How to tailor a health insurance policy to your needs & budget

In recent years insurers have moved away from rigid fixed policies which offer the same benefits to everyone. Instead they’ve developed more flexible solutions, allowing individuals to pick and choose the benefits they want. This is great for policyholders as it allows you to design your policy to be as comprehensive or specific as you like, catering for both your healthcare needs and your budget. So before you take out a new policy, give some thought to the following options which are available from most large insurers.

Additional policy options

Adding additional benefits to your policy will increase your premiums but will offer valuable advantages over a standard policy.

  • Psychiatric benefit – Adding a psychiatric benefit to the policy will allow you to be covered for in-patient psychiatric treatment in a private facility. It’s worth mentioning that treatment for alcohol and drug abuse will not generally be covered. These are general exclusions on all policies. For further information see psychiatric benefit.

  • Dental and optical benefit – These benefits allow you to claim back the cost of routine dental and optical treatments. It will cover you if you need fillings or a crown at the dentist, or a change in optical prescription via your optician. There is a maximum amount you can claim back each year and normally there will be a small excess to pay.

  • Routine consultations – If you’re suffering from a long term chronic condition that requires regular monitoring, a routine consultation benefit could be useful.

  • Primary care benefit – Primary care covers any care you receive under the authority of your GP, so essentially anything prior to being transferred to a specialist. Although your insurer won’t pay for you to see a private GP, you can claim privately for GP referred scans such as MRI, CT, ultrasound and X-ray. You’ll also be entitled to see a private physiotherapist, chiropractor or osteopath – saving you a long wait on the NHS.

  • Protected no claims discount – For added peace of mind you can pay a little extra each year to keep your no claims discount safe. This is similar to the process you’re probably familiar with from your car insurance, where if you make a claim in this policy year you won’t lose your discount for the following year.

  • Extensive hospital lists – Every policy has a list of private hospitals you are able to use for your treatment. The standard list may not cover the top London facilities which charge higher prices, so by selecting this option you can increase your choice.

Reductions in benefit

Reducing the benefits on your policy can help lower your premiums and make private medical insurance more affordable.

  • 6 week rule – If you can receive in or day patient treatment on the NHS within 6 weeks your policy will not cover you for the treatment privately. This is an ideal option to choose if your main motivation for taking out your cover is so you are able to be seen quickly, and you don’t mind using the NHS. For further information see the 6 week rule.

  • Excess – An excess is the amount you have to pay yourself at the beginning of a claim. It can vary anywhere between £50 to £5000 and naturally the higher your optional excess, the lower the cost of your premium. For further information see adding an excess.

  • Outpatient limit – Adding an outpatient limit lowers your benefits by entitling you to either a fixed value of outpatient treatment, or a set number of consultations. This reduces the cost of your premiums. Bear in mind if you go over the outpatient limit you will need to pay any additional costs yourself. For further information see setting an outpatient limit.

  • Reduced hospital lists – By restricting your hospital list to NHS trust hospitals and lower end private facilities you can reduce your premium. This is ideal if you want to save money and don’t have any preference as to which hospital you want to use.

  • Opt out of cover abroad – If you don’t travel much then you can save money by taking this element off your policy.

  • Opt out of oral surgical procedures – Oral surgical procedures are those which cannot be performed in a dentists chair and require hospital admission. They include root canals and impacted wisdom teeth.

Having the flexibility to create the policy you want is a useful tool, but don’t sell your self short and sacrifice benefits you later wish you’d taken out. You can add and remove benefits at the end of each policy year, enabling you to keep your cover up to date and suitable for your present healthcare needs.

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