Private Health Insurance Query

[anonymous-user]

Evening guys, after some advice please.

I’ve only ever had private healthcare previously as a job benefit. I’m currently considering taking out a new policy as I’ve got a couple of health matters I need to get investigated, which I haven’t seen a GP about or been referred for. I don’t know if they can be considered pre-existing conditions since I haven’t been diagnosed with anything.

Can I take out a policy and then claim straight away in order to see the specialists I need? I am unsure how it works?

[DeWar]

When you request a private referral the insurer generally asks to view a copy of the referral letter from the GP to look for whether the condition appears to pre-date the policy. If it’s not obvious then they may write to the GP to ask when the condition first arose.

So if there is no mention in your medical records of the problems you’re being referred for, then it all depends on what you tell your GP and what he subsequently documents.

[Biglips]

Be aware that private healthcare is virtually non-existent at present other than some telephone consultations as the NHS is still using the private hospitals. This is likely to continue for some months yet. I would suggest that you talk to the insurers before you sign up to see what they are currently offering. Services are coming back on line but it is not what it was prior to Covid

[dalenorth]

You might be able to continue with your company policy privately, and most private hospitals are now back to normal.

We broker PMI so pm me if you need any help?

[Biglips]

dalenorth said:

most private hospitals are now back to normal.

Not sure about this. The NHS is retaining a large interest in private hospitals (75% local to me) and I am severely limited as to what private treatments and services I can provide as a consequence of this. Non face to face consultations are OK, but very little else possible. It will improve but we are a long way from normal services

[rlg43p]

There will usually be an initial period in which you cannot claim - is it called a "moratorium" period?

[Radec]

You may be able to, but it depends on a few things.
How long did you last have PMI at work?, are you at the same place and are they still offering it?
If you are at a new place do they have PMI available?

What and how & when you claim for something will depend on your underwriting of which there are 4 types I believe.

Full medical underwriting - means you will fill in a app when first joining a PMI policy declaring all your medical history for which any pre-existing conditions will be excluded, anything new you will be able to claim for.

Continuing medical exclusions - as above but if you move to another insurer you will receive a certificate showing the exclusions so your new insurer can carry these on without the need to fill another app in.

Moratorium - you will have to be clear of a certain condition and not had medication or advice about it for a certain amount of years before you can claim for it again.

Medical history disregarded - basically means you can claim for whatever you want in regards to the benefits of the policy, no need to disclose any medical history.
However this is only limited to company healthcare policies of more than 15 or 20 employees I think.

Most company schemes have a continuation scheme that allows you to take out an individual policy on no worse terms than the company policy you are on and normally this mirrors most of the benefits you had, although you have about 30 or 45 days to take this out from when you left the company scheme.

Once you are covered you can claim straight away once you get a GP referral.
Services are slowly becoming available depending on where you are but depends on your ailments really to what you can get access to at this moment in time.
I do recommend you go via a broker though rather than trying to find it yourself as they will probably able to give you the best steer on it, think someone above said they were so give them a shout.

Edited by Radec on Thursday 25th June 00:49