Health insurance for a family

Some families look at private health insurance to cover parents and children together. Policies differ in what they pay for, who they cover and which conditions they leave out.

The kinds of cover

The Financial Ombudsman Service describes private medical insurance as cover for the cost of investigating and treating medical or dental conditions. Some of the main kinds it lists are:

Cover through work

Where an employer provides the cover, the Ombudsman explains, the employee is a beneficiary of it rather than the policyholder. If the complaint is about how a group policy was sold, the employer usually has to make it.

Conditions someone already has

The Ombudsman defines a pre-existing medical condition as an illness or injury you had before the policy began or was renewed. Its examples include diabetes, asthma, high cholesterol and a long-term back condition.

The Association of British Insurers (ABI) says treatment for some illnesses, including pre-existing conditions, is likely to be left out of an individual private medical insurance policy. If you switch insurer, it warns, the new one might not cover conditions your current insurer covers.

Using a policy

The ABI says treatment usually starts with a referral from your GP. Before arranging private treatment, it asks people to call their insurer to check they are covered.

Choices within the NHS

In England, the NHS explains that when a GP refers you, in most cases you have the legal right to choose the hospital or service. This includes many private hospitals that provide services to the NHS, as long as it costs the NHS no more than a referral to a standard NHS hospital.

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