The medical costs of curable, short-term injury or illness will be covered under Private Medical Insurance. These types of conditions are commonly known as acute conditions. This type of medical insurance ensures that people receive medical attention within a short time of claiming.
As receiver of private medical care, you have the opportunity to choose the consultant you want to see, the hospital you want to receive the treatments at and when the treatment should take place. You can also receive all the comforts of an en-suite room.
You should note that there may be exclusions for certain treatments and illnesses. This means that these particular injuries and illnesses will not be covered from your private medical cover. (See section 5 of this guide.)
Another important fact that you should bear in mind is that private medical insurances does not aim at covering all the services offered by NHS. There may be certain accidents and emergency situations that could not be handled by the private hospitals.
Some of the treatments that are usually included in a private medical insurance are:
- Acute medical conditions
- Tests for in-patients
- Surgery
- Nursing and hospital accommodation
Some of the treatments that may be included only sometimes:
- Tests for out-patients
- Consultations with a specialist for out-patients
- Treatment followed by cash payment for an NHS in-patient
- Overseas cover
Some of the treatments that are usually not included in a private medical insurance include:
- Pre-existing conditions (please read section 7)
- Services by GPs
- Long term illnesses that cannot be cured
- Accidents and emergency
There are two ways that an insurance company would accept your payments. One is medical history declaration where you are asked to fill a form, stating your medical history. In some cases, the insurer will clarify this information from your GP. The emphasis here should be to give out the correct information about all your pre-existing medical conditions. Failure to do so may result in non-payment in a claim situation where the insurer gets to know the truth about your real conditions. If you have a condition which is possible to come back, insurance will make exclusions for that particular condition in your cover.
The other method that an insurer will accept your payment is through moratorium. In this kind of a situation, you are required to fill a form but you do not have to disclose information about your medical history. The insurer will ideally not cover any condition that prevailed within the last five years (the number of years could vary with different companies). Insurers usually give printed information on how they operate in a “moratorium” situation. If you have any doubts or questions, do not hesitate to clear them out with an officer from your insurance company. |
