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Private Medical Insurance

People go private for a higher standard of healthcare, with better facilities and shorter waiting times to see specialists.

According to Department of Health statistics for 2009/10 throughout England only 36% of patients requiring in-patient hospital treatment can be seen within 3 weeks of referral by their GP. Waiting times can be much longer for routine operations, which is why many people are taking out Private Medical Insurance (PMI).

There are many advantages to having PMI:

  • No queues: although waiting times on the NHS have improved to a maximum of 18 weeks between referral and treatment, you won’t have to wait this long for private treatment.
  • Peace of mind: if the worst happens, your treatment will be as quick as it can be. Many people are also concerned about the problem of MRSA in NHS hospitals.
  • Choice: you can choose your consultant and where you want to be treated, with the proviso that some policies restrict treatment to set lists of hospitals.
  • Private room: you don’t have to worry about being on a mixed-gender ward. Depending on your policy, you may have an ensuite bathroom.
  • Unrestricted visiting hours.
  • Personal care: a retinue of medical students won’t accompany your appointment with the consultant, you won’t be kept waiting for hours to see them and you will have more time to discuss your symptoms.
  • Continuity of care: you are likely to be seen by the same consultant throughout your treatment.
  • Specialist claim team: your insurer may have a team that deals specifically with a certain type of condition, such as cancer, who can help advise you.

There are also certain drawbacks that you should be aware of:

  • Not all conditions are covered: it depends on your policy and any previous medical conditions, but most policies only cover short-term illness or injury.
  • Some appointments and treatments are not covered: once you’ve got a referral from your GP, you need to call your insurance company to check they will cover the costs before you see the consultant or arrange any treatment.
  • It can be difficult to know which PMI policy suits you: with so many companies offering PMI, it’s worth talking to an independent financial adviser, who can help you see the differences between the policies. Advisers at insurance companies can only discuss their own policies and can’t give you advice on how it compares with others.
  • You get what you pay for: the more cover you want, the higher your premium will be.
  • Premium costs are rising above the level of inflation: medical treatment costs are rising by 10 per cent each year, according to group health intermediary Mercer. When insurers’ costs rise, premiums tend to rise in line with the costs.
  • Expertise: private hospitals might not have the same depth of expertise found in teams within the NHS or all departments on one site. So if you have a problem with your mouth, it might not be easy to coordinate treatment between a dental department and the ENT (ear, nose and throat) unit.
  • Time constraints: if your consultant also works in the NHS, your treatment will need to be given in the time he or she has free from the NHS.

(Based on a text by John Illman, medical writer)

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