Private Medical Insurance

What does Private Medical Insurance do?

Private Medical Insurance (PMI) covers the costs of private medical treatment for curable short term medical conditions referred to frequently as acute conditions. PMI includes the costs of surgery specialists accommodation and nursing at a private hospital or in a private ward of a NHS hospital.

There are two types of insurance plans to choose from – Standard and Comprehensive.

– A Standard Private Medical Insurance Plan covers hospital or emergency treatment. It will include in-patient and day-care treatment only.

Comprehensive Plans include the above plus additional coverage including outpatient treatment, dental treatment, complementary medicine, maternity travel and personal accident cover.

In general Private Medical Insurance Plans do not cover chronic or critical illness which cannot be cured, e.g. multiple sclerosis, asthma or diabetes. However in a crisis most PMI policies will pay the cost of treatment for stabilising a patient and returning them to their previous level of health when possible.

Private Medical Insurance contracts are offered on a yearly basis with premiums payable monthly, quarterly or annually. Discounts are sometimes offered should you pay the whole annual premium in one go or take up a voluntary excess on claims. Some insurance providers will accept new clients at any age but most place upper limits at 65-75 years old.

Once you’re accepted into a plan the insurer usually continues to offer cover year on year albeit at an increasing premium with age. If you receive Private Medical Insurance as a perk with your employment and you leave your company most insurers will offer you and your family cover but it may be on differing conditions and different premiums.

Its crucial to understand the terms on which plans are being offered to avoid hassles and disappointments when making a claim. If you have a current Private Medical Insurance plan but wish to change to another insurer maybe to save money, receive additional cover or simply to escape from bad service, then it is possible to ensure that you receive a plan on “no worse terms”. This is known in the trade as a Continuing Personal Medical Exclusions (CPME) plan and an independent financial adviser specialising in this area should be able to help.

This simply means that the underwriting company of the new plan will offer you cover on the same terms as the previous plan. If you have had claims and particularly exclusions from cover these too will be carried forward or considered by the new insurer. This CPME transfer method allows for continuity of cover particularly if you are presently undergoing treatment or have had treatment in the recent past, and are concerned as to a re-occurrence of such a medical problem.

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