What to look for in a health insurance policy

Taking out health insurance might seem like a minefield, with many different benefits and levels of cover available. But finding the right policy for your needs can actually be a lot simpler than you realise, once you know what to look for! Read our guide to make sure you buy the right private medical cover for you and your family.

Why do I need health insurance?

Many people are more than happy to use the NHS and not to pay for healthcare services that are provided for free in the UK. We all like to think that the NHS will be there for us in our hour of need and, for many patients, this is indeed the case.

However, waiting lists are growing, not just for surgery and hospital treatment but also, in many parts of the country, even to get a GP appointment. Many people are also uneasy about the future of the health service. Following the Conservatives’ landslide election win in 2019, we saw an increase of more than 800% in health insurance queries, with customers telling us they were worried about NHS funding and staffing levels.

Having the right health insurance can help you bypass lengthy waiting lists to get diagnostic tests and treatment in a timely manner. You can also choose where you would like your consultations to take place and, should you need to stay in hospital, you will receive a cash sum for every night you’re there.

What are the different types of health insurance?

There are different policies depending on whether you need individual health insurance, joint health cover for you and your partner or family health insurance. 

There are also different levels of cover, with most of our insurance partners offering entry, mid and comprehensive health insurance to suit your needs and budget.

Entry-level health insurance provides cover for basic inpatient needs, including hospital fees, specialists’ fees and diagnostic tests. There is usually an element of radiotherapy and chemotherapy cover too, although you might find that the benefit is capped. Entry-level health cover tends not to include outpatient costs.

Mid-level health insurance can be a good halfway measure, offering extra reassurance at a competitive price. A mid-level policy has all the benefits of a basic policy, as well as including many outpatient services, although these usually have a limit attached.

Comprehensive health insurance gives you peace of mind that you can access a range of inpatient and outpatient services, including CT, MRI and PET scans, radiotherapy and chemotherapy, physio and diagnostic tests.

Additional health insurance benefits

As when buying any type of insurance, it’s as important to compare health insurance features as it is to look at the price. Different insurers will provide different benefits as standard, as well as offering a range of ‘pick and mix’ extras, and you will want to make sure they are relevant to you. 

For example, our partners Axa and General & Medical both offer pregnancy and maternity cover. This is fantastic news if you’re thinking of starting or adding to your family, but if your children are grown up or you’re not planning a family, you might find yourself paying a higher premium for cover that you don’t need. 

On the other hand, with predictions that one in two people will get cancer during their lifetime, you might decide that cancer cover is a worthwhile investment. According to financial information business Defaqto, nearly 75% (38 out of 51) health insurance products include cancer cover*, with benefits ranging from hormone therapy, reconstructive surgery and stem cell therapy to breakthrough treatment not otherwise available on the NHS. 

Many of our partners, such as Aviva, for example, offer chemotherapy and radiotherapy as standard with comprehensive health insurance. In addition, some policies - such as Axa’s Health Inspire - cover members for treatment including complementary therapies, which can go hand in hand with traditional cancer treatment. 

With mental wellbeing firmly on the health agenda, many customers want to make sure their policy includes psychiatric treatment, counselling or 24/7 telephone support. And if you have children, you will want to stay with or close to them should they have to be in hospital overnight. Our partners including Bupa, The Exeter and General & Medical all cover the cost of parent accommodation should this happen.

Does health insurance cover pre-existing conditions?

If you’re looking for health insurance with a pre-existing medical condition, it’s important to understand that PMI is designed to cover unforeseen illnesses and injuries arising after the policy has started. 

Most health insurance is underwritten on a moratorium (MORI) basis, meaning that the premiums tend to be lower but cover for any condition you have had in the last five years is automatically excluded. 

Sometimes, you can take out full medical underwriting (FMU) health insurance. FMU is more expensive than MORI but there is more flexibility around your own personal circumstances and, sometimes, a condition you have previously had can be covered. Read our guide to the difference between MORI and FMU health insurance.

Which do I need - critical illness cover or health insurance?

Critical illness cover (CIC) and health insurance are not the same thing, although many people understandably confuse the two. CIC pays out a lump sum on the diagnosis of a serious, chronic or terminal condition and you can use the money however you wish, whether to pay off your mortgage, take care of the bills while unable to work or pay for treatment and mobility adaptations to your home. 

When comparing health insurance prices, you may also come across health cash plans. These are a great way of getting money back each time you go for a routine health appointment, such as the optician, dentist or physio - but it’s important to note that these policies are not the same as private medical insurance and won’t cover many of the issues listed above. 

* Figures correct as of January 2020.