FAQ: Health Insurance


Health Insurance Insurance

health-coverHow does private health insurance work?

To receive private treatment you simply need to take a few steps:

– First visit your GP and let them know that you have private medical care insurance.

– Should treatment be required, your GP will transfer you to a hospital of your choice.

– You should then inform the insurance company on the claim on the policy and to verify the cover.

– Once approval is provided by the insurer to the GP, the GP will book the appointment with the specialist. The costs will be paid by the insurer.

Please note, health insurance cover doesn’t include emergencies, so you should still go to the Accident and Emergency unit as per usual. Once your health is stable, the cover can be provided for further treatment.

Types of health insurance policies

There are effectively 3 different types of options, namely, Budget, Mid-range and Comprehensive cover.

Budget: Cheapest of the 3, budget insurance only covers in-patient and day-patient treatments. It will also have an upper limit on the amount of claim that can be made.

Mid-range: In most cases, mid-range policies cover in-patient, day-patient and some certain outpatient treatments. For a good level of cover at an affordable price, mid-range is a good option.

Comprehensive: The most expensive of the 3 types of policies, comprehensive cover includes full in-patient, day-patient and outpatient cover, with other extra benefits like free therapy sessions.

Factors that affect the premium of my health insurance cover

There are many factors which can reduce and increase the premiums you are paying. For example, some insurers offer discounts to buyers who are fit and exercise regularly, but, those who are currently in ill health with a medical history will see an increase. Much like life insurance, if you are a smoker, you will also see a significant change in the premiums.

Are there ways to reduce my premiums?

Without having to sacrifice on the cover you want, there are a few ways in which you can make your policy more affordable.

Six week option: if the treatment you require is available within 6 weeks of you requiring it, than you would be treated by them. However, if It is longer, then you can rely on your policy to get immediate treatment.

Co-payment: If you are willing to pay a pre-agreed percentage of your claim, then your premiums will reduce as you now carry some of the insurer’s risk.

Excess: When buying your policy, you have the opportunity to increase the excess level voluntarily. The excess is the about of money you are willing to put forward when you make the claim, so if you increase this amount then you would get cheaper premium quotes.

Hospital option reduction: By reducing the amount of hospitals at your disposal, you effectively decrease your cover slightly and hence cheaper premiums are available. But if you know there are hospitals which you almost certainly wouldn’t be requiring then you can reduce the list.

Are pre-existing medical conditions covered by the policy?

Health insurance covers you for conditions that take place once you have actually purchased the insurance. However, depending on which one of the 3 underwriting options you select, you could cover pre-existing conditions in the future.

Moratorium: Policies that are moratorium will not include conditions that took place in the last 5 years. Nonetheless, should you have no treatment, symptoms or advice on the condition for the first 2 years of the policy, then you can get cover for these conditions again.

Full medical underwriting/FMU: FMU policies will require you to submit a full medical history and usually the pre-existing conditions are not covered.?

Switch underwriting: allows the policy holder to change the insurance provider without a decrease in the level of cover. The premiums are likely to change and it is recommended that holders review their options every year to ensure a good deal.

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