Does health insurance cover anything at all?

DGDG

I just had my gp refer me to three specialists but vitality are being difficult. They won’t cover anything which could be chronic, and that definition seems very wide. Basically anything which would require more than one treatment is deemed chronic, and not covered, according to call centre staff.

So what do I need them for? If it’s urgent and treatable (eg broken leg) I’ll go to the a&e. If it requires ongoing treatment, they won’t cover it (I’d have to pay back any treatment costs if this turns out to be the case) but will refer me to the NHS. They offer a health screening- but what if that screening turns up something which needs more than one treatment? I’d have to go to the nhs? I can’t figure out what sort of conditions they actually cover, what am I missing? 

This is a business policy which is meant to give me and my family top notch cover.

DGDG

I’m so used to having health insurance and I’m lucky I’ve never had to use it until now, so I am absolutely shocked at how little they cover. Just to give an indication one scan has showed what could be a red flag for cancer but vitality won’t cover any follow ups because I don’t have any symptoms, it’s not causing me any discomfort, and probably won’t until it would be pretty late. Awkward!! 

DullGreyGuy

PMI typically doesnt cover the ongoing maintenance of a chronic condition but will cover acute episodes and initial diagnosis.

A chronic condition isnt one that requires more than one treatment but something that isnt curable and is instead about maintenance. So cancer requires surgery and several rounds of chemo etc but isnt typically a chronic condition. Diabetes cannot be cured so PMI wont pay for your life long annual appointments etc but if you were to need surgery as a consequence of diabetes and its long term impacts then the PMI may step up again. 

Obviously each policy is unique and you need to check the terms of what you bought. The more budget the option then often the more restrictive the terms.