Please note: this service is not provided by The Mortgage Advice Professionals. We will introduce you to a specialist firm we are partnered with, who will advise you and arrange the cover. MAP will stay alongside you throughout, supporting you at every stage of the process
Treatment on your timetable
Private medical insurance pays for treatment in the private sector. The reasons people commonly give for taking it out are speed and choice: shorter waits for diagnosis and treatment, a say in which consultant you see and where, a private room, and access to some drugs and procedures that aren't routinely available on the NHS.
It sits alongside the NHS rather than replacing it. Emergency and accident care, chronic condition management and maternity care generally stay with the NHS regardless of whether you hold a policy.
What a policy usually covers
Cover levels vary widely, so the detail of the policy matters. A typical policy may include:
Specialist consultations
Consultations with specialists, allowing you to access private medical expertise where the policy provides cover.
Diagnostic scans and tests
Diagnostic investigations, scans and tests where they are included within the level of cover selected.
Surgery and hospital stays
Surgery and the hospital stay that goes with it, subject to the policy terms and hospital list.
Outpatient treatment
Outpatient treatment can be included, although some policies place limits on how much is available.
Cover levels vary
Some policies limit outpatient spending, restrict the hospital list, or require a GP referral before anything begins. Dental, optical and therapies such as physiotherapy are often optional extras rather than standard.
What it generally doesn't cover
Chronic conditions
PMI is built around acute conditions — ones that respond to treatment and resolve.
Ongoing management of a long-term condition such as diabetes or asthma is normally excluded.
Pre-existing conditions
Usually excluded, or covered only after you've gone a set number of years without symptoms or treatment, depending on how the policy is underwritten.
Other exclusions
Cosmetic surgery, A&E, and treatments regarded as experimental are also typically outside the cover.
Ways to reduce the premium
Premiums reflect your age, where you live, your medical history and the level of cover. You can usually reduce them by accepting some restrictions or paying more yourself when you claim.
Accept an excess
Agreeing to pay an excess when you claim can reduce the premium.
Narrower hospital list
Choosing a more restricted hospital list can reduce the cost of cover.
Limit outpatient cover
Reducing outpatient cover can lower the premium where you are comfortable with a more limited benefit.
Six-week wait
Some policies only fund private treatment if the NHS waiting time exceeds six weeks.
How the six-week option works
A six-week wait policy only funds private treatment if the NHS waiting time for the relevant treatment exceeds six weeks.
Think about what you actually want the policy to do
Private medical insurance is primarily about access to private treatment, rather than replacing the NHS.
The level of cover matters. Hospital lists, outpatient limits, excesses and referral requirements can all affect how useful the policy is when you need it.
It's worth checking the exclusions and underwriting terms carefully before deciding what level of cover you need.
Specialist advice when you need it
We don't advise on private medical insurance ourselves. If it's something you're considering, we'll refer you to a specialist provider who can review the options available and explain how the underwriting works.
Getting it right
Private medical insurance can provide access to private diagnosis and treatment, but the detail of the policy determines what is actually available when you need it.
The important things to understand are what is covered, what is excluded, how the policy is underwritten and what restrictions apply to keep the premium affordable.
Speak to us and we'll help you understand where private medical insurance fits alongside your wider financial and protection arrangements.
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