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  • What is private medical insurance?

    Private medical insurance helps your employees get prompt, private treatment if they are unwell. It’s designed specifically to treat acute conditions that start after the policy begins; an acute condition is a disease, illness or injury that’s likely to respond quickly to treatment so that you can return to your previous level of health. You pay a premium to the insurers and in return they’ll provide your employees with healthcare benefits. It gives you & your employee’s peace of mind, knowing that they will get the treatment and care they need, quickly.

    It is not meant to be a replacement for the NHS, but works alongside it to help you get diagnosed quickly and treated efficiently.

    In addition, our policy gives you extra benefits that can help your employees maintain their wellbeing and improve their fitness. This includes discount off selected UK gym memberships and access to an online health programme, myhealthcounts.

  • What are the main benefits of Private Medical Insurance?

    For the business
    Reduced absenteeism: Ensuring that your employees have speedy access to treatment, getting them back in the workplace and reducing the impact on productivity.

    Improved staff morale: Having a private medical insurance policy for your employees shows that their health and wellbeing is important to the business, and as well as improved morale, can help to attract and/or retain quality staff.

    Healthier workforce: Better access to quality healthcare & discounts to improve health & fitness should mean a healthier workforce.

    For the individual
    Be seen quickly: the average NHS waiting time is now 13 days but once you have an open GP referral, you can bypass the NHS waiting lists and get a prompt appointment.

    Greater Flexibility: you can choose when, where and by whom you are treated from a list of approved specialists and hospitals often with comfort and privacy.

    Latest drugs & treatment: Our policy gives you access to the latest approved in-house drugs and treatment.

    Bespoke: you can tailor your policy to include spouses, children and additional services such as dental & optical. Or you can reduce cover with deferred periods and excesses.

  • What are chronic conditions?

    Chronic conditions have one or more of the following characteristics: –

    • It needs ongoing or long term monitoring
    • It needs ongoing or long term control or relief of symptoms
    • It requires rehabilitation or specific training to be able to cope with the condition
    • It continues indefinitely
    • It has no known cure
    • The condition returns or is likely to return

    Claims for chronic conditions are not generally included as part of your policy cover, although we do provide cover to allow treatment to stabilise chronic conditions when first diagnosed or where a chronic condition has led to a sudden illness. Also, if you add ‘Routine and GP referred services’ to your cover, there are some additional benefits available for chronic conditions.

  • What is excluded?

    It is not a replacement for Accident and Emergency, but you can get further treatment once you’ve been to A&E. All policies have standard exclusions which will be listed in your policy wording. As a general rule, it doesn’t cover things like pregnancy, fertility treatment, cosmetic surgery, gender reassignment or any other treatment that comes from choice rather than necessity. Always check the small print!

  • Will you cover my pre-existing medical conditions?

    Private medical insurance is designed to cover ‘new’ illnesses, so if you have a pre-existing medical condition (one that is known about before taking out the policy, or have had treatment for in the last 5 years) they may not be covered. It depends on the level of cover opted for and also the form of underwriting used when setting up the policy.

  • What information do you need to provide a quotation?

    We’ll need details about your employees such as their address and details about their health

    If you’re switching from another provider, you’ll also need to know the following;

    • Your current renewal date
    • The type of underwriting on your current policy
    • Details of your claims history

    Our simple ‘Get a Quote’ form explains everything for you.

  • What kinds of underwriting are used?

    We offer the following types of underwriting:

    Full Medical Underwriting – Means that we ask your employees questions about their past health and any pre-existing health conditions. This means that related conditions may be excluded unless the insurers agree to accept them. We offer this as standard to all previously uninsured businesses covering between 2 -99 employees. Companies covering between 100 – 249 employees, who wish to contain costs may also opt to be fully medically underwritten.

    Continued Medical Exclusions – If you are transferring from an existing fully medical underwritten policy, we can accept the existing medical exclusions (if any) that were applied by your existing insurer.

    Moratorium – This replaces asking for full medical history details. An automatic exclusion applies to any disease, illness or injury (whether or not diagnosed) or any related condition if:

    • Your employee had symptoms of, medication for, diagnostic tests for, treatment for, or advice about such a disease, illness or injury within 5 years before joining an existing policy or taking out a new policy

    and

    • There has not been a clear 2 year period after joining during which your employees have been free of medication for, diagnostic tests for, treatment for, and advice about such a disease, illness or related condition

    Continued Moratorium – You can apply to transfer from an existing medical insurance policy which is currently underwritten on a moratorium basis. The moratorium wording on the new policy will show the original moratorium start date for each member rather than the new policy start date.

    Medical History Disregarded – Any pre-existing conditions of members are covered providing that they fall within the terms and conditions of the policy. Obviously due to the wide nature of the cover, this type of underwriting tends to be the most expensive.

  • Do I need to include all of my employees?

    No, you don’t have to. You may wish to offer a basic healthcare package to your entire workforce or a more specialised policy to a small number of staff. The choice is yours and the policy can be as flexible as you need it to be. Speak to us about how you can adapt your policy to suit your business.

  • Is there a maximum amount that our employees could claim on our policy?

    No, although some benefits have specific limits. The number of times your employees can claim each policy year is also unlimited.

  • Does the policy include cover for international travel?

    If your employees are temporarily abroad, for a period of up to 90 days per policy year, the policy includes emergency overseas cover for immediate in-patient or day patient treatment.

  • Can I use the hospital that I want, when I want?

    When you take out private medical insurance with us, you’ll decide which hospital list you’d like us to use if you need to make a claim on your policy. As part of our core cover, you and your employees have access to the Key Hospital List, which provides access to around 300 private hospitals throughout the UK. There are additional options that you can select to either add more, or to remove hospitals from your cover. For example:

    • The Extended Hospital List is an upgrade which gives access to more hospitals, predominantly in the Greater London area.
    • The Signature Hospital List is a reduced hospital list but is a great choice for companies whose employees are solely based in Scotland or Northern Ireland, as this list excludes all hospitals in England and Wales.
    • The Trust Hospitals List is a cost saving option that uses the excellent private patient units of NHS trust and partnership hospitals.
  • What’s the difference between an out-patient, a day- patient or an in-patient?

    An in-patient is someone who is admitted to hospital and who occupies a bed overnight or longer, for medical reasons. A day-patient is someone who is admitted to hospital or day patient unit because they need a period of medically supervised recovery but they do not stay overnight. An out-patient is someone who attends hospital, consulting room or out-patient clinic and is not admitted to hospital as a day –patient or an in-patient.

  • Is there a lot of paperwork involved in making a claim?

    Your employees do not need to worry about having to fill out long claim forms with their GP. Our approved insurers, Aviva, use experienced claims consultants who will go through everything on the phone with them, and in the vast majority of cases, approve their claim there and then, with no need for further information.