Private medical insurance (PMI) is designed to cover the costs incurred by private healthcare. This will cover you for the diagnosis and treatment of a disease, illness or injury that may develop after your policy begins.  Although most pre-existing conditions would be excluded from cover, we can in some instances get these included (depending on the condition, whether it is controlled, and how long it has been since diagnosis).

The level of cover available can vary and is dependent on the type of policy you have. Most providers broadly offer three types of healthcare insurance: Basic, mid-range, and comprehensive. All three options will generally cover any inpatient treatment, where you are required to stay in hospital – either as a day patient or overnight. Where they differ is the level of outpatient support provided (eg. Scans, consultations, tests, rehabilitation etc.).  Comprehensive health insurance tends to cover all outpatient treatment in full.

Private health insurance usually begins with a referral from your GP for specialist treatment. Before you arrange any treatment, make sure you contact your insurer to check that you are fully covered minus the policy excess. Once your GP refers you to a specialist and your insurance covers you for outpatient treatment, you can make an eligible claim. The specialist may undertake diagnostic tests and then if needed will refer you to undergo more investigations or treatment at a private hospital. All of this will be covered and an eligible claim can be made under the inpatient or day patient section of the policy.

Health insurance usually only covers acute conditions that have not previously occurred. So a disease, illness or injury that is likely to respond quickly to treatment that aims to return you to the same level of health you were in before. In some circumstances, it is possible that a pre-existing condition can be covered but this is typically if the insurer believes it unlikely for the condition to return.

We would recommend using a broker like ourselves, who can approach a panel of insurers, explain the complex jargon, and different levels of cover available. We would advise that you consider your lifestyle, budget and areas of your life that concern you the most. This approach will lead you to purchasing a policy that is tailored to your needs at a competitively priced premium. We use our buying power and specialist knowledge to provide you with the very best terms available.