Is health insurance for me?

What is health insurance?

Health insurance is a quick and effective way to access private health care without having to pay thousands out of your own pocket for what you need.

Simply pay a monthly price for your cover, and get what you need, when you need it.

How does health insurance work?

In exchange for paying a monthly price for your plan, an insurer will cover the cost of your private health care needs, settling the bills directly with the hospital.

You should not have to pay anything up front, unless you have an excess, and the insurer will not give you a cash lump sum to settle the bills yourself.

How to get health insurance?

To get health insurance it couldn’t be easier.

There are three main ways to do so and each have their ups and downs. We’ve included some of them below:

  1. Direct from an insurer- whilst they may offer you a good deal, they can only offer you their own product, so it’s no guarantee you will get the best price or cover for your money.

  2. Comparison sites: buying online is something that we do not recommend. Whilst you do get a good general overview of what insurers are offering, chances are, they won’t put all their available options online, and if you have cover in place, you could end up losing your pre-existing conditions cover without meaning to..

Brokers/intermediary: this service is free for people to use, and a qualified adviser can talk you through all your options to tailor your plan to you. They can then look across the market to match a provider and plan to your needs, and often get special deals that you won’t find anywhere else. We tried to think of a negative here, but honestly couldn’t think of one! If you were looking to rewire your home, you would go to an electrician, not Google how to do it yourself ( at least we hope so!) and it’s the same with health insurance.

What is covered?

What does health insurance cover?

Core cover- this is the most basic cover you can have. It includes the main features shown below:

  1. In or day patient -treatment.

  2. In patient diagnostics– e.g x-rays or check ins with a specialist while you are in hospital.

  3. Scans – MRI, CT and PET.

  4. Cancer care- this is a big one, and most insurers offer it as part of their core cover in full. It gives access to drugs and treatments the NHS can sometimes struggle to provide.

Out patient cover:

This is an add on for most plans, and gives you the benefit of being able to go privately for the following:

  1. Consultations and follow ups with a specialist.

  2. Tests to find out what’s wrong, like x-rays or colonoscopy’s

  3. Scans like MRI, CT and PET.

Add on’s:

These are extras you can have on a plan if you feel they would be useful, and cost a little more.

  1. Mental health cover- care for conditions such as stress, anxiety or depression.

  2. Therapies- things like physio or osteopathy.

  3. Dental and optical- this is money back system, where you can get a “refund” from the insurer for check ups, fillings , eye tests or new glasses.

  4. Travel insurance- cover for you if you are abroad and need medical care.

  5. Private GP- convenient, quick appointments. You can facetime or have an in person appointment with a GP who can send prescriptions to your local pharmacy or refer you to a specialist.

  6. A six week wait– this can be added to your core cover to reduce the cost. If the NHS can treat you within 6 weeks of being told you need it you would use the NHS. If they cant do it, you can then use your plan for treatment if you want.

  7. Excess– an amount you pay yourself the first time you claim in a year. By having one it can reduce the monthly cost of your insurance.

Commonly covered conditions include:

  • Acute conditions

  • Alternative therapies (acupuncture, chiropractic, homeopathy, etc.

  • Cancer including palliative care, diagnosis, chemotherapy, radiotherapy, etc.

  • Complementary therapies such as physiotherapy and osteopathy

  • Heart disease including aftercare cover;

  • Mental health issues including counselling and psychiatric care

  • Sports injuries unless you’re a professional sports person

  • Stroke aftercare

What kind of things aren’t covered?

Each insurer will have their own list of exclusions, generally these exclusions include:

  • Accident and emergency

  • Dangerous sports

  • Chronic conditions – Post diagnosis ongoing monitoring is unlikely to be covered however flare ups can be covered.

  • HIV & Aids

  • War, riots and terrorism

Can I switch from my current private medical insurance provider to another insurer?

Changing health insurance providers

Yes absolutely – We are proud to offer an independent consultative service and our aim is to get you the best policy at the best price. So, if you do feel like you would like to switch insurers our friendly advisers will be there to help you with your switch. If we cannot organise a switch on the first attempt we will be able to give you a long term plan to keep your costs down.

Most health insurance plans will renew every 12 months. At that point, you can decide to stick with the provider you have or move to a new one.

If you decide to move providers to save money or simply get more cover, make sure you switch to them, rather than start all over with your medical history.

When you switch providers, an insurer has a set of questions they will ask to see if they can continue to cover everything you are covered for now, or if they will need to make some changes.

Usually, they will ask about things in the last 12 months, and if you have anything ongoing.

Dependent on what those conditions are, the new insurer will then accept you as you are or place an exclusion for the recent medical issue you’ve had.

What should I consider when choosing private health insurance?

Jargon buster

When starting your search for PMI do look closely into where you are comparing quotes. Some comparison websites do not take a whole industry approach which will give you limited information and reduces the guarantee of finding the best policy. Do look for quotes from independent and impartial brokers like Switch Health, as we will advise you based on your needs and wants out of a policy.

1- Health insurance– An insurance that gives you quick, easy access to private health care without having to foot the bill for the cost yourself!

2- Consultation– an appointment with a doctor who specialises in your particular problem.

3- Diagnosis- methods used to find out what’s wrong with you e.g a blood test or scan.

4- Treatment– Fixing the issue once you know what it is. This could be an operation or therapy for example.

5- Underwriting- How an insurer writes your policy when you join. This is likely to be tailored to you, as everyone’s medical history is different! It tells you what medical conditions an insurer can cover straight away and what they can’t


6- Pre-existing conditions- these are medical issues you’ve had before your policy starts. They can range from achy knees all the way through to a problem with the heart or cancer.

7– Excess- A great cost saving tool to have. It’s the amount of money you agree to pay before the insurer takes over the rest of your claim. It’s only payable once in a year, on the first claim you make.

8- Exclusion– A condition that an insurer can’t cover right away. If you are worried about this give us a call to find out if an insurer can cover your issue!

9- Switch – If you have cover in place, this is an easy method to make sure your medical history moves with you to a new insurer. It means that ( as long as you meet their criteria) everything you were covered for with your old insurer stays covered with the new one- just at a better price!

10- Whole of market- This means we look across every health insurance provider to find you the best offers and cover for your needs.

11- Advice– Being helped step by step to find the policy that’s right for you.

Access to the best deals on health insurance, and a whole of market approach. Continuous care throughout and a dedicated renewals advisor to negotiate discounts the next year. ( Some customers get months free! )

Can I get PMI on a budget?

When choosing a plan our expert advisers will tailor your options based on your personal needs. Like other types of insurance there are options you can add or exclude, as well as looking at your excess to give you an option that is affordable to you.

Can I get private health insurance with a pre-existing condition?

Yes, depending of method of underwriting and insurer we can look to cover pre-existing conditions, some conditions may have to undergo a moratorium period before being covered again. For a better idea of your personal conditions please contact us for a review and advice.

Can I be treated at a hospital or by a specialist of my choice?

Depending on the policy and insurer you choose, this may cause restricted access to certain hospitals and specialists. If you have a preference our advisers will be happy to talk through this with you.

How to make a claim?

How to make a claim?

  1. See your GP and get an open referral. This means it is not for any specific consultant or hospital. Instead, it will be a referral to see a specific kind of specialist. E.g a neurologist.

  2. Call your insurer to let them know. If this is your first ever claim, an insurer may want to check with your GP that it is a new condition you are claiming for and wasn’t there before you took out the plan.

  3. Book an appointment with the hospital and specialist of your choice (from your insurers approved list.)

  4. If you aren’t sure who to see. Ask the insurer. They will be able to suggest consultants that are covered to choose from.

  5. Pay your excess. (If you have one)

  6. Have your appointment and focus on getting better!

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