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.'

New AA Health Insurance

Many more consumers will exposed to the benefits of health insurance as AXA PPP healthcare have teamed with the AA to offer their customers three levels of medical cover. The Automobile Association will also be offering the products to non-members.

Simon Douglas, director of AA Insurance, said:

'This is a logical expansion of our health and life related products which include life insurance and critical illness cover.

'The AA has built a trusted reputation amongst its 15 million members for helping to ensure the health of their cars.

'Looking after the health of our members and their families is an obvious step and we've launched into private medical insurance with one of the leading providers in this market.

'Private health care, once the province of the well off, is now available to anyone and we think that this cover will be widely welcomed. We expect to expand the range of services later this year with, for example, health screening cover. We already offer Accident Healthcare which provides medical treatment in the event of a car accident.'

Currently new customers are being offered one month free private medical insurance and customers who have had AA membership for a year or more are being offered two free months of health cover.

Mental Health Cover

In the US private medical insurance is very necessary. Without it medical costs are extremely high. Despite their reliance on this system of health care the government has only just passed a law demands that health insurance providers give equal weight to mental health issues as well as physical ones.

Of course health insurance in the US is very different from what it is in the UK. They rely on it to keep their citizens healthy. Only 15% of US citizens do not have health insurance. Those that don't are not provided with very good alternatives.

Because there is no comprehensive, free health care like we have in the UK with the NHs, their insurance policies have to cover more. They cover substance abuse and addiction, for example, whereas UK policies do not. The new laws are designed to extend the level of mental health cover.

US Secretary of Labor Hilda L. Solis said about the new laws:

'Today's rules will bring needed relief to families faced with meeting the cost of obtaining mental health and substance abuse services. The benefits will give these Americans access to greatly needed medical treatment, which will better allow them to participate fully in society.'

In the UK health is not covered as standard on all policies. Psychiatric cover is provided only in the more expensive and top-of-the-range policies and even then with restrictions. Even then addiction issues, like drug and alcohol abuse, are never covered.

The problem is that mental health issues are quite prevalent in society. For example, at any one time it is thought that one in ten adults is suffering from depression. This means that it is an expensive thing for insurance companies to cover. It is also an area which is still surrounded by subjectivity, unlike physical health which has more known 'symptoms' used to diagnose it.

Of course if you take out a policy when you have already been diagnosed with a mental health condition then you will not be covered for this condition anyway. However if your policy covers mental health and you develop a condition you will be covered but each policy has its own limits of cover.

Bupa, for example, stipulate:

'Subject to your cover under your benefits, we may, at our discretion, pay for eligible treatment of a psychiatric condition ......'

The words 'at our discretion' suggest the arbritary nature of this kind of cover. This clause could mean that an insurance company has the ability to deny psychiatric cover to a client. 'Our discretion' is not a concrete term that can be contested.

Of course psychiatric treatment is available on the NHS but the resources are very stretched. Paying for treatment privately is expensive particularly when you consider the long term prognosis of many mental health conditions.

Cancer Lottery

National Health Primary Care Trusts (PCT) are responsible for healthcare in their area. They individually control funding and this is the reason why NHS healthcare across the UK is very uneven. This is a contributory factor to why some people like to take out health insurance: they have a high standard of care no matter where they live.

PCTs are responsible for spending around 80% of the national health service budget. They work within the overiding rules of the Department of Health and there are 152 care trusts in England.

Cancer sufferers seem to be particularly vulnerable to the 'postcode lottery' as the situation has been coined in the media. According to the National Colorectal Cancer Audit 60% of patients have a major resection (where parts of the bowel are removed) but there are variations across the country from 20% to 80%.

Survival rates vary too. In Kensington and Chelsea patients have a 43.7% survival rate for lung cancer and only a 15.4% rate in Herefordshire. Breast cancer patient one year survival rates are 89.3% in Tower Hamlets and a 99% in Torbay.

In the private health arena there is a more standardised level of care. Bupa the private health insurance provider, for example, include Avastin in their range of allowed drugs but some NHS trusts do not. Avastin is a chemotherapy treatment used for metastatic or secondary cancer and it costs around £60,000 a year per patient. The drug does not cure cancer but it prolongs life.

If you are considering private medical insurance you may be deterred when you hear that the NHS is improving. This is true, there have been improvements in the NHS over the last five years. However the improvements are not standardised across the country. It still depends on where you live and which hospital you go to.

Health insurance for cancer is available from many private medical insurance providers although there is currently a great deal of debate in the industry about the high costs of cancer treatment and what the industry plans to do about cover for this illness in the long term.

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.

New Bupa Select

Bupa Select is a new health insurance offering for small to medium sized businesses. It became fully available from 1st December and aims to offer flexible cover in these difficult financial times.

Director of business markets for Bupa, Ann Greenwood, said:

'High broker demand told us we needed a policy that was much more flexible and modular rather than simply opting for a ‘one size fits all’ approach with lots of features you pay for but may never use. When we tested BUPA Select in the run-up to the launch, brokers were impressed, particularly with the web-enabled functionality and the flexibility available to build bespoke cover.'

This private medical insurance cover enables companies to build a bespoke cover for their employees by enabling them to add or remove various cover options. The policy is available for companies with between 50 and 250 employees.

According to Bupa they have made all their administrative procedures more efficient and streamlined in order to provide a better customer experience. They are also offering a 30% discount for companies that sign up to the scheme before 31st December 2009.

Some of the main features of the product are:

• £1000 towards out-patient consultations, treatment and diagnostic tests
• £250 towards complementary medicine
• full refund for in-patient and day-patient hospital charges and accommodation in a Bupa Partnership Network hospital.
• Full cancer cover
• up to 45 days of psychiatric treatment
• private ambulance
• £50 NHS cash benefit to cover each night in an NHS hospital
• 24-hour Bupa HealthLine
• Free use of Positive Health

Reduction in Costs:
• Policy excesses of £100, £150 and £200
• reducing out-patient benefit to £750, £500 or £250
• excluding psychiatric treatment

Extra Cover:
• Including cash cover to help with optical, dental and prescription costs.
• increasing benefits for out-patient treatment to £1500
• removing the limit for complementary medicine
• increasing the range of hospitals available

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.'

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.'

FOS Health Insurance Complaints

The Financial Ombudsman Service (FOS) published its public complaints figures this month. But are they valuable and what do they tell us about complaints made about medical health insurance?

If people are unhappy with their health insurance company they have to follow the company's official complaints procedure and if they are still not satisfied they can appeal to the independent FOS who will make a final decision in each case.

The statistics collected for insurance include different types of insurance including private medical insurance as well as critical illness insurance and income protection therefore there is not an easy comparison. However out of all the insurance complaints they received 70% were upheld. This is a large percentage and means that 7 out of every 10 complainants had not received fair treatment from their insurance company.

Individual companies were named although again it is hard to compare as different types of products were being scrutinised.

Complaints Upheld
Bupa - 25%
Aviva Health UK - 36%
AXA PPP Healthcare - 44%

Maggie Craig, director of consumer strategy at the Association of British Insurers (ABI), said:

'It’s absolutely right that consumers should know about the performance of firms who look after their insurance and investment needs, and complaints handling is an important part of that. But any such data must be presented in a way that helps consumers make informed choices.

'Unfortunately, the way that the FOS has chosen to present the data doesn’t achieve this aim, and may in fact mislead consumers about the performance of individual firms. For example, consumers can’t compare performance by sector or by product.'

Even though comparisons between figures may be misleading it must provide an extra incentive for the private medical insurance industry and individual health cover providers to look at their complaints statistics and procedures and see where they are going wrong.

More transparency is what some quarters are looking for. Critical illness insurance providers, for example, have to declare their claim rejection figures every year. Transparency enables solutions to come quicker even though it may be painful for a company to expose its results to the general public.

The complaints figures for this year were almost the same as last year which is a good sign. Since 2005/6 complaints have come down from 2,291 to 1,874. The ABI's work on improving non-disclosure is one of the reasons for this reduction.

According to FOS one area where they still receive complaints is in health insurance cases where consumers received reveiwed premiums which they feel are unfairly steep. Their website states:

'We continue to receive complaints from consumers who have entered into so-called "reviewable" insurance policies, where the insurer has the right to review the premium at intervals of five or ten years. These disputes generally involve reviews that have been carried out after many years – and have resulted in a significant increase in the premium.'

Unfortunately FOS does not publish the results from companies who have had less that 30 complaints. F0r a small company this may represent a large number of complaints and it would be good for the public to have this kind of information available to them.

New International Health Insurance

Aviva have recently launched a new private medical insurance product for people who live abroad. International Solutions is a flexible plan that offers different options for Brits who live abroad.

In the UK we have a fantastic base level of care in the NHS and, bar a few charges, its free for all UK citizens but what about UK citizens who live and work abroad? Different countries offer different levels of health care and for those who want to ensure they keep receiving good care private medical insurance is a very attractive option.

International Solutions offer a comprehensive core policy with a variety of add-on options that will enable people to choose different modules including:

• Wellness, Dental and Optical
• Increased Out-patient
• Compassionate Travel
• Maternity

International Solutions is offered to both individual and corporate clients and cover costs vary according to where you are in the world. If costs are cheaper in one area then they are reflected in the premiums that you pay and if you are in a more expensive band you will also be covered in areas that are less expensive than yours.

Andrew Turner, Aviva’s head of international, said:

'As Aviva’s healthcare arm, we’ve a wealth of experience in the global market and recognise that healthcare provision differs across the world. With budgets tight, both corporate and individual customers need the flexibility to be able to tailor their medical insurance to suit their needs and to complement the healthcare provision in their country of residence.

Offering one of the widest choices of modules available in the market, International Solutions enables them to do just that. And, with additional benefits such as the medical information helpline providing topical information on anything from vaccinations to swine flu, we believe that International Solutions offers some of the most comprehensive benefits in the market.'

Premiums can be reduced in the following ways:

• Increasing excess
• Reduced Out-patient cover
• Reducing Additional Benefits

One interesting thing with International Solutions is that it includes a limited amount of cover for the maintenance of chronic conditions. Normally health insurance does not cover chronic conditions. This may give peace of mind particularly if you are new in a country and unused to its medical system.

The Advantages of Health Insurance

The statistics show that the NHS is improving its targets all the time so what are the advantages of having medical health insurance?

Get seen quickly
Hospital waiting lists are down to 18 weeks but this is still too long. If you have private health insurance you can be seen very quickly. This is reassuring and means you are tackling your health problems quickly abd therefore improving your chances of good health. It also cuts down on the stress of having to wait for important diagnosis and treatments.

Choice
With private health insurance you have much greater choice about which consultant you see and which hospital you go to. Different medical insurance companies offer a range of different hospital networks.

Cleanliness
Survey's conducted this year cited the poor NHS standards of cleanliness as the main reason that people would consider taking out private health insurance. Concerns over superbugs such as c.difficile and MRSA are particularly important and the private health sector is perceived as having much higher standards of cleanliness.

Comfortable Surroundings
Many private hospitals offer very pleasant and comfortable surroundings. Usually patients have a room to themselves with a television and they are provided with good quality meals.

Staying with Children
Most medical insurance policies cover a parent staying overnight in hospital with their children of 12 or under. For many people with children this gives great peace of mind.

Budgeting
Paying monthly premiums for health insurance enables people to budget their money better. For people who want private health care, medical insurance helps to spread the cost and mainly avoids large, unexpected medical bills.

Individual or Company Health Insurance?

Many employers offer private health insurance as part of your remuneration package. Is it better to take up this offer or to have your own individual health insurance?

Most people in the UK who have health insurance have it through their employer and overall if you can get health cover through work it is usually the best option. There are three main differences between company and individual health insurance:

1) It will be cheaper. You will normally not have to pay anything towards the premium although it is a taxable benefit. Companies can normally negotiate much lower rates for their employees than can be obtained by individuals and this will keep down the taxable amount that you have to pay.

2) A company scheme will be less strict about exclusions. Because policies have to be underwritten en masse there are differences between the policies when it comes to pre-existing conditions. Company policies tend not to exclude these whereas individuals policies certainly do. Chronic conditions are normally excluded on company schemes however in the same way as they are on individual policies.

3) Company health insurance normally covers partners and children of the employee too which is not automatically the case with individual private medical insurance. You would normally have to pay a lot more to include a partner although with some companies children can be included for free.

Problems
Problems arise when people leave their jobs and want to keep some form of health insurance. Most people find that the premiums that they have to pay are much higher than they expected. If you are moving within the same insurance company it may be possible to negotiate better rates and its always worth asking as you never know what could be offered to you.

MP's Attitudes to Private Health Insurance

The private health sector and the NHS have been sitting along side each other ever since the inception of the NHS in 1945. Some are not keen that people should be able to pay for private treatment if they can afford it but others are keen to move the NHS towards privatisation. Most people lie somewhere in the middle.

On the whole the British are proud of the NHS which gives free treatment to every UK citizen at the point of use. A new poll by health insurance provider BMI Healthcare reveals that conservative MP's are more supportive of the private health sector than other parties.

The BMI poll showed that two thirds of MP's backed tax relief on private medical insurance. In contrast only 1% of the labour MP's wanted this option.

The conservatives have been criticised for wanting to turn their back on the NHS despite Mr Cameron's insistence that they are 'the partly of the NHS.'

Allastair Darling, Chancellor of the Exchequer, said that the introduction of tax relief on private health insurance would harm the NHS:

'Tax breaks for private health care would take money away from the health service and undo the real progress we have made with the NHS over the last 12 years.'

'After a torrid two weeks, David Cameron can no longer hide the two faces of his party on the NHS – this poll shows where the heart of the Tory party lies.'

Adrian Fawcett, chief executive of General Healthcare Group (which owns BMI Healthcare), said:

'The results help progress what, in the run-up to an election, is an important debate about the future of health provision in the UK. I do not believe there are many in the private healthcare sector that would support a switch to the US model. The UK already has a growing partnership between the public and the private healthcare sectors and we are pleased that so many MPs take a pragmatic view about how such a partnership can be further developed and how it can be used to meet the health needs of an increasingly ageing population.

'The NHS delivers strong core health services but the patient experience, the clinical outcomes and the timeliness of treatment can undoubtedly be further improved, if the private sector is encouraged to work more closely with the NHS to deliver reduced waiting times and improved value for money.

'In my view, the private sector is not advocating a root and branch reconstruction of health provision in this country, rather measures to widen patient choice and improve patient services and outcomes as part of a closer public-private partnership.'

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.

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.'

What are Exclusions?

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

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

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

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

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

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

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

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

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

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

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

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.

Heath & Medical Insurance Information

Over 7 million people in the UK now have some form of private health or medical insurance. This shows a growing dissatisfaction with the speed of the NHS in treating acute conditions and a desire for choice of treatment venue.
Our health is important to us, without it we are unable to work, unable to earn a living, unable to live life to the full. This is where medical insurance comes into play. We want to choose our consultant, we want to choose the day and place of our operation, we expect the best.
Bearing this in mind, we will be covering the health insurance industry and look to help people to find a medical insurance policy to suit them, to help them to reduce their premiums, to provide information about what is happening with the NHS and with the private hospitals.