• Help! I don’t know what to choose from all the policies out there.

We know it can be confusing with various levels of cover, pricing and benefits in the market. For help, please contact one of our experts who will be able to explain the choices and answer any questions you might have.

  • What is a Health Cash Plan?

We would refer to these as an ‘everyday healthcare policy’ offering cover up to pre-determined limits for everyday healthcare costs such as dental, optical, therapies and consultations. These can be purchased personally or by a company on behalf of its employees, typically starting at £1 per week per employee.

  • What is PMI?

Health insurance or private medical insurance (PMI) typically gives you choices to gain prompt access to private treatment for early diagnosis and, when appropriate, hospitalisation for surgical procedures without the wait often associated with the NHS. Health insurance is not in competition with the NHS and nor will it replace it – however, it does offer the ability to receive treatments which are sometimes not funded by the NHS.

  • How do I make a claim?

For medical insurance there is a process to follow and this may vary from insurer to insurer. In most cases we would suggest you always contact your GP. However some insurers now offer online GP consultations to reduce waiting times. If you need specialist treatment you should contact your insurer to pre-authorise the treatment and seek assistance, they will guide you accordingly. Should you experience any difficulties your insurance advisor should be able to assist you.

  • How can I get support and assistance with claims?

Sometimes things don’t go as smoothly as you would like. Contact an AMII expert who will be pleased to assist.

  • What’s the best way to obtain quotes?

Costs can vary from one insurer to the next, but AMII members are independent and impartial. AMII members will carry out a Fact Find with you to determine your exact requirements and then source a policy to meet your specific needs. Contact an AMII through the Ask an Expert tool for further help.

  • I am worried about NHS waiting lists - will a medical insurance policy help?

Patients are enduring increasingly long delays to see a specialist and before any treatment is undertaken, which can be debilitating and often painful. The alternative with health insurance is that you go privately for treatment which would cut out the delay and ensure you are back on the road to recovery as soon as possible. Health insurance, like any form of insurance, starts off with limited cover when you are working on a budget, to more expensive comprehensive policies which offer additional benefits and cover limits. By going privately the waiting times are usually much lower with access to higher standards in quality of care.

  • I already have a medical condition – can I get cover for this?

Insurers sometimes exclude known or ongoing medical conditions, but you shouldn’t assume that the condition will NOT be covered by the policy. Whether you will be covered for a known condition is dependent on a number of factors - please speak to an AMII expert for assistance.

  • Will a policy cover me for cancer?

In most cases health insurers will cover cancer treatment, however, the cover can vary based upon the policy you have selected. We would recommend you ask an AMII expert to explain the options available to you.

  • How can I be sure my policy is right for me?

The best option is to contact an AMII expert who will undertake a Fact Find with you and guide you accordingly.

  • The cost of my policy is too high, can you help?

Yes we can. Please contact AMII and one our members will be able to research the market to find a cost effective policy to suit your needs. They will also be able to advise you in regards to different ways to reduce the premium and what the implications are, whether this is remaining with the same insurer or switching to another.

  • Can I change insurer and not have exclusions?

Often you are able to transfer from one insurer to another without the need to re-declare your medical history. However this will very much depend upon a number of factors, please ask an AMII expert.

  • What happens when I leave a company scheme?

Your cover will cease on the day you leave the employment, the insurer will therefore NOT cover any treatment costs after this date, irrespective if it started before you ceased cover.

If you leave a company paid scheme most insurers will allow you continue the cover albeit on a personal basis providing you have no break in cover. This could be very important if you are mid treatment as the personal policy will continue to cover the cost of your care. If, on the other hand, you have no ongoing medical conditions ask an AMII expert and they will explain all the options available to you.

  • How does an excess work?

These typically work on the principle of being a one off payment per person per contract year, not per condition or per claim. Please be careful when claiming at the end of your contract as you could end up paying two excess payments if they are in two different benefit years.

Assuming a policy with a 1 January renewal date with a £100 excess, for example, if you had a £100 claim in December and a £100 claim in January the insurer would not pay either claim. If you had two claims of £100 in December the insurer would not pay the first claim but they would cover the second claim as the excess has been paid.

  • What is underwriting?

You are asked to give details of your medical history. The insurer may write to your doctor for more information, but they do not in every case. You must give all the information you are asked for. If you don’t, your insurer may refuse to pay any claim that you make in the future, or may cancel your policy.

If you are not sure whether to mention something, it is best to do so. If you have a medical condition that is likely to come back, the insurer will issue a policy, but that condition (and any related to it) might not be covered. This condition may never be covered, or not covered for a set period of time.

  • What is a moratorium?

You are not asked to give details of your medical history. Instead, the insurer does not cover treatment for any medical condition that you have received treatment for, taken medication for, asked advice on or had symptoms of. In other words, you will not be covered for any condition that existed in the past few years. Five years is the usual time period. These conditions may automatically become eligible for cover. But this will only happen when you do not have symptoms of, or receive treatment, medication, tests and advice (from your GP, a healthcare professional or a specialist) for that condition, or a related condition, usually for a continuous period of two years after your policy has started.

You do not need to tell the insurer about your medical history when you take out the policy. If you claim, however, your insurer might ask for medical notes that are needed to decide if your claim can be covered here are some conditions, for example chronic conditions, that will probably never be covered. This is because you will always need treatment, medication, tests or advice for them. You should not delay getting medical advice or treatment, simply to get cover under the moratorium terms.

Your insurer will give you information explaining how their moratorium works.

  • What’s not covered on a Health insurance policy?

Insurance policies vary from one insurer to the next, however in the main the following conditions are not covered:

  • Going to a general practitioner (GP)
  • Going to Accident and Emergency
  • Drug abuse
  • HIV/AIDS
  • Normal pregnancy
  • Mobility aids, such as wheelchairs
  • Organ transplant
  • Injuries you get from dangerous hobbies (often called hazardous pursuits)
  • Gender reassignment (sex change)
  • Conditions you had before taking out the insurance (commonly known as pre-existing conditions)
  • Long-term treatment and chronic conditions
  • Dental services
  • Prescription drugs and dressings, after leaving hospital or as an outpatient
  • Deliberately self-inflicted injuries
  • Infertility
  • Cosmetic treatment
  • Experimental or unproven treatment or drugs
  • Kidney dialysis
  • War risks

As well as these everyday questions, our AMII members are also on hand to answer more complex queries about Life Policies, Critical Illness Cover and Income Protection, for you or your company. Simply visit our Ask an Expert page.