Health Insurance Guide

This Medical Health Insurance Guide, developed and published by the Association of British Insurers, is designed to help you understand more about what private medical insurance (PMI) in the UK is, why people buy it, and how it works, so that you will be able to make an informed choice before you buy a policy.

The Association of British Insurers publish this guide on behalf of all insurers who offer PMI, whether they are our members or not. The ABI is the recognised trade association that represents insurance companies working in the UK. Their members make up more than 90% of the UK's insurance business.

As well as this guide, the information you receive from PMI companies will tell you more about the products that you are considering buying. They
outline what is, and is not, covered.

Remember that products from different companies will vary. If you have any questions, your financial adviser or insurance company will be able to answer them.

What is private medical insurance?

Private medical insurance is designed to cover the costs of private medical treatment, for what are commonly known as 'acute conditions' that start after your policy begins.

Most insurers define an acute condition as a disease, illness or injury that is likely to respond quickly to treatment and aims to return you to the state of health you were in immediately before suffering the disease, illness or injury, or which leads to your full recovery. Your
insurer can tell you about their cover for this and other conditions, such as cancer and chronic (long-term) conditions.

Why buy private medical insurance?

Most people buy this type of insurance to:

be reassured, knowing that treatment is available quickly if they become ill or are injured;
have a choice about when treatment will take place, the specialist who treats them and the hospital; and
have the privacy of an en-suite room with a TV and other home comforts.

How does private medical insurance work?

Although policies can be different, medical treatment usually has to start with a referral by your GP to an appropriate specialist.

Before you arrange any private treatment, you should call your insurance company to check that you are covered for the treatment. In fact, most insurers need you to do this.

Stay in touch with your insurer at each stage of your treatment. Your insurer will confirm if you are covered. Treatments for some illnesses, including pre-existing conditions (conditions from which you are already suffering, or have already had) will not be covered by a private medical insurance policy. It is also important to remember that private medical insurance is designed to work alongside, not to replace, all the services offered by the NHS. Some services, such as accident and emergency, are not available at most private hospitals.

Next: How do I buy private medical insurance?

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