Private Medical Insurance

4. How do I choose the right cover?

When looking at cover, it is useful to know that treatment is categorised in the following way.

In-patient: This is when you go into hospital for private treatment or investigations and stay for one or more nights.

Out-patient: This is when you receive treatment or investigations or consultations which do not need you to stay in hospital either as an in-patient or daypatient.

Day-patient: This is sometimes referred to as day-care, or day-case. It is when you go into hospital for private treatment or investigations but do not need to stay in hospital overnight.

There is a large variety of schemes available - from low-cost schemes, offering limited cover, to those which offer wide-ranging cover and benefits. Most schemes offer cover for in-patient and day-patient care, but not always out-patient.

This is how the treatment usually works:

Go to your GP - If you have private medical insurance, your GP recommends you to see a specialist. Your GP can arrange for you to see a specialist privately. Out-patient consultation with a specialist who may recommend further tests. If tests are needed these can be arranged promptly. Your specialist recommends either inpatient or day-patient treatment. If you need treatment, it can be arranged promptly. Your specialist helps you to arrange hospital treatment. You may be treated in the comfort of a private hospital or in an NHS hospital, as a private patient, at a time to suit you.

You will need to decide what sort of cover you want:

• Do you want your cover to include seeing a specialist as an out-patient?

• Do you want a choice of hospitals, or would you be satisfied to receive any treatment that you might need in a hospital

• available from a limited range chosen by your insurance company?

The answers you give to questions such as these could have a significant effect on the premium that you pay (please see Section 6).

Private Medical Insurance Guide:

1. About this guide
2. What is private medical insurance?
3. How do I buy private medical insurance?
4. How do I choose the right cover?
5. What am I covered for? What does my cover not include?
6. What will affect my premiums?
7. Will I need to provide details of my health?
8. Will my cover be affected if I am disabled?
9. How do I make a claim?
10. How is private medical insurance controlled?
11. What if I want to change to a new insurance company?
12. Your private medical insurance checklist
13. Useful addresses