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Should you get health insurance?

22.03.22

When it comes to paying for private healthcare, there are two main options – paying for your own treatment and taking out health insurance. But how do you decide which option is best for you? To help you out, we’re put together some pointers to aid you in your decision-making.

Check what’s covered

Before buying a policy, it’s really important to find out what it covers. There are lots of different providers out there and each will provide varying types and degrees of coverage. If you have pre-existing or chronic conditions, you’ll be hard pressed to find an insurer which covers them – you may be able to get coverage but it probably won’t cover the conditions for which you really need it. Depending on what the pre-existing or chronic condition is, some providers simply won’t cover you. Others might, but you’ll need to pay a higher amount per month (premium).

Types of police

Basic policies usually cover surgery and associated tests if you’re coming into hospital as an inpatient, but they may not cover consultations with doctors or any sort of outpatient treatment. More comprehensive insurance will generally cover inpatient and outpatient treatment, but generally won’t pick up the costs for any pre-existing conditions, cosmetic surgery, normal pregnancy and childbirth costs, organ transplants, or chronic illnesses such as diabetes, high blood pressure, HIV or epilepsy. If you’re looking for treatment which covers any of the above, rather than taking out insurance and then finding out you’re not covered, your best option would be to pay for your own treatment, have treatment on the NHS, or mix and match NHS and private.

How quickly do you need treatment?

If you want to be seen and treated as soon as possible, paying for your own treatment is a good option as you won’t need to go through the process of filling out forms, getting authorisation, and filing claims that you need to do with insurance. When you pay yourself, you can simply call the doctor you want to see and book an appointment.

Referrals

For a claim to be valid, most health insurance providers need proof of an initial referral from a GP. As such, you’ll need to book an appointment with your NHS or private GP and request an onward referral letter for the treatment you need. Only once your insurer has seen the letter, will they authorise treatment.

If you’re paying for yourself, you can simply refer yourself. Obviously, you’ll already need to have some idea about your condition in order to do this! If you don’t, your best option would be to book an appointment with a GP first, who will be able to investigate and find out more for you. We have our own private GP Clinic, with same day appointments from £150, or there’s always your local NHS GP practice.

How much can you afford to pay?

Insurance

According to ActiveQuote, the average price for UK private health insurance is £1,155 a year (correct as of September 2021).

As ever though, the cost of insurance will vary from person to person, so it’s not easy to give a ballpark figure to help you budget. The best thing to do is find a plan that looks good for you and covers what you need, and then decide. Price comparison sites such as https://www.gocompare.com/and https://www.comparethemarket.com/ are great places to have a browse and see what’s out there.

Aside from your monthly fee, you’ll also need to choose the excess you’d like to pay should you need treatment. The higher the excess, the lower your monthly payments will be.

Paying for yourself

If you’re paying for yourself, again, prices vary greatly depending on the treatment you need, but as a hospital, we’re competitive. An appointment with one of our private GP costs from £150 and a consultation generally costs around £200. Treatment costs vary greatly (a dermatology appointment will be much cheaper than a spinal operation!) but for our top 15 most common procedures we do offer fixed price packages, which means you’ll know exactly how much you need to budget, and won’t receive any surprise bills later down the line.

Claiming health insurance: how does it work?

If you know you need a treatment, the first thing to do is to contact your insurance company ASAP and let them know.

Some providers will ask you for proof of a GP referral, so if this is the case, get in touch with your GP and ask them for an Open Referral letter. Explain you need this for your insurance to authorise treatment.

Once you have this, contact your insurer by phone or online and start the claim process. They’ll send you any paperwork you need to complete and ask you for all the details they need, which will include your Open Referral Letter.

Once they’ve agreed to cover your treatment, you can book an appointment with a specialist straight away, or you can ask your insurer to do this for you.

If you want to book your own appointment, your insurer will give you an authorisation number or letter of guarantee, which you’ll need to show to the hospital or doctor that you use. They should send the bill directly to your insurer, who will pay it for you. If you have an agreed excess, you’ll need to pay this directly to your treatment provider. Your insurance will pay the remaining sum.

Most policies only make you pay the excess once a year, so if you make another claim, the insurer will pay the whole amount directly to your doctor or hospital.

We hope this guide has given you some food for thought and helps you, should you decide to go private. Remember that the NHS is always available, and you can always have some treatments on the NHS and some private, depending on what you want and need.

https://www.hje.org.uk

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