Editorials

What our customers say...

“Tip of the week is fantastic! I use this site on a regular basis, I trust your advice more than the other sites out there, keep up the great work, cheers.”


The information in this article was correct at the time of publication and contains time sensitive data and links, it may not be accurate at the time of reading.

Private Medical Insurance - Is It Right For You?

Published: 10/06/2008

The sale of private medical insurance (PMI) has increased steadily over the last couple of years and shows no sign of abating. Only recently, BUPA reported a 20 per cent year on year increase in business during the first quarter of 2008.

With a number of high profile outbreaks of MRSA occurring during the last few years, it is no real surprise to see increased demand for PMI as more consumers seek clean hospitals, shorter waiting times and speedy access to medical specialists.

Whilst such a policy does not guarantee that you will be covered for everything that goes wrong, our wellbeing is certainly becoming more important to us, and the continued media reporting of healthcare scandals will only reinforce this mindset further.

So, is PMI right for you? Before making a decision to spend some of your hard earned cash on a monthly insurance premium, there are a few things you should consider:

  • Check with your employer first to see if you're already covered by a scheme run by your company.
  • Do you really need this additional peace of mind and is it worth the price you've been quoted? If you suffered an illness or had an accident and you didn't have cover, how much would it really cost you?
  • Consider if you would be better just to save some money each month, you may feel that this is a preferable option, however bear in mind that many hospital treatments can prove very expensive.

If you decide that PMI is for you, don't rush in and buy the first policy you are offered, it is an incredibly complex product and as such you should seek the help of an independent financial adviser.

It is important that you understand from the outset what is and what isn't covered by your insurance, for example, many policies will exclude HIV/Aids, infertility treatment, psychiatric care and arthritis.

However the most important matter to establish is whether the insurer you choose offers fully underwritten PMI, and as such doesn't include cover for any pre existing conditions, or whether they have a moratorium, which means they may cover you for a condition as long as it hasn't recurred during the previous two years.

It is vital that you understand what Moratorium means, particularly if your past medical record excludes you from benefits in certain areas. When insurers offer PMI plans, they are taking on clients without the need to disclose their medical history. This has both advantages and disadvantages which have to be carefully weighed up. For example, if you had a medical treatment last year and took on a Moratorium Plan, then 12 months into your new Plan the medical condition for which you were treated recurred, this could be excluded from cover under Moratorium due to the previous condition being a pre-existing condition less than two years ago.

If you have a current PMI Plan but wish to change to another insurer it is possible to ensure that you receive a plan on "no worse terms", and an independent financial adviser specialising in this area should be able to help.

This means that the underwriting company of the new PMI 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.

Another potential problem area is that of "non-disclosure". Basically this means that a claim will be invalidated if you do not let the insurer know about any condition that you have suffered in the past, even if this is not the same illness for which you subsequently make a claim.

So whilst PMI will make life easier in that you will be able to get appointments and treatment when you need them, it is essential that you read and understand the small print before putting pen to paper, as you don't want to find that your claim is invalid or treatment unavailable when you come to rely on your PMI policy.

It is worth remembering that there are ways you can reduce your premium, for example, by limiting the payout for certain operations or agreeing to pay an increased excess on any claim. Last year Prudential launched an innovative PMI product which allows you to cut the cost of your premium by adopting a healthier lifestyle. Consumers can cut the cost of their cover by, amongst other things, going to the gym, giving up smoking or having regular health checks.

Once you've done your research and decided what you want from your private medical insurance, take the time to get quotes from two or three providers and select the one that suits your requirements and your budget.

Copyright ©2010 Sterling Business Consultants