A guide for an informed Private Medical Insurance (1 of 4)

Association of British Insurers has published a complete guide for the individuals who want to buy a Private Medical Insurance (PMI). You may read a summarized guide of it in these upcoming four posts.

The ABI has designed it to help the individuals who want to buy a PMI to make an informed decision before buying a policy. And the guide is also useful for the companies who offer PMI, mainly to avoid miss-communication. ABI informs you to contact the company or agent for any questions regarding your Insurance Policy.

What exactly are you buying?


Private medical insurance ranges according to premium levels and cover levels. You may have the options of about the varieties of treatment covered and for what levels, where treatment is offered, and the payment you might be willing to pay to the cost of the treatment (the excess).

Take your time to consider the requirements of your health and to compare the cover limits and the benefits for an equal premium of each insurer.

Generally, you would like to know about the monetary limits on the policy (if any), what stages of cancers and treatments are covered, any discounts for no claims, and what happens when I reach my cover limit. Clarify about what happens if you reach the cover limit – whether you can return to NHS or you’ll need to pay to continue private treatments.

PMI is frequently called ‘health insurance’ and, income protection, health cash plans, and critical illness plans can sometimes be confused with PMI.

Private Medical insurance – what really is it?


PMI is intended to cover the expenditure of private medical treatment for diseases, illnesses or injuries that are expected to respond quickly to treatment that intended to return you to the health level you were in before it or which guides to your full healing. These conditions are called acute conditions. Ask the insurer if there is any cover for longer term conditions called as chronic conditions.

Some PMI policies may provide coverage for long-term treatment or maybe even treatment for chronic conditions, which is not typically the main intention of PMI.

This is designed to work together with and not to replace all the services obtainable from the NHS, and policy holders preserve their right to use the National Health Service in all the cases.

People can have timely admittance to healthcare, select preferred treatment options and consultation, comfortable and high quality services when they buy a PMI. If you select to use NHS, PMI will opt to pay you cash benefits.


Before a medical treatment start from a referral by a general practitioner for specialist treatment, you should check whether you are covered by calling your insurer. Your pre-existing conditions and treatment for some illnesses may not be covered by your private medical insurance. It’s very important to continue communicating with your insurer at each stage of treatment.  

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