Private Medical Insurance (PMI) covers the costs of private medical treatment for curable short term medical conditions, frequently referred to as 'acute conditions'. Costs may include the cost of specialists, surgery, accommodation and nursing at a private hospital or private ward of an NHS hospital.
It will not generally cover 'chronic' illness (long term incurable conditions such as multiple sclerosis, asthma or diabetes). However, in a crisis, most PMI policies will pay the cost of treatment for stabilising a chronic patient and returning them to their previous level of health when possible.
Pre-existing conditions will not be covered by PMI. This includes any disease, illness or injury for which you have received medication, advice or treatment; or you have experienced symptoms; whether the condition has been diagnosed or not in the 5 years before the start of your cover.
However, under certain policies (see Types of Policy) you may be covered for these conditions if you have been advice-free, symptom-free, treatment-free and medication free for two consecutive years after the commencement date of your policy.
In general, PMI offers:
- Treatment in a private hospital of your choice (within the policy hospital list)
- Treatment in private wings of NHS hospitals if preferred
- Speed of treatment
- Choice of specialists and surgeons
- Accommodation in a comfortable room with privacy - no wards
- Peace of mind
However, private medical care does not offer the same range of treatments that the NHS does. Its aim is to provide care for straightforward, treatable conditions. It does not provide emergency treatment, or care for a long term condition.
Arranging Cover
Private Medical Insurance policies are offered on an annual basis, with premiums payable monthly, quarterly or annually. The cost of these premiums is determined by your personal circumstances (sex, age, previous medical history) and the type of cover you choose. If you offer to pay annually, or take up a Voluntary Excess on claims, you may be offered a discount.
Some PMI providers will accept new clients at any age, but many will place upper limits at 65 to 75 years old.
Once you are accepted into a plan, the insurer will usually continue to offer cover, year on year, albeit at an increasing premium with age. You can change PMI provider as often as you want, but you will need to complete a medical questionnaire each time, and possibly attend a medical examination.
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