Demystifying Health Cover: Understanding Terms in Your Insurance Policy

In order for your medical insurance plan to be valid, your personal details and the information you give your insurance provider about your health must be accurate. Any misinformation could result in your policy being invalid and payouts for claims being rejected. Therefore it’s vital that you fully understand the information you need to provide and what you are agreeing to when taking out your policy.

Let’s take a look at some terms that may need some clarification.

Your policy is the agreement between you and your insurer. You are the policy holder and it is possible to buy individual insurance policies as well as group policies for couples and whole families.

Your insurance premium is the amount you pay for your insurance policy. You can pay your premium annually in a single payment, or spread the cost monthly. The amount of your premium depends on a number of factors including the level of cover you opt for, who the policy is for, factors like the excess you choose to pay, and your underwriting preference.

When you choose your health insurance plan and agree to the terms, your insurance provider sends you a certificate of registration confirming the important details. These include your level of cover, who the policy covers and their name and address, the policy start date and payment method. Keep this information safe in case you need to reference it when making a claim.

Underwriting is how an insurance company assesses the risks involved in providing you with a medical insurance policy. It determines the price of the policy you receive based on all risk factors considered. There are two types of underwriting; full medical underwriting and moratorium underwriting.

●      Full medical underwriting means you disclose your full medical history to an insurance provider. This identifies pre-existing conditions that you may not be able to claim for and is often the cheaper option.

●      Moratorium underwriting means that you are simply not covered for pre-existing conditions until you have met certain criteria over a period of 2 consecutive years insured.

Annual renewal date

Your annual renewal date is the date that your health insurance cover comes to an end. It is exactly a year from the start date of your policy. As this date approaches, it’s time to make sure you have the best deal on your private medical insurance for the following year. Usay Compare takes care of this for you.

Health insurance cover comes with an excess, which is a payment that you must make towards the claim you are making. The excess varies from policy to policy, and in many cases you have control over the amount of excess you wish to attach to your plan. The value of the excess you choose has an effect on the overall cost of your insurance policy. Often increasing the excess payment means you can reduce the annual price of the policy.

When you shop around for a private medical insurance policy, insurance companies ask you to declare any pre-existing medical conditions. These are illnesses or injuries that you have previously had symptoms of or received treatment, medication or advice for, usually within the last five years. Insurers want to know about pre-existing conditions because they don’t generally provide cover for them.

A chronic condition is an illness that has no cure or that requires ongoing monitoring, treatment or rehabilitation. Private medical insurance does not cover chronic conditions as insurance companies regard these as an exclusion to the policy.

Unlike chronic conditions, your insurance policy covers acute conditions. These are illnesses or injuries that are treatable and you can recover from with the right care.

PMI includes inpatient care as standard, which means any care that you need to receive in hospital overnight or longer, requiring a bed. Outpatient care, however, isn’t part of every policy and means any treatment you need as an outpatient in a clinic or specialist treatment centre. If outpatient care is important to you, you must read the terms and conditions of each insurance policy to find an option that includes what you need.

You receive your no-claims discount each year that you hold your health insurance policy for and do not make a claim. Making a claim can raise your premium. It is possible to opt for no-claims protection which allows you to preserve your no-claims discount even if you have to make a claim. With this option you can still claim as many times as needed throughout the year, the PNCD will just be removed at renewal.

The Financial Conduct Authority (FCA) is the body that regulates all financial services firms in the UK, including insurance companies and insurance brokers. All legitimate companies have an FCA registration number. If you want to check a company to make sure they are legitimate, you can search their number on the FCA register for confirmation.

Now you understand the terms in your insurance policy, it’s important to spend some time thinking about what factors are important to you. You have a range of options depending on your current health, the level of cover you are looking for, and your budget. Comparing private medical insurance providers will help ensure you get the best deal for you.

If you're looking for private medical or life insurance, visit usaycompare.co.uk and sill out a form for a free quote.

Read more: Key factors to consider when choosing Private Medical Insurance