Health Insurance

What is Health Insurance?

Health insurance is a type of insurance coverage. It’s often provided by employers and pays for employee medical expenses and sometimes their families’ too. Health insurance is designed to protect the physical wellbeing and, depending on the country, the financial security (eg. USA) of employees in cases of serious illness or injury.

Who is eligible for health insurance?

Both full & part-time employees usually qualify for health insurance through their companies. Some companies require employees to work a certain number of hours every week to make them eligible for cover. 

Some companies also only grant employees access to health insurance once they’ve passed probation e.g., after 3-6 months. This just depends on the company policy — check out our policy generator to get some inspiration for your health care policy. 

Is health insurance the same as private medical?

Generally speaking, health insurance and private medical insurance (PMI) are the same thing. The two terms are interchangeable and there are no differences between them!

That said, in the UK it tends to be referred to as Private Medical Insurance as there is already a comprehensive public health service (the NHS) in place. 

What does health insurance cover?

Typically, health insurance will cover medical expenses like GP appointments, hospital stays, prescriptions, tests, as well as preventive care. It may also cover some mental health and dental care depending on the policy.

In the UK, Private Health Insurance pays for specialist services outside of using the NHS, for example diagnostic testing, specialist consultations and treatment in private healthcare facilities.

It’s good to keep in mind that not all health insurance providers offer the same level of cover. For example, many plans don’t cover pre-existing medical conditions, whereas some do. It’s always a good idea to read the full plan in detail to check what you’re covered for!

Depending on the company’s health insurance policy, employees can sometimes also add extra coverage. For example, you might want to add dependents to your plan, or increase your level of coverage. 

Types of health insurance

There are a few different types of health insurance available. It’s important to research each type thoroughly to find the best plan for you and/or your team. 

Here are the various types…  

  • Group plans — these are employer-sponsored  (e.g. PPOs and HMOs)
  • Individual plans — purchased through insurance exchanges 
  • Government-funded plans — such as Medicaid and Medicare in the US

Benefits of having health insurance?

Health insurance is a great option if you want faster access to healthcare or want additional coverage for treatments not available on the NHS.

The NHS offers health care to all UK residents, and while it is pretty comprehensive, there are still some things it doesn't cover…

  1. Waiting times — demand is high and resources are limited, so you might have to wait a while before you can get certain treatments and procedures done.
  2. Prescription charges — There are only a few exceptions for items like contraceptives and aspirin. 
  3. Routine dental care and eye tests aren’t covered by the NHS, so you'll have to pay for those on your own.
  4. Long-term care is not covered — nursing homes aren’t covered by the NHS. 

This is why some people choose to get PMI as a way to supplement their NHS support or to get quicker access to treatments. 

Are there any limitations to health insurance?

Although health insurance is a great alternative to public health services, it's super important to understand the full extent of your policy to make sure you’re aware of the limitations.

When it comes to private medical insurance in the UK, it's important to be aware of a few things: 

  1. It’s more expensive than relying solely on the NHS. With PMI, you’ll have to pay higher monthly premiums, and there might be extra out-of-pocket costs to think about too.
  2. PMI policies can also have restrictions. There might be annual limits on what your policy will cover, and some pre-existing conditions might not be covered at all. You should always read your policy carefully so you know what you're covered for.
  3. There may still be waiting times for certain treatments & procedures. This depends on demand and the policies of your insurance provider. Plus, your policy might only cover treatments from certain providers, and if you see someone outside of that network, you may have to pay more.
  4. The older you get and/or if you develop medical conditions, your PMI might not be available or might cost more. You should review your policy regularly to make sure it still meets your needs and is up-to-date.

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