In the UK Private medical insurance (PMI) is available for individuals
, families and businesses and it is intended to pay for medical treatment for unforeseen acute medical conditions. Acute conditions are those that are treatable and curable. Private medical insurance does not cover the costs of long-term or chronic conditions.
There is much confusion about what is and is not covered under private medical insurance, and many forget that the National Health Service (NHS) is there for emergency treatment and that there are no PMI policies that cover this type of treatment.
Perhaps the best way to illustrate what is covered is by way of an example, if you injure your arm and this will respond quickly to medical attention you would be covered under a private medical insurance policy. However, monitoring of a chronic condition such as asthma would not be covered. As private medical insurance is designed for the unknown, existing health conditions will usually be excluded for at least the first two years of the policy.
Pre-existing medical conditions may become eligible for cover after a waiting period, if the condition that was existing has not returned for a set period of time. If you are not sure if you are covered for any medical conditions then check with your insurance company or broker that arranged the cover for you.
What is not covered?
The following treatments are not covered by most medical insurance policies. These include:
Chronic conditions
Pre-existing medical conditions
HIV/AIDS
Cosmetic surgery
Drug, solvent and alcohol abuse
GP consultations
Pregnancy and infertility
Dental treatment
These conditions would not be covered under the majority of private medical insurance policies, if you are unsure then check the policy terms and conditions.
To arrange cover in most cases the best place to start would be an insurance broker or independent financial adviser. There are many insurance companies offering private medical insurance and there is a huge difference in the range of cover available and also the premiums that are charged for cover, and this is the reason you should use a broker to search the entire market for you.