Private Medical insurance | Covid-19

This article addresses the COVID-19 pandemic and what this means to you and your private medical insurance cover. We have also included some useful frequently asked questions which should help provide some additional clarity.

At present all insurers will not cover any individuals for treatment in any of the UK private hospitals for COVID-19 as these hospitals are not adequately equipped for patient isolation. The virus is highly contagious and requires specialist treatment in designated isolation units, which the NHS has in place. At present all patients diagnosed with Covid-19 would be sent and treated in one of these NHS isolation units.

The nation is in an unprecedented situation. Health services across the country are under tremendous pressure and many families, individuals and businesses are facing great uncertainty. As a result some private medical appointments you have for planned treatment may be deferred but will not be cancelled.

In a bid to make sure you continue to get the necessary support we should point out that you can still access many of your PMI providers key benefits. Dependent on your policy this may include things such as:

• Remote/ Digital GP access
• Therapies cover
• Mental health and some employee assistance
• NHS cash benefits
• Dental & Optical cover

We are of course always here to help and if you do need to speak to someone, do not hesitate to get in touch with our designated specialist Healthcare team on 01603 967955 or email [email protected]. We can also keep you updated with any changes specific to the type of policy and cover you have.

Below are some FAQs and responses with regards to your policy cover and benefits, accessing treatment, ongoing claims, health insurance questions and getting further help.

Policy Cover and Benefits

What cover is available for testing, screening or treatment for COVID-19?

Given COVID-19 is a public health emergency, it is appropriate that diagnostics and treatment of COVID-19 is conducted by or at the direction of the NHS. Testing and screening is therefore not covered under your health insurance policy, and any treatment would only be covered to the extent it is eligible treatment provided to you as a private patient in a private facility. In the current circumstances, it is unlikely that this would be the case and COVID-19 patients would be treated under NHS care, whether at NHS or private facilities.

What if COVID-19 exacerbates an underlying condition?

This is a novel virus, but with each passing day we are learning more about its potential impact on individuals. Care for anyone who has underlying conditions which are exacerbated by COVID-19 will be managed in-line with policy terms and conditions in the usual way, including subject to the satisfaction of applicable policy underwriting.

I know that the NHS’s decision to cancel elective, non-emergency and non-time-critical procedures in private hospitals will affect my access to some of the benefits I’m covered for. What can I still claim for?

The terms and conditions of our policies haven’t changed, so your cover will still apply – although under the present circumstances it will be harder to get access to certain care and treatment can therefore be deferred.

If I’m having care for COVID-19 under the NHS, but at a private hospital, can I still claim NHS Cash Benefit?

Possibly. If you’re under NHS care, any valid claims for NHS cash benefit will still be paid, no matter whether you’re attending an NHS hospital or a private one. Please speak to the Healthcare Team to just check what benefits apply under particular policy.

Would my policy cover me for any treatment abroad?

The terms and conditions of your policy haven’t changed so if you have access to emergency overseas cover, this will remain in place, although under the present circumstances it will be harder to get access to certain care.

I’m due to renew my policy. Will the terms remain the same?

At present when you renew, the current terms will still apply. We will monitor the situation and update you in light of any relevant developments, based on what your insurer is offering. If you’d like to discuss anything regarding your policy, please contact the Healthcare team using the above contact number given.

If I cancel my policy now, and take out a new one after the COVID-19 pandemic has passed, how might this affect my claims or premium in the future?

Cancelling your policy would mean losing any previous underwriting and therefore, benefits. This would mean not being able to claim for a previous condition you currently have cover for. Please speak to the Healthcare team to discuss this further.

Accessing Treatment

Will I be able to claim without a GP referral during the current crisis?

The terms and conditions in your policy for claims won’t be changing as a result of the NHS’s new measures, so GP referrals will still be required in most cases. The easiest way to access a GP referral would be through some of the Artificial Intelligence apps available. Otherwise you should contact the NHS via your usual methods. Remember you don’t need a GP referral for some benefits, which you can again check with the Healthcare team with for clarity.

If people suffering from COVID-19 are admitted to private hospitals, will they be admitted as NHS patients?

Yes, that’s right. If you’re admitted to a private hospital under these circumstances, you’ll be under NHS care.

Can I bring my treatment forward if the hospital I’m going to is still accepting patients for my condition?

This is something you’d need to check by contacting your specialist or hospital directly, however this announcement means that it’s unlikely any specialists or hospitals will be accepting non-critical cases.

I don’t yet have a diagnosis for a condition I’m suffering from. Would I still be covered to have investigations carried out privately?

If your policy terms provide cover for the investigations you need, and you are able to arrange these privately, then these would be covered as usual. However under the present circumstances it will be harder to get access to certain care.

I am feeling stressed about this situation can I speak to someone?

Absolutely. All insurers till have their stress counselling helplines and employee assistance features available.

Current Claims

I’m currently receiving care in a private hospital; will you continue to cover me?

The terms and conditions of your policy hasn’t changed; however, the availability of private treatment has been restricted by the COVID-19 pandemic. If your treatment is available privately, your cover will still apply.

I have a claim in progress. Will I still be covered?

Similar to the above point, the availability of private treatment has been restricted by the COVID-19 pandemic. If your treatment is available privately, your cover will still apply.

I have treatment booked today or this week, should I go?

The best thing to do is to contact your consultant and/or treatment provider who will make this decision and determine what happens next.

I have treatment booked but I am being redirected to a different specialists and/or treatment unit, will I be covered?

Yes, provided the specialist and/or facility is recognised by your incumbent insurer. If you find yourself in this situation, please contact the Healthcare team for direction.

I have had treatment cancelled – what should I do?

You need to contact your consultant for further advice, there may of course be a delay whilst they make the right decisions for all of their patients. If you have a concern about treatment you need that has not yet started, you can contact your consultant, private hospital or your GP for further advice.

Premiums and Payments

Do I still need to pay my premiums?

Yes, to make sure there are no gaps in your cover, you do need to continue to pay premiums. If you don’t maintain your premiums in line with the terms and conditions of your policy, you or your insured members may not be covered for any previous condition that you may have claimed for.

Business health insurance questions (For individuals under groups)

What would happen if my employer cancels my private health insurance? Is there any way to keep my cover?

Yes, you can continue cover by switching to an individual policy. The actual policy benefits may be different. To discuss this further please contact the Healthcare team.

I’ve found out that I am being made redundant. Can I continue my private medical insurance policy as an individual?

Yes, you can. Similar to the above point, please contact the Healthcare team for further details.