Private Health Insurance
Private health insurance exclusions / limitations

All insurance policies come with terms and conditions that include statements as to their exclusions and limitations. Private health insurance is no exception to that so checking the cover details carefully in advance should help you ensure that you get the right policy for your needs.

Private health cover (sometimes called private medical insurance or PMI) is aimed at supplementing the services provided by the NHS. The objective is to provide you with fast access to medical experts and treatment for conditions that are not critical or life threatening (where cover would be provided by the NHS). Treatment is often available in private clinics or hospitals and patients accommodated in private rooms.

This can provide you with confidence and the peace of mind of knowing that if you needed rapid medical treatment, even if non-urgent, then it would typically be available at a time and place of your choosing.

Of course, as with all insurance policies, there will be private health insurance exclusions / limitations. The exclusions on such policies will vary among PMI companies but these will usually include emergency treatment following an accident and injuries caused by hazardous pursuits, among others.

Your policy may also exclude treatment for conditions relating to:

• the misuse of alcohol or drugs;
• HIV/AIDS;
• pre-existing medical conditions;
• cosmetic surgery and related treatments;
• normal pregnancy;
• some forms of dental and ophthalmic treatment.

Some policies may, depending upon several factors including price, offer faster or slower guaranteed access to specialists and specialist treatment than others. Other policies may offer additional advantages (free or at a reduced price) such as access to health screening, health clubs, vaccination programmes and wellbeing centres. These benefits may not be available in all cases.

Private health insurance may revolutionise the way you and your family think about your health protection. Taking a few extra minutes to shop around and think carefully about those exclusions could help you rest that bit more easily.