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Eight Things to Check When You Compare Medical Insurance Policies

By Edited Feb 13, 2014 0 0

Take Extra Care of Your Health

Many people who live in the United Kingdom are happy with the treatment provided by the National Health Service (NHS). However, if you are looking for specialist drugs or treatments that aren’t available on the NHS or if you want to have more control over waiting times and treatment options, private healthcare may be a smart choice. If you are planning on acquiring private healthcare in the near future, it is extremely important to take a very close look at specific details while you compare medical insurance policies. In particular, pay attention to the following eight things.

1) Inpatient coverage:
Firstly, it is important to be sure of exactly how much in-patient treatment is covered by a health insurance policy. Almost all basic private medical insurance will cover almost all treatments that require a hospital stay, including all of the costs involved in day surgery, major surgery, and investigative tests (such as drugs, post-operative care and payments to surgeons). However, the precise nature of this coverage may vary between policies, so check to see which particular inpatient procedures may be ruled out by each policy you consider.

2) Outpatient coverage:
Not all medical insurance will cover the cost of out-patient treatments (such as consultation appointments with specialists, and diagnostic procedures such as MRI scans). Be sure to check whether out-patient coverage is part of any health insurance policy you consider, and to examine the details of any limitations on coverage that is offered.

3) Mental health coverage:
Some policies cover treatment for depression and other mental health problems (e.g. anxiety disorders, schizophrenic and so on). However, not all will, so do not simply assume that any attractive-looking policy will pay the costs of any psychological consultations or medications that you may need in the future. In addition, note that even some providers that offer coverage for mental health problems will not cover the cost of treatment for long-term psychiatric illnesses.

4) Chronic illness coverage:
In general, medical insurance policies have some sort of restriction on the amount that they will pay towards the cost of treating long-term illnesses. However, different providers have a different view of what constitutes a chronic illness, so it pays to familiarize yourself with the specific of a policy’s chronic illness coverage. For example, some policies will refuse to cover hypertension and any associated complications, and many others may consider conditions like diabetes, asthma and epilepsy to be outside the purview of the policy.

5) Pre-existing condition coverage:
Most insurance policies will not cover any costs resulting from health problems that predate your taking out the policy, including problems that relate to congenital or genetic problems. For example, if you need heart valve replacement surgery because you were born with aortic insufficiency, this is unlikely to be covered. However, some providers allow you to pay extra money to gain coverage for specific conditions, so it is worth investigating this if you suffer from a health problem that is likely to need more treatment in the future.

6) Coverage for elective treatments:
Procedures like cosmetic surgery are typically considered to be elective and will therefore not be covered by most medical insurance policies. However, some providers may offer exceptions if a cosmetic procedure is intended to compensate for serious disfigurement, so make sure you ask exactly what types of medical treatments are considered elective. Similarly, many health insurance providers consider fertility treatments (such as IVF) to be elective, and may not cover them as a result.

7) Pregnancy coverage:
Most policies will not cover the normal costs resulting from pregnancy and childbirth, as these events are considered ‘normal life events’ rather than medical problems. However, some policies will cover such things as medically necessary C-sections, where the mother and/or baby would be at an abnormal level risk if delivery occurred naturally.

8) Injury coverage:
When you compare medical insurance policies, you should also pay close attention to the extent to which they cover different injuries. Many will not pay for any medical expenses incurred as a direct result of engaging in extreme sports, and some will have other conditions that relate to the extent to which you are culpable for your injuries.



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