Private Medical Insurance.

In the UK, we’re lucky to have the NHS, but the waiting list to be seen is growing and growing, and there’s an ever-growing backlog, which ultimately will take years to clear.

According to the December 2023 stats from the BMA…

Around 7.20 million people are waiting for treatment

A record high of 3.1 million of these patients waiting over 18 weeks

406,035 of these patients waiting over a year for treatment

Private healthcare is designed to complement the NHS, but with the NHS under strain, more and more people are turning to private healthcare. Taking out private medical insurance will cut the NHS wait times and not have to fork out a massive sum for private treatment.

In the UK, we’re lucky to have the NHS, but the waiting list to be seen is growing and growing, and there’s an ever-growing backlog, which ultimately will take years to clear.

According to the December 2022 stats from the BMA.

Around 7.20 million people are waiting for treatment

A record high of 3.1 million of these patients waiting over 18 weeks

406,035 of these patients waiting over a year for treatment

Private healthcare is designed to complement the NHS, but with the NHS under strain, more and more people are turning to private healthcare. Taking out private medical insurance will cut the NHS wait times and not have to fork out a massive sum for private treatment.

Cancer isn’t classed as a chronic condition and therefore is covered under private medical insurance with most providers. You will have access to full cover for the latest treatments and technologies to treat cancer, from an oncology team who will support you through the process and help get the treatment privately.

When it comes to private medical insurance for yourself and your family, our private healthcare insurance brokers are here to help. We always talk about the items/things we insure, but what about us? Here at Protex Financial, we strive to take most of that stress away and make the process as quick and straightforward as possible to get your hands on the necessary private health care to protect you and your loved ones.

If you are brand new to private medical insurance, or even if you’ve been around the block a few times, if you have zero or a million questions, our private medical insurance brokers can guide you through the entire private health care advice process and answer all the questions you have. We have seen insurance horror stories, so we pride ourselves on our straightforward and very effective process whilst keeping you informed every step.

From your first appointment with us to handling your claim, god forbid you ever need to make a claim. Our team will keep you up to date and maintain constant communication flowing. Now, we all know speed bumps can happen, and hiccups can occur. This is why we are very cautious about whom we partner up with. We aim to protect you with only the highest of standard insurance companies, so if the worst ever happens, you can rest assured you will be okay.

In-patient (included as standard) – when you’re required to stay in the hospital overnight.

Day-patient (included as standard) – when you require a hospital bed but just for the day.

Out-patient (optional extra) – where no hospital bed is necessary, includes diagnostic tests, scans, therapies, and consultations. It can be added as a cap to a monetary limit or unlimited.

Why add outpatient cover?

The standard treatment process goes like this:

GP referral – outpatient consultation – diagnosis – treatment (in/out-patient) – follow-up – therapies

If you do not have outpatient coverage, only the inpatient treatment will be covered, whereas with outpatient cover, the whole process will be covered after the GP referral through to additional therapies.

If you suffer an injury, your GP may refer you to an osteopath, acupuncturist, physiotherapist, chiropractor, pain clinic, podiatrist, and dietician.

Optical: Contributes towards the cost of eyesight tests, a new pair of prescription glasses or a year’s supply of contact lenses.

Dental: Helps to cover the costs of preventative care such as check-ups and hygienists.’

Fees, and major treatments like fillings, crowns and dentures.

Cash plans are insurance that provides small cash sums to the insured if they need treatment from a pre-agreed list. In addition to traditional funds, health cash plans are also offered by a number of mainstream insurance companies.

Today, the most used benefits are:

Dental costs – this covers regular costs, such as half-yearly check-ups, plus treatments, such as filings and accidental damage to teeth and specialist treatments, such as bridge work.

Optical costs – This covers eye tests and spectacles, and contact lenses.

Typically, every day, a healthcare or health cash plan pays 50-100% of the cost of treatment up to a fixed annual limit. Sometimes, a health cash plan may fund outpatient consultations, run alongside private medical insurance excluding outpatient consultations. Other benefits may include:

Cash payment for each night or day spent in the hospital

Recuperation benefit (a cash lump slim payable after spending 7-14 days continuously in the hospital)

A maternity/paternity cash grant

Complementary therapies (this may include homoeopathy, osteopathic and acupuncture and less common therapies, Including reflexology)

Hearing aids.

Prescription costs

Helplines.

On individual plans, there is usually an initial period after starting the plan, during which claims may not be made. This is typically three or six months (longer for maternity and some other benefits).

Picking the proper policy relies on your own situation, financial position and objectives for the future. Our advisors are going to evaluate what you require and advise which policies would be best for you taking into account variables like coverage sum, term duration as well as other perks.

A moratorium in the context of private medical insurance (PMI) refers to a specific underwriting method used by insurers to determine coverage for pre-existing medical conditions. Here’s a detailed explanation of what a moratorium PMI means:

Moratorium Underwriting in PMI

• Definition: Moratorium underwriting is a way of managing pre-existing medical conditions in private medical insurance policies. Instead of requiring detailed medical history at the time of application, the insurer imposes a waiting period (moratorium) during which any pre-existing conditions are not covered.

• Pre-existing Conditions: Pre-existing conditions are medical issues or illnesses you have experienced before taking out the insurance policy. These conditions can include chronic illnesses, past surgeries, or ongoing treatments.

• Waiting Period: Under a moratorium policy, there is typically a waiting period of 12 to 24 months. During this time, any treatment related to pre-existing conditions is not covered. If you have not had any symptoms, treatment, medication, or advice for a pre-existing condition during this period, it may be covered under the policy after the waiting period ends.

• Continuous Coverage Requirement: For the moratorium to end and the pre-existing condition to be covered, you must not have any recurrence of the condition, receive treatment, or take medication for it during the specified moratorium period.

• Advantages:

• Simpler Application Process: There is no need for a detailed medical questionnaire or examination at the time of application, making the process quicker and less invasive.

• Potential for Coverage: Conditions that remain symptom-free and untreated during the moratorium period can eventually be covered.

• Disadvantages:

• Initial Exclusions: Any pre-existing conditions will not be covered during the moratorium period.

• Uncertainty: There is no guarantee that a pre-existing condition will be symptom-free and untreated during the moratorium, so future coverage is not assured.

The cost of private healthcare can vary widely based on several factors, including the type of coverage, the level of care, age, health status, and the insurance provider. Here are some of the key factors that influence the cost and an overview of potential expenses:

Factors Influencing the Cost of Private Healthcare

• Type of Coverage: Comprehensive plans that cover a wide range of treatments, hospital stays, outpatient services, and specialist consultations are more expensive than basic plans that might only cover inpatient care or specific conditions.
• Age: Older individuals generally pay higher premiums because they are more likely to need medical care.
• Health Status: Pre-existing conditions can affect premiums. Some insurers might increase costs, exclude certain conditions, or require a waiting period before covering pre-existing conditions.
• Location: The cost of healthcare can vary significantly by region. Premiums might be higher in areas with more expensive medical facilities or where the cost of living is higher.
• Level of Coverage: Plans with higher coverage limits, lower excess (the amount you pay before insurance kicks in), and fewer exclusions will cost more.
• Extras and Add-Ons: Additional coverage options, such as dental care, optical care, and mental health services, can increase the cost.

Certainly, your business can pay for your health insurance. Usually included in an employee benefits package, health insurance is provided to employees as one of their privileges. Private healthcare coverage may be regarded as an attractive benefit to help you draw and retain the best talent. Businesses can purchase policies under group health insurance that covers many employees at once and often at a reduced price compared to individual plans. This not only fosters the well-being of workers but also improves job satisfaction and loyalty.

The company can pay for private medical care insurance for owners of businesses or companies, directors, or self-employed individuals. This might be shown as a company expenditure with potential tax benefits. However, it’s necessary to understand how premiums and benefits are taxed because they could be treated differently depending on various factors, such as taxes applicable within specific jurisdictions.

For example, insurance costings may be deemed as taxable benefit-in-kind, which means it attracts income tax plus national insurance contributions (NICs). To ensure you follow all regulations correctly while maximizing any available advantages, seek advice from tax advisors or accountants.