Private health insurance is similar to other types of insurance. You pay a monthly or yearly fee called a premium.
If you have a health issue, see your GP and let them know about your private cover. They may refer you to a specialist, and you might choose private hospitals or specialists not offered by the NHS.
Tell your insurer you want to make a claim. They'll check if your policy covers the treatment you need. If it does, your claim gets approved.
Your GP will book your appointment, and your insurance covers the cost if your policy is active. You might pay an excess depending on your policy.
Group Health Insurance is a form of private health insurance commonly procured by businesses for their employees. It caters to multiple staff members, ensuring access to various medical services and treatments. This private medical insurance grants employees the flexibility to select their preferred consultant, hospital, and treatment date, bypassing NHS waiting lists and restrictions. Businesses opt for this to provide comprehensive healthcare benefits, promoting the well-being of their workforce while maintaining productivity. With Group Health Insurance, employees receive timely medical attention without the constraints often associated with public healthcare systems.
Group health insurance plans typically cover a range of medical services and treatments, including:
It's important to note that all three types of care can potentially be covered by a group health insurance plan, offering flexibility and comprehensive coverage for employees.
Group health insurance plans often come with the insurers providea variety of added value benefits to enhance overall well-being. These may include:
These benefits go beyond traditional healthcare coverage, offering comprehensive support for employees' health and lifestyle needs.
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If you are looking for a starting point, you can consider it to be £75 per employee. Remember, it can be higher or lower depending on the factors above.
Exclusions in group health insurance plans include:
It's essential for individuals to review the policy details carefully to understand any exclusions and limitations before enrolling in a group private medical insurance,plan.
Pre-existing medical conditions may be excluded under certain underwriting options in group health insurance. Moratorium underwriting excludes conditions experienced in the past 5 years. Full medical underwriting often excludes pre-existing conditions upfront. Medical history disregarded (MHD) underwriting ignores pre-existing conditions entirely, but it's typically available only to larger companies. The approach to pre-existing conditions varies based on the chosen underwriting method.
Excess, also known as a co-payment, is a predetermined amount that employees contribute towards eligible treatment costs under a group health insurance policy. In return, the company receives a premium discount. Excess amounts typically range from £50 to £2,000, with £100 per person per policy year being common. It's important to note that employees may need to pay the excess multiple times for the same condition if treatment extends across policy years. Understanding excesses is crucial for employees to anticipate their healthcare expenses and benefits accurately.
Psychiatric cover in group health insurance is essential for mental health treatment, which can be costly. Despite the expenses, it's worth it, considering mental health issues cost the UK £70 billion each year. This business health insurancecover shows support for employees' mental well-being, helping them stay healthy and productive.
Dental and optical cover in group health insurance is important for routine care like eye tests and dental checkups, which are not usually covered. Including this benefit in company health insurance allows employees to visit opticians and dentists under the policy, ensuring their basic eye and dental health needs are met. While policies often cover surgical procedures such as cataract removal or wisdom tooth extraction, routine care is typically not included unless specified.
Group health insurance often extends coverage to immediate family members of employees, including spouses and dependent children. Depending on the employer's policy, the cost of adding family members to the plan may be borne by either add family membersthe employee or the employer. This option allows employees to ensure the health and well-being of their loved ones, providing peace of mind knowing that their family members have access to the same quality healthcare benefits.
Employers have the flexibility to select private hospitals and facilities covered by their group health insurance plan. Major hospital groups available through UK health insurers include NHS private facilities and various private hospital networks. Some insurers offer full hospital coverage as standard, in group health plans while others categorize hospitals with different premium costs. Employers must assess what suits their employees best when choosing hospital coverage options to ensure comprehensive healthcare access.
Shared responsibility in group health insurance involves both the employee and insurer agreeing to split the cost of treatment claims until the employee's contribution reaches a predetermined amount. For instance, the split could be 25%/75%. Once the employee's share reaches the predetermined threshold, the insurer covers all remaining costs. This approach, akin to a co-payment, ensures that both parties contribute to healthcare expenses, mitigating financial burdens on employees while still providing comprehensive coverage through the insurer. It's a collaborative strategy that promotes cost-sharing and ensures that employees receive necessary medical treatment without excessive financial strain.
The "6-week rule" in group health insurance dictates that if an employee needs in/day-patient treatment available on the NHS within six weeks, they must follow the NHS route. However, if the NHS cannot provide treatment within this timeframe, the employee can access private care immediately. This rule does not apply to outpatient treatment, which remains accessible without waiting. It offers employees timely access to medical care, ensuring that necessary treatments are received promptly, whether through the NHS or private healthcare providers.
Full Medical Underwriting (FMU) involves employees disclosing their complete medical history to the insurer. While this option typically results in the cheapest premiums, pre-existing conditions are likely to be excluded from coverage. However, employees are informed upfront about any exclusions that apply. Despite being cost-effective, FMU requires thorough paperwork as employees must declare their entire medical history.
Moratorium Underwriting requires minimal initial information from employees. Conditions are excluded if the employee experienced them within the past 5 years before the policy start date. Employees don't need to disclose medical history upfront. Instead, the insurer verifies at the claims stage to ensure the condition hasn't occurred during the disqualification period. This approach simplifies the application process but may lead to uncertainty regarding coverage until a claim is made.
Medical History Disregarded (MHD) underwriting is the most comprehensive option available most insurers. It completely disregards any pre-existing conditions, regardless of when employees experienced them. This means employees can claim for any eligible condition under the policy's terms, without their previous medical history impacting coverage. While MHD offers extensive coverage, it is typically the most expensive type of underwriting. This option is usually available to larger companies, typically starting with at least 20-25 employees.
Group health insurance premiums are typically paid by employers from pre-tax earnings, treated as a business expense by HMRC. However, for employees, employer-provided medical and buy group health insurance is considered a taxable benefit in kind (P11D), resulting in additional tax payments. Employers must fill out a P11D form to declare the benefit provided and may also need to pay employer's National Insurance on the premiums. This taxation process ensures compliance with tax regulations for both employers and employees.