Health Insurance provides cover for private medical treatments. Typically, health insurance helps people avoid NHS waiting lists and provides a greater choice of when and where treatment takes place, often in a private hospital under the care of a private specialist medical professional.

Over the last few years, the scope of health insurance has widened to include access to GP services and Health and Wellbeing support. Depending on your needs, policies can cover individual people, families, multiple families, and businesses of all sizes.

Individuals and Families
If you’re an individual or a family the motivation to purchase Health Insurance is usually to provide peace of mind and choice. The NHS is a fantastic organisation which we are all rightly proud of. However, it is often under pressure and there can sometimes be delays in getting treatment, especially for non-life-threatening conditions.

Health Insurance can provide the peace of mind that comes from knowing that you have a choice. The ability to get a diagnosis and treatment quickly. A choice of who provides the treatment and where you have it. It also often provides other benefits that can just make life that little bit easier, especially if you have a busy lifestyle. Access to a remote or online GP service which provides a consultation with an NHS qualified GP within 24 hours, is both convenient and reassuring.
• Prompt access for diagnosis and treatment
• Choose when and where you are treated
• Cover for potentially lifesaving drugs not available on the NHS
• Increased comfort and privacy

For companies, the motivations can be similar to individuals, but often there are a number of additional reasons to consider Health Insurance. The most important asset for any business are the employees. Most companies, big or small, have people who they just can’t do without. That can be down to the skills they have or the years of knowledge they’ve built up. A well designed company health scheme can look after your key people, but it can also offer so much more for all employees:
• Reduced absence rates – Early diagnosis and treatment helps employees return to work -more quickly
• Better staff retention – Health Insurance is consistently considered one of the most valuable employee benefits
• Improved recruitment – Offering Health Insurance benefits makes a company’s brand stand out against competitors
• Employee engagement and productivity – Health Insurance packages often come with Health and Wellbeing support which helps encourage employees to be healthier, and can improve overall productivity

It is also worth remembering that every employee is an individual and has different needs. What we value and need in our twenties is
different to our fifties. A good Health Insurance scheme should be tailorable to the differing needs of different employees and can often be
introduced at a fraction of the perceived cost.

Typically, a good Health Insurance plan can be tailored to your needs, whether you’re an individual or a company. Plans can have a blend of benefits which include:

• GP services – to provide easy and convenient access to a GP who can prescribe medication
• Consultations with a Private Specialist – if your GP can’t deal with your issue they will often refer you to a Specialist to help diagnose the issue or provide treatment
• Diagnostic tests & scans – Your specialist will often use diagnostic tools such as MRI and CT scanners to help diagnose the problem and develop a treatment plan
• In-patient treatment – This is where you stay in a private hospital for the treatment your Specialist has recommended
• Day/Out-patient treatment – Again this will be treatment recommended by your Specialist but can be done without the need to stay in a private hospital overnight
• Therapies – Such as physiotherapy or chiropractic treatment
• Dental – These benefits are often cash back for dental care such as check-ups or filings. They can also cover dental injuries and emergency dental treatment
• Optical – Cash back for eye tests, glasses and contact lenses
• Health Assessments – Help to cover the cost of Health Assessments to identify any issues early before they become a major problem

Health Insurance can be confusing, but we at ASP Health are specially trained to help understand your needs and use the range of WPA Health Insurance plans to create a solution that is tailored to your needs.

Private medical insurance is designed to cover the cost of private medical treatment for acute conditions that develop after your policy has started. An acute condition is a disease, illness or injury that is likely to respond quickly to treatment and return someone to the state of health they were in before, or lead to a full recovery.

It doesn’t usually cover treatment of long-term (chronic) conditions, where the main aim is to keep the symptoms under control – these are still treated within the NHS. Private medical insurance also won’t cover any pre-existing conditions that you may have when taking out a plan.

What isn’t covered with private health insurance?

It doesn’t usually cover treatment of long-term (chronic) conditions, where the main aim is to keep the symptoms under control – that would make premiums much more expensive.

Private medical insurance also won’t cover any pre-existing conditions you may have when you take out a plan.

There are some standard treatments and conditions that we don’t cover.

These are:

  • Any regular monitoring or treatment of long- term (chronic) conditions, like diabetes or allergies
Any treatment you receive outside the UK
  • Emergency treatment or visits to your NHS GP
  • Pregnancy, childbirth and most related conditions
  • Cosmetic treatment
  • Any treatments or practices that are experimental, unproven or unregistered
  • Targeted Therapies if readily available on the NHS

Please contact us for full detail on what is and isn’t covered on our plans.

An acute condition is a disease, illness or injury that is likely to respond quickly to treatment that aims to return you to the state of health you were in immediately before suffering the disease, illness or injury, or which leads to your full recovery.

A chronic condition is a disease, illness or injury that has one or more of the following characteristics:

  • It needs ongoing or long-term monitoring through consultations, examinations, check-ups or tests.
  • It needs ongoing control or relief of symptoms.
  • It requires your rehabilitation, or for you to be specially trained to cope with it.
  • It continues indefinitely.
  • It has no known cure.
  • It comes back or is likely to come back.

A pre-existing medical condition is any disease, illness or injury that:

  • You have received medication, advice or treatment for in the five years before the start of your cover, or
  • You have experienced symptoms of in the five years before the start of your cover whether or not the condition was diagnosed.

Private medical insurance doesn’t normally cover pre-existing/chronic conditions, but you can still take out cover for conditions that may affect you in future.

Private health insurance gives you all the benefits of private healthcare without the worry of how to pay for it.
You pay regular subscriptions, then your insurer pays for your treatment, as long as it’s covered under your plan. That means you can put all your energy into getting better, knowing that side of things is taken care of.

For the majority of claims, medical treatment begins with a GP referral for specialist treatment.
This can either be your NHS GP or a private GP. Any onward treatment is managed by working closely with your private medical insurer, to ensure that you have quick and easy access to the right medical treatment.

Private medical insurance is designed to work alongside all the services offered by the NHS, but focuses on providing quicker access to treatment for acute medical conditions.

PMI members can still use all services offered by the NHS. But with pressures on the NHS to meet healthcare demands growing rapidly, compounded by increasingly stretched resources, PMI can play a complementary role.

It’s what you pay in order to be covered by a plan – e.g. health insurance. You’ll normally pay for your insurance premium by monthly or annual direct debit. Your premium is reviewed once a year and changes depending on your age, medical inflation and claims if on a business scheme.

The excess in health insurance is a contribution you agree to make towards any claims. The larger the excess you agree to, the lower your premiums will be. Some insurers ask for you to pay the excess after each claim, while others ask you to pay it on the first claim in any plan year only, regardless of the number of claims you make.

If you have no pre-existing conditions when you join, there’s no need. Just pick your level of cover and answer some basic questions about your medical history.

If you do have a pre-existing condition, we may need to ask you more questions about your health, or contact your GP. We’ll always tell you if that’s the case.

Call us and we’ll let you know if we need any more information before giving you a quote.

It is difficult to say exactly how much a typical health insurance policy costs, as not everyone will choose the same cover.

It’s entirely down to your personal circumstances and what you’re looking to be covered for.

However, there are two major factors that can affect the cost of your health insurance;

Your personal circumstances

This includes:

  • Your age
  • Where you live
  • If you smoke

Your chosen cover

This includes:

  • The level of health insurance cover
  • The level of excess you want to pay
  • Your policy benefit limits – for example, outpatient limit
  • Who you’re covering – yourself, you and your partner or your family?

We’re passionate about providing help. Our advice and quotes are FREE and there’s no obligation.

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