Since the coronavirus pandemic reached the UK, we have entered an unprecedented era for healthcare. Following the deal between the independent health sector and the NHS to free up an additional 8000 hospital beds and almost 20,000 staff, the face of medical treatment is changing and private medical insurance (PMI) has fallen under the spotlight.

Applications for protection insurance have soared with statistics from mid-March showing a 106 per cent year on year increase in applications. As consumers become more and more aware of the value of fast-tracked access to quality medical treatment, we wanted to offer more insight into the PMI situation both for current policyholders and for those interested in taking out cover.

Making a New Application

If you’re one of the many people for whom the pandemic has highlighted the importance of protecting yourself during both good times and bad, then you may be considering taking out a new PMI policy.

The process may include additional questions about coronavirus, and there may be a delay if you have symptoms or a positive test result. While providers are adapting their PMI policies with many positive measures, it is crucial to ensure that you fully understand your policy, as new exclusions and limits on cover are also being introduced.

Cancelling Existing Policies

While many of us are concerned about finances and may be considering cancelling our protection arrangements, the backlog of non-urgent treatments will mean even longer NHS waiting times after the pandemic. This makes priority access to treatment more valuable now than ever.

If you have an existing policy, we recommend taking steps to protect your underwriting status and level of cover to avoid additional exclusions and increased premiums if reapplying at a later date.

Coronavirus Treatment

A major concern for many is whether PMI covers coronavirus. The NHS is currently coordinating all coronavirus care, which means you cannot be privately treated for the virus. However, if you are hospitalised with coronavirus within the NHS, your insurer may offer a cash benefit.

This is usually around £100-£200 a night up to a maximum amount. Some providers have a pandemic exclusion as standard, which means no cash benefit would be available on these policies and longer-term complications caused by the disease may not be covered.

Other Treatments

Most private treatment is currently being put on hold – even if it is covered by the individual policy – but time-sensitive treatment, such as cancer care, is continuing as usual. If you are currently being treated for a condition that is not considered urgent, you may have the remainder of your treatment delayed.

New Measures

With social distancing and lockdown restrictions in mind, most providers have introduced alternative ways to access care during the pandemic. This includes digital access to GPs with live video appointments, as well as a dedicated triage team offering referrals to cancer, cardiology, ENT, gastroenterology, gynaecology, orthopaedic and paediatric specialists.

In addition, those with existing conditions who are waiting for non-urgent or elective surgery, can access care for managing pain relief, have prescriptions delivered to their door and take part in online physiotherapy.

Many providers are introducing Covid-19 symptom checkers and online advice on next steps. They are also increasing access to mental health care to help deal with the increase in anxiety, depression and stress caused by the pandemic and the pressure of self-isolation.

In some cases, specialist mental health lines are being introduced, as well as digital access to counselling and other services for adults and children. To further support wellbeing, some health insurers are developing apps with free workouts, yoga and mindfulness classes to help customers while fitness centres are closed.

New Claims

In most cases policyholders can still make claims, though these may be delayed – particularly if they are not deemed urgent. Some providers are pre-authorising private treatment now so that customers can rest assured that their treatment will go ahead once normal service resumes.

To avoid further strain on the NHS, many insurers are looking for alternative ways to make payments. Not all claims will require GP reports – customers may be asked for additional paperwork, and some insurers are using their own chief medical officers to help verify claims.

Potential Rebates for Policyholders

Due to an expected decrease in claims for non-urgent care during the pandemic, an increasing number of providers are vowing to pass back any exceptional financial benefit to customers who believe they have not received the level of care outlined in their policy due to coronavirus. This will likely involve third-party financial reviews once the pandemic has passed, with any rebates calculated and paid at a later date.

All policies and providers vary, so if you have any concerns about your current cover or the terms of a new policy, contact our qualified advisers today.