Changing health insurance

dizzie

In response to my previous gripes about BUPA, I thought I'd clear up an issue that many people worry about if they are thinking about changing their health insurance policy.

It's the issue of "Pre-existing Conditions"

For a long time, I too laboured under the misconception that although I was not happy with my experience of BUPA, I was stuck with them, because we'd made claims as a family.....and these would be classed as "pre-existing conditions" if I changed to another insurer.

What I didn't know at that time was that a change of health insurance can involve THREE possible types of policy:

1. Full Underwriting: If we'd gone for this option, then yes - all of our previous "conditions" would have been likely to be excluded by the new insurer

2. A Moratorium: This type of policy agrees to cover you for "pre-exisiting conditions" as long as you have been symptom free for a number of years.

3. A Switch: Some insurers (like Exeter Friendly) offer what is called a "switch policy". Under this type of policy, an insurer essentially agrees to provide cover with the same exclusions as your previous provider.

Example of a switch policy:

Lets say you joined BUPA 15 years ago (and at that time, BUPA had excluded your left big toe as a "pre-existing condition")

Then, in the last 15 years, you've had knee surgery, a problem with your back, and another problem with your eyes.

You might be thinking that all of these three additional problems are going to be added to the list of pre-existing conditions with another insurer.

When in fact, if they agree to a switch policy - the only pre-existing condition that they'll exclude from cover will be the same as your old insurance provider (which in this example was the left big toe)

Out of all the three types of policies, the switch is more expensive.....but don't let that stop you enquiring.

We have gone from BUPA to Exeter Friendly with a "switch policy".....and we are paying over 40% less than we did with BUPA!

Now, I don't know whether to feel elated with Exeter Friendly for giving us much lower premiums:j...

or annoyed with BUPA for fleecing us for all those years!:mad:

j.e.j.

It would be great if there was a sticky on this board about private health insurers and their pros and cons, and feedback about the service you get with them, etc. It's hard to find this sort of information.

Maybe most people just take pot luck with the NHS, but I think there are also a lot of people who would look to getting private health cover if they knew how it worked, what to look out for and where to start.

dizzie

j.e.j. wrote: »

It would be great if there was a sticky on this board about private health insurers and their pros and cons, and feedback about the service you get with them, etc. It's hard to find this sort of information.

Maybe most people just take pot luck with the NHS, but I think there are also a lot of people who would look to getting private health cover if they knew how it worked, what to look out for and where to start.

True, I guess I was at an advantage when I went to the Insurance Broker because I knew what questions to ask.

I'd say the key things are:

(i) What do the policies actually cover you for (Cancer seems to be a biggie, with some insurers just covering you up to the point of diagnosis if you have terminal disease (sorry that this sounds so morbid), whilst others also cover you for palliative care if you are diagnosed with terminal disease).

(ii) What are the limits. Most have something called an annual outpatient limit. Essentially they have an "Outpatient benefit pot" which is limited each year. Different policies take different things out of this benefit pot. Sometimes, it is consultations and therapy fees....sometimes it's consultations and x-rays, and sometimes it's all outpatient treatment too. So ask about this.

(iii) What is the annual excess (e.g. a lot of policies make you pay the first £100 of any claim in the policy year, but you can sometimes chose to increase the excess and lower your premiums in exchange)

(iv) Some insurers will only allow you to see Specialists and Therapists on their "approved lists" (notably BUPA and AXA, and also PRU to some extent), which essentially restricts access. Others will let you see any practitioner as long as they have the appropriate qualifications and registrations, which allows you much more freedom.

(v) Hospitals - some insurers really limit the hospitals you can be treated at, others will include most private hospitals except some very expensive London-based ones, and a few will allow you to use those expensive ones too (although this will be reflected in your premium)

(vi) Ask about procedure limits. BUPA and AXA tend to pay the lowest rates so you can face shortfalls if your chosen specialist's fees are higher. From my own research, companies like Cigna, WPA, Exeter Friendly, General Medical and CSS Healthcare tend to be more generous with reimbursement rates.

(vii) Discounts: Some companies like Pru also give you discount for having a healthy lifestyle (i.e. gym attendance etc) which might prove cost effective - even if you do offset the fact that they are limiting physiotherapy choice and cutting reimbursement rates too. Some give you discounts for not making a claim.

Finally, my advice is not to agree to anything on the phone. Get the paperwork and read it carefully so you can make a thorough comparison of all of the features of a policy. If there is anything you don't understand - ask about it. Go on the internet and read the reviews of the insurer(s) you are considering, to find out what patient experience has been of them.

Hope this is useful for you.

pmduk

Having worked in this area one of the biggest problems is customers assuming what the cover is. Even when restrictions are clearly stated in large bold print.

Tombola591

Dizzie, thanks for posting.

I haven't really had much time to look into switching but I too was reluctant to change because I thought I wouldn't be covered for pre-existing conditions.

I did know that some insurers would only exclude cover for a pre-existing condition for a certain period, i.e. 5 years - but I just knew that knowing my luck as soon as I changed, an old condition (from 10-15 years ago) would flare up!