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As with any product or service, there can be a lot of new jargon to understand when considering private medical insurance. We believe in keeping things simple, so here are some explanations about some of the most common terms.
The underwriting determines what cover you have for pre-existing medical conditions - the underwriting options are Continued Personal Medical Exclusions (CPME), Full Medical Underwriting (FMU), or Moratorium underwriting. CPME underwriting (not always available) will provide cover for pre-existing conditions that are covered under an existing scheme, as well as any new conditions. (subject to terms and conditions)
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An acute condition is typically defined as a disease, illness or injury that is likely to respond quickly to treatment that aims to return you to the state of health you were in immediately before suffering the disease, illness or injury, or which leads to your full recovery.
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A chronic condition is typically a disease illness or injury that has one or more of the following characteristics: it needs long-term monitoring, control or relief of symptoms, it requires rehabilitation, it continues indefinitely, and it has no known cure or is likely to come back.
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A patient who is admitted to hospital and who occupies a bed overnight or longer, for medical reasons.
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Out-patient cover is for a patient who attends a hospital, consulting room or out-patient clinic and is not admitted as a day-patient or in-patient.
A patient who is admitted to hospital or day-patient unit because they need a period of medically supervised recovery but does not occupy a bed overnight.
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Investigations, such as x-rays, blood tests or scans, to find or help to find the cause of your symptoms.
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If you have a no claims discount (NCD) on your policy, this means that any claims you make on your policy will directly affect the premium that you pay at your following renewal. NCD's also allow you to benefit for not claiming, by increasing your discount, offsetting part or all of the increase you would normally see for age and medical inflation. The NCD's offered by each insurer differ, and Jelf's healthcare advisers can talk you through how yours works. A point to raise is that you shouldn't avoid claiming for the sole purpose of maintaining your NCD, it is recommended that whatever the level of illness, you should use your PMI and the benefits it offers
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Medical inflation is an inflationary factor applied to all PMI schemes each year to take into account the rising costs of treatment, particularly the more advanced treatments, the fact that more and more people are claiming each year, and these two combined mean that the insurers are paying more out in terms of claims. To continue to meet these claims, the premiums must be increased.
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An excess is the amount of money you must contribute towards eligible treatment costs covered by your policy each year. The excess applies to each person covered by the policy. The excess will be applied either per claim or per policy year. Please see your policy documents for details of how your excess works, or speak to a Jelf healthcare adviser.
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Psychiatric cover provides benefit for the treatment of mental illness such as anxiety, depression and stress.
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If there are any terms we have missed which you require help with, please get in contact with us and we will be happy to help clear them up for you.
The information above is based on the Association of British Insurers - A guide to buying private medical insurance
