Frequently Asked Questions
Why use a specialist healthcare broker?
Oh where to start! First, we are on your side, not the side of the insurers. So when negotiating, we are working on your behalf to make sure you’re getting the best deal.
Second, as specialists, we know more than anyone should know about insurance, which means we can help you navigate through the language, and read the fine print so that you don’t make a potentially major error when choosing your policy.
Third, our service is FREE, we get paid through commission, so we work with hand-picked providers who are competing for our and our client’s attention which means they offer us better rates, which means that you receive better rates.
Why should I review my private health insurance policy?
Excellent query! You should review your policy regularly, because insurance actually gets MORE expensive the longer you stay with one provider. (Crazy right? Where’s the loyalty?!) This means that it’s absolutely in your best interests to have your policy reviewed regularly. During the review, we (your specialist brokers), can compare your current policy with other insurers, and negotiate with your current provider to bring your premium down in line with the competition. If they are unable, or unwilling, to match the better price, then we can help you switch to a new policy. Unlike insurance companies, our loyalty lies with YOU, so it is in our interest to make sure you’re getting the best value out of your policy.
If I change providers will I still be covered for my previous conditions?
In a word, Yes! During a review, we compare different policies to see which providers can continue your coverage if you decide to change. The term for this is “continued underwriting” and it’s available for both personal and business policies. The process of changing providers using “continued underwriting” is normally very straightforward as long as you meet certain criteria. It is absolutely worth noting that clients who have been with their current provider for an extended period, are often the ones that can make the most savings when they choose to change, which is why we offer policy reviews to all of our clients annually.
How do you make your money?
Great question! Our profits are based purely on commission that we earn from the insurers when we place a policy with them. This business model allows us to offer all of our services to our client’s FREE of charge.
The commission only model can lead to some brokers ‘working the system’ and changing their client’s to new insurers as often as possible to try and earn the most commission…but we’d rather sleep at night. So instead of switching insurers, we negotiate with our client’s current provider annually to ensure best value for their policy, while still earning our annual commission. Not only does this mean that our client’s are getting the most for their money, but our karmic consciousness stays squeaky clean.
This is the process that determines whether your health insurance policy will exclude cover for certain “pre-existing” medical conditions. There are quite a few options but this is arguably the most important part of a healthcare policy, get this wrong and you might find that your claim is rejected so here’s an overview of policy vocabulary.
The advantages to moratorium are that you don’t need to supply medical information when arranging your policy, and that pre-existing conditions may automatically become eligible for cover at a later date.
Your eligibility to claim will be assessed at the point that you need to use your policy but it’s important to know that pre-existing conditions suffered in the 5 years before arranging your policy are unlikely to be covered in the first instance. However, after completing a period of membership it’s possible that pre-existing conditions, which might have been excluded in the first instance, might become eligible for treatment.
Full Medical Underwriting
Some people would prefer to know which conditions are excluded from cover from the outset, regardless of the fact that this option may make it unlikely that they will become eligible for cover at a later date.
This option requires a medical declaration at the point of application and any excluded conditions will be listed on your membership certificate and these will only be removed by asking permission from your insurer after at least 2 years of membership, but their removal is not guaranteed.
If you’re already covered on a healthcare plan you might wish to move to a new insurer but may be disadvantaged if you started the underwriting process again due to changes to your health since taking out your original policy.
To combat this, all providers will allow you to take out a new policy with them but continue your moratorium or full medical underwriting terms from your previous provider leaving you free to move without being disadvantaged, although this is subject to certain conditions. A good broker will discuss all the implications with you.
Medical History Disregarded (MHD)
This option is most commonly seen on company policies with membership in excess of 20 members although some providers occasionally offer this to smaller groups whilst others insist on a member list in excess of 50. This is a very useful option as it means the provider won’t look to reject a claim if a person had a medical condition prior to joining the plan. This makes the claiming process simple but of course it is a more expensive option as it presents a greater risk to the insurer.
Most insurers offer different choices of hospital access ranging from a comprehensive option that includes nationwide coverage of private hospitals including the top London facilities like The Cromwell, Wellington and Lister along with private patients’ units at NHS hospitals, reducing to a limited choice of hospitals or where the member is directed towards a hospital by the insurer – the wider the choice, generally the higher the cost. In many cases choosing a reduced hospital list can mean significant savings, and this can often have a limited impact if your preferred hospital happens to be on one of the reduced lists.
Many providers offer a choice of excess to help reduce the premium. The higher the amount you choose to pay in the event of a claim the higher the discount. In many cases choosing to pay a small excess should you claim can mean some big savings but beware as some providers offer a ‘per claim’ excess which means that you pay for each condition you claim for whilst others offer a ‘per policy year’ excess meaning you only pay an excess on your first claim of the year.
This is cover for when you’re not actually admitted to hospital but have to attend for things like specialist consultations and diagnostic tests. Most providers offer a range of out-patient cover to suit your budget ranging from “full” to “none” although even if you chose no out-patient cover, out-patient costs associated with cancer care along with expensive scans like MRI, CT & PET often remain covered in full. Again, your broker will discuss what’s best for you based on your budget and what you feel is important.
Peace of mind in this area is incredibly important and some providers make it simple by only offering “full” cover as standard. This means they fund treatment and care without limitation until it is no longer required, and they will also pay for follow ups until such time that your consultant deems these no longer necessary. There are also a number of providers who will allow a relatively inexpensive upgrade to full cover, from their standard limited cover. Finally, there are some providers who have limited cover as their standard but don’t have the facility to upgrade their policies or who will only pay for some expensive drugs when these are not available on the NHS. A specialist broker is well aware of all these differences and can guide you through this element of cover.
6 Week Option
This is a cost saving option offered by some providers, it has no bearing whatsoever on your activity as an out-patient meaning that you would still get the prompt diagnosis that a private healthcare policy provides but should a hospital stay be required then the 6 Week Option becomes relevant.
This means that if the NHS waiting list is less than 6 weeks at the point you’re advised that you need a hospital stay, you follow the NHS route but if the NHS confirm that the procedure you require isn’t available inside 6 weeks then you can go privately at your convenience, and you don’t have to wait until the 6 weeks have lapsed.
More and more clients are seeing the importance of including mental health care on their policies so whilst some insurers include out-patient mental health care such as counselling and CBT as standard with an option to upgrade cover to include in-patient mental health care, other insurers opt to offer a mental health care upgrade that includes both in-patient and out-patient.
Including mental health care can help define what your mental health needs are, what help you require and what treatment would be best for you and as with most medical conditions, early intervention can make a huge difference to the speed of someone’s recovery so when you consider that the cost of this upgrade is often modest, including this type of cover on your policy could be well worth consideration.
Most private healthcare polices, with an element of out-patient cover, will allow a policyholder to access some physiotherapy if they need it but adding a ‘therapies’ option can increase the available level of physiotherapy and can add cover for treatment provided by acupuncturists, homeopaths, osteopaths and chiropractors.
Some insurers will also help their members access care without the need for a GP referral, but however you access care we would also urge caution to our clients who have personal policies with ‘no claims discounts’ as the cost of this type of treatment can be modest and the impact of a claim of that nature may bring around an increase in premiums that’s beyond the amount claimed on the therapies.
An Employee Assistance Program (EAP) is a work-based program that offers confidential assessments, If your employees have worries concerning their work or personal life. EAPs address a broad and complex body of issues affecting mental and emotional well-being, such as alcohol and other substance abuse, stress, grief, family problems, and psychological disorders and assistance can often be provided in either Face to Face or online.
Increasingly, insurers are offering the chance to add popular extra’s to their healthcare policies such as travel insurance and dental & optical care which can be a great way to add value to a policy without someone having to received medical treatment in order to benefit from their policy.
Furthermore, some insurers now offer loyalty programs that include heavily discounted gym memberships, travel, entertainment and sports equipment. No two insurers are the same in this area so product knowledge is key when considering these options – again talk to your broker.