK's largest private health insurance provider, offer a specialist health insurance for HM Forces. The cover provided is offered at a 47% discount and includes the following:

• private medical treatment in eligible establishments
• the option to cover just your partner or your children
• access to private in-patient and day-patient treatment
extensive private cancer cover
• cover for injuries resulting from dangerous sports and military exercises
• complementary medicine
• psychiatric treatment after two years’ membership

The forces which are covered by this health insurance scheme are:

the Royal Navy, the Royal Air Force (RAF), the Royal Marines and the Army

It is important to note here that as members of the forces are often stationed abroad they will not always be able to be treated in a Bupa hospital or NHS hospital. In these circumstances Bupa will cover hospital stays up £200 only.

Another interesting aspect of this policy is that it appears to include cover for injuries arising from dangerous hobbies and self-inflicted injuries. It is very unusual for private medical insurance companies to offer these elements within their policies.

It is important to note that the Bupa HM Forces policy does not cover repatriation. Repatriation refers to the return of soldiers to their homeland. Also, the psychiatric treatment that they offer is discretionary and needs to be cleared by Bupa before the treatment goes ahead.

Bupa also offers dental insurance for HM Forces and MOD staff as well as health insurance for MOD staff at a 47% too.

Musculoskeletal Disorders Cause Absence

A recent study, Fit for Work Europe, shows that people who live in the EU are having to take a lot of time off work due to musculoskeletal disorders (MSD's). 49% of all absences and 60% of permanent work incapacity were accounted for by musculoskeletal disorders. Health insurance companies have been aware of working hours lost through these issues for quite some time.

Companies who provide their staff with health insurance are keenly aware that the sooner a problem is sorted out the quicker their staff members can return to work, not just healthy but also with more peace of mind.

The authors of the report say that the high levels of work absence is making Europe less competitive than America or China. They recommend that all bodies work together in order to reduce time lost at work but appreciate that this does not tend to happen:

'In many of the countries we studied - awareness, resources and political will are not yet at a stage where coordinated and effective early intervention is currently deliverable.

'The consequences of this lack of readiness may be far-reaching for workers with MSDs who want or need to retain contact with the labour market. Successful early interventions require clinicians, employers and the health care and social welfare systems to work together. This is rarely the case, even to achieve positive clinical outcomes. It is even less common to find that job retention or return to work is the goal.'

In the UK, earlier this year Aviva, a private medical health insurance company, launched a new product for its business clients: Back-Up. This product aims at dealing with back and neck complaints quickly in order to reduce time taken off by staff. It has been so successful that the product is now also open to individual private customers as well.

Back-Up customers are encouraged to call the Back-Up service where they will speak to a case manager who takes a full history of your problem and offers 'practical and clinical advice and support.' They can also work with the persons line manager to advise on how the person can be helped to proceed at work.

It is estimated that in the UK 9.5 million working days were lost in 2005-2006 due to musculoskeletal disorders. This presents a problem for the UK economy. Very often the NHS can do nothing for you. The problem is too widespread and they do not have enough resources. Private health insurance on the other hand can help to support a person much speedily and tailor-made schemes such as the Aviva one are even more useful as back conditions can often be chronic and are therefore sometimes not covered under normal medical insurance.

Making a Health Insurance Claim

Different health insurance companies have slightly different ways in which they deal with claims so it is important to find out ahead of time how your company deals with claims.

A lot will depend on the type of health cover policy that you have: whether its a moratorium or fully underwritten policy. The most important advice is unless you are prepared to be out of pocket do not agree to any treatment or consultation that has not been agreed by your insurance company.

1. Visit your GP
This should alsways be your first port of call. If your GP agrees that you need to be refered for treatment or further investigation then you need to inform them that you are making an insurance claim and give them the details of the company that you are with.

In order to make a claim you will need details of your condition and probable diagnosis and the treatment that has been suggested. You will need the details of the consultant/hospital that you would like to have treatment with.

2. Contact your medical insurance company
Some companies provide an online claims method as well as a telephone number for you to ring.

You will be asked about the details of your condition and in some cases you will be informed that the insuerer will need to contact your GP to get more details about your health status. When you sign a private health insurance policy you must make sure that you have answered everything truthfully - any differences in what you have said and what the GP reveals about your records may invalidate your claim at this stage.

3 Confirmation of claim
You health insurance company will confirm whether you are covered for treatment/consultation under your policy. Companies vary in the length of time that they take to do this. Pruhealth issue an authorisation code which you need in order to have your bills paid efficiently.

4 Make an appointment
Once your medical insurance company have agreed to pay for a claim you can book an appointment to begin treatment. You will need to take your insurance details with you when you go.

5 Paying the Bill
Companies vary in how bills are settled. In most cases bills are sent directly to health insurance companies who then settle up with the health care providers. In some cases you pay the bill and your insurance company pays you back. With some policies, for example with Freedom Healthnet Ltd, the rules are very different. Freedom pay you the cash and then you pay the health provider directly.

Complaining About Health Insurance

If you have a complaint related to your health insurance then you do have redress, initially with the medical insurance company and if you are not satisfied, with the Financial Ombudsman Service (FOS).

1) Your first port of call is your health insurance provider. They will have a complaints procedure which you will have to follow. Ask to be sent a copy of the complaints procedure. This will give you a timescale by which they agree to deal with your complaint. Without following this you have no standing with the Financial Ombudsman.

2) Decide what you want to achieve from your complaint and make sure that you communicate this with the insurer.

3) Write to your insurance company explaining in as much detail as possible the nature of your complaint. Include all your details as well as copies of any documents that are relevant to the complaint. If you keep to written communication then you will have a copy of everything that has transpired. Its easy to forget what has been said in telephone conversations. IF you do have telephone contact take down the date, name of the person you spoke to and details of your conversation.

4) You should receive a reply within their agreed time scale. If not write again.

5) IF you are not pleased with a company's response then you can ask for a letter of deadlock. With this you can appeal to the Financial Ombudsman service which looks at each case impartially and decides whether applicants have a case. They can rule insurance companies to pay out up to £100,000 per case. Their website is: financial-ombudsman.org.uk

Bupa Talks Swine Flu

After a decline in cases of swine flu over the summer months health professionals are preparing for a possible increase and severity of the virus over the autumn and winter months. Bupa UK Health Insurance assistant medical director Dr Rebecca Small spoke to Health Insurance and Protection Magazine about what Bupa are doing about about Swine Flu.

Dr Small said that they were taking measures to limit the spread of swine flu:

'We have introduced more rigorous office cleaning regimes, implemented hygiene measures including provision of alcohol gel for staff for hand-washing, published advice and helplines for staff on what to do if they suspect they have flu and issued specific protocols for managers.'

There have been many queries about what kind of cover can be expected from private health insurance companies when it comes to swine flu claims. Usually health insurance policies only cover people for non-emergency treatment of acute conditions.

Most cases of Swine flu are very mild and those that are affected are usually people who have underlying health conditions. This complicates matters as medical insurance companies will normally only cover conditions which are 'new'. If the complications of swine flu are brought about by underlying conditions this will surely muddy the waters when it comes to an medical insurance claim.

According to Bupa, swine flu is covered by them. Dr Small said:

'Those with Bupa health insurance can be reassured that they are covered for inpatient and outpatient treatment of swine flu by a consultant so long as they are referred by their GP.'

6) Excess

When you make a health insurance claim the 'excess' refers to the amount you have to pay upfront yourself before the insurance company will pay out. Paying more or less excess will affect the amount you pay for your monthly health insurance premium and paying extra is one way in which people can keep down the costs of their health cover. Each provider offers a different range of options when it comes to paying an excess. Some companies offer policies where you do not have to pay any excess at all.

Why do you have to pay an excess?
Firstly, excesses do help to keep your health insurance premium down. It means that you have to pay something if you need to make a claim but overall when you are not making a claim your premiums are reduced. The more excess you pay the cheaper your insurance will be.

Having an excess also stops people making claims small claims for things that could easily be cleared up by the NHS. This helps the insurance company to keep costs down. This is one reason why some people are against excesses as they feel that it might stop people seeking medical attention when they need it particularly as small health issues could be an indicator of something more serious.

How much excess will I have to pay?
Excesses normally start at £100 but the amounts vary from provider to provider. Most range from £100-£500. Some companies offer policies with no excess.

Some providers offer a one level excess. Freedom Healthnet for example, who offer one of the cheapest health insurance policies on the market, ask for a £100 excess on each claim.

Some companies offer very large excesses. Sometimes these medical insurance policies pay unlimited amounts for treatments costs and care should you become ill. The monthly premiums are then kept very low.

How much less will I have to pay for my premiums?
The discounts offered vary from company to company. Below is a selection of quotes from various health insurers for a 40 year old man who is in good health and has a healthy lifestyle.

Bupa's Select Heart and Cancer Care
This policy has several excess options available: £100, £150, £200, £250, £500, £1,000 or £2,000. Bupa do not give online quotes for their health insurance plans.

PruHealth: Comprehensive Plan
0 excess: £71.16
£100 excess: £68.47
£250 excess: £64.45
£500 excess: £60.43
£1000 excess: £53.38


AXA PPP: Comprehensive Cover
£100 excess: £48.06
£200 excess: £44.08
£500 excess: £40.52


XS Health
This provider offers large excess contributions which significantly lower your monthly premiums.

£1,500 excess: 19.08
£3,000 excess: £11.71
£5,000 excess: £7.21

With this company once your treatment costs have exceeded your limit WPA will cover the cost in full for all eligible treatment for a further 12 months. This kind of policy is usually only recommended to healthy individuals who are not expecting to make any claims.

The most important thing to consider is whether you would be able to pay for a large excess should you become ill. If not, then you are better off budgeting with higher monthly premiums. If you have savings that you can dip into the higher excess policies may be for you but if you will struggle to pay the excess then this is not the right type of policy for you.

5) Moratorium & Full Medical Underwriting

Health insurance companies are like bookies. They have to work out the odds of people becoming unwell in order to charge them appropriate premiums. This is known as underwriting.

There are two ways that medical insurance companies assess you in order to provide you with health cover. Moratorium underwriting or full medical underwriting. Each has advantages and disadvantages.

Some companies offer both types of underwriting and others only offer one or the other.

Full Medical Underwriting
This involves companies taking a full medical history (Medical History Declaration) and lifestyle profile of you right from the start. In some cases your GP may be contacted to clarify issues that may be unclear. This is always done with your consent.

Advantages
-What you will and will not be covered for will be very clear. There will be no surprises should you become ill
-If you do become ill clearing your treatment will be speedy as all your information has already been collected by the insurer
-Companies that use full medical underwriting often have health reward schemes which enable you to reduce your premiums by performing certain health enhancing activities.

Disadvantages
-This type of policy tends to be more expensive
-You have to fill out long forms at the beginning and getting cover may be delayed whilst everything is checked out
-You are responsible for full disclosure when you take out this type of policy. If you have omitted anything you may not be covered. And it may be difficult to prove that the insurance company was at fault.

Moratorium Underwriting
This type of underwriting means that initially you only have to give out brief information about your health and lifestyle.

Under this type of policy you are not covered for any condition that you have, up to five years prior to taking out the policy until you have been on the policy for two consecutive years. After this time, if you have not had a recurrence of the condition or its symptoms you will be covered.

Advantages
-You can get health insurance very quickly with this type of health insurance. You won't have to fill out long medical forms and your application will be quick as the underwriting is not done until you actually make a claim.
-Premiums tend to be cheaper
-Once your period of moratorium is up you will be covered for everything as long as its in the policy document.

Disadvantages
-Treatment can be delayed if the insurance company needs to check out details of your medical history with the GP.
-Because this type of policy does not investigate your medical history thoroughly you could be surprised and disappointed to find that you are not covered when you go to make a claim.
-People could be put off seeking medical advice if they are trying to eek out their time until their two year, symptom free, window is up. This is potentially catastrophic.

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

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.

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.'

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.

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.

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.