What am I covered for? What does my cover not include?
Generally private medical insurance packages will include coverage for acute conditions, surgery, accommodation, theatre time, tests and consultations, with possibilities including out-patient tests and consultations, cash payments gained as an NHS in-patient and overseas cover. Rarely included are areas such as pre-existing conditions, long-term conditions, A&E admissions, GP services and other areas such as conditions resulting from drug use.
However, there are specific packages that will vary the cover provided:
Fixed Package:
- Normally, there are a range of areas that are covered by a fixed package. First there are costs related to in-patient procedures that might require you to stay overnight. Likewise there are also out-patient costs that will be covered in your typical fixed package, where you may visit a consultant and not need to stay in hospital. Then there are costs associated with day-patient procedures, where a patient will visit hospital but will not stay overnight.
- Typical fixed packages may also cover patients in need of physiotherapy following an injury. Other areas, such as forms of diagnosis, are also usually covered.
- A typical fixed package may also cover consultant fees, which cover the costs of using a medical consultant to assist with the claims process.
- If you are staying hospital you will also be charged for accommodation and as a result such packages will cover you for areas including food.
Limited Cover:
- In some cases a patient will not require cover for all of the areas listed above and so they may opt for another form of fixed package that will provide less cover. Such patients may visit the NHS for the remaining treatments.
Personalised Cover:
Then there are those that will not require a fixed package and will instead wish to tailor their private medical insurance to their own needs. You might fall into this category if you work on a freelance basis/require cover for a business or if you require cover for specialist areas related to physical activities. There may also be other areas of insurance that you wish to include in the package but are not normally covered such as dental treatment, optical treatment, or if you wish to include children on a policy. You can also tailor the policy to partially or completely cover you for medical assistance.
- Specific polices may not include treatments for injuries received from dangerous activities so personalised policies can be adapted to these
- Likewise you should check whether you are covered for in-patient, out-patient and day-care as some customised packages may exclude out-patient procedures.
- Some packages can be tailored to include home-nursing, health screenings and in some cases gym discounts.