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Private Medical Insurance FAQs
What is Private Medical Insurance?
Private Medical Insurance (PMI) covers the cost of treatment for acute conditions at private medical facilities. Acute conditions are short term, usually curable illnesses or conditions. PMI will take care of costs related to seeing a specialist, having surgery, and staying at a private hospital or in a private section of a National Health Service hospital.
What cover is excluded by PMI?
Every private medical insurance policy has a list of exclusions from cover, and some companies place limits on the amount they will put toward certain benefits. Benefits with limited cover often include routine dental checkups and maternity costs. Some other common exclusions include: pre-existing conditions, sleep disorders, cosmetic treatments, vaccinations, nursing home stays, and outpatient drugs.
Which hospitals may I choose from?
Most PMI providers will offer a list of available hospitals when you ask for a quote. Many PMI providers have preferred hospitals that they like their clients to use. It is very important to carefully look over which hospitals are available with any plan you're considering. PMI providers have come up with a ranking system for hospitals. They rank them with A, B, and C grades, with A being the best and most expensive. Be sure that there are hospitals available in your area that are ranked in your price range before you choose a PMI policy.
In order to take out a PMI policy, do I need to undergo a physical exam?
Some PMI providers will need you to undergo a physical exam in order to approve you for a policy. Some insurers will write to your doctor to get your health records, while others will only require you to fill out a health questionnaire.
When you fill out a health questionnaire, it is important to be as thorough as possible. Any omissions may be cause for the insurance provider to deny you a policy.
What factors will affect changes to my premium in the future?
Policy premiums may change over time due to advancements in the way that illnesses and conditions are treated. With more expensive drugs and equipment come higher premiums. Some insurance providers may also choose to raise premiums annually in accordance with medical inflation. Also, depending on whether there are tax incentives associated with your plan, the government may be able to alter your premium.
How do I make a claim to my PMI provider?
When you have a PMI claim to make, contact a representative at your insurance company. This person will be able to guide you through the process of making a claim. They will also be able to help you with choosing a hospital and/or a specialist that is approved under your policy. Often, insurance providers pre-authorise claims so that there do not need to be any financial transactions made between you and the hospital. Instead, all transactions will be handled by the insurance company. If your provider does not pre-authorise claims, you will need to provide the original bill when submitting the claim to your PMI provider.
If you're interested in finding a PMI policy, take a moment to fill out our short private medical insurance form, and we will introduce you to a PMI broker that will find the best PMI policy for you and your particular needs.