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Health insurance FAQs
Answers to your frequently asked questions
What is health insurance and how does it work?
Are PMI, health insurance and private healthcare the same?
Yes, they’re all different ways of describing the same thing. But there are different types of private healthcare. Private health insurance covers the cost of eligible treatments or conditions. Healthcare cash plans provide cash payments to help with some routine healthcare costs. We provide private health insurance. We also give you rewards for getting active and staying healthy.
How does private health insurance work?
Let’s say you develop a condition which needs medical attention. With us, you could get a private GP video consultation within 48 hours. Our Vitality GPs can even refer you for onward treatment. This means you don't have to visit your NHS GP to access private treatment.
The Vitality GP will always let you know if they can't help. This may mean they refer you to your NHS GP or to get in touch with us.
Once you get a GP referral, it only takes a few days to get access to a consultant, specialist or hospital treatment. You then have the flexibility and freedom to fix appointments and treatment dates at a time to suit you. You have more choice about who treats you.
The Vitality GP will always let you know if they can't help. This may mean they refer you to your NHS GP or to get in touch with us.
Once you get a GP referral, it only takes a few days to get access to a consultant, specialist or hospital treatment. You then have the flexibility and freedom to fix appointments and treatment dates at a time to suit you. You have more choice about who treats you.
What do I get with private health insurance?
Private health insurance is for curable (acute) conditions only. These respond to treatment and return you to the state of health you were in before, or lead to a full recovery.
What isn't covered?
Long-term (chronic) conditions, where the main aim is to keep the symptoms under control. This would make premiums much more expensive. Private medical insurance also won’t cover any pre-existing conditions. There are some standard treatments and conditions that we don't cover. These include:
- Any regular treatment of long- term (chronic) conditions, like diabetes or allergies
- Any treatment you receive outside the UK
- Emergency treatment or visits to your NHS GP
- pregnancy, childbirth and most related conditions
- Cosmetic treatment
- Organ transplants
- Any treatments or practices that are experimental, unproven or unregistered
- Any treatment for learning difficulties, delayed speech disorders and other developmental problems
Our plans are designed to cover new conditions that arise after your cover begins.Our plans are designed to cover new conditions that arise after your cover begins.
What's an insurance premium?
The insurance premium is what you pay to be covered by a plan - e.g. health insurance. You’ll pay for your insurance premium by monthly or annual direct debit. Your premium is reviewed once a year and can change, depending on things like your age and whether you make a claim. Your insurance premium also includes Insurance Premium Tax (IPT).
What should I consider before buying health insurance?
Do I need to have a medical before I take out health insurance?
No. If you don't have any pre-existing medical conditions when you take out a plan, you just need to give us your personal details, pick your level of cover and answer some basic questions.
If you do have a pre-existing condition, you’ll need to speak to our underwriting team and give them details. They’ll let you know if you need to provide any more information before we can offer you a quote.
If you do have a pre-existing condition, you’ll need to speak to our underwriting team and give them details. They’ll let you know if you need to provide any more information before we can offer you a quote.
What should I look out for?
Our Advanced Cancer Cover meets all in-patient and out-patient costs in full for:
You can choose to set your own excess at zero, £100, £250, £500 or £1,000. You then decide whether to pay once a plan year or each time you make a claim. The higher your excess, the lower your starting premium.
- Radiotherapy
- chemotherapy and follow-up consultations
- biological therapies
- hormone and bisphosphonate therapies
- cancer surgery and reconstructive surgery
- stem cell transplantation.
You can choose to set your own excess at zero, £100, £250, £500 or £1,000. You then decide whether to pay once a plan year or each time you make a claim. The higher your excess, the lower your starting premium.
What are my cover options with you?
With our health insurance, everyone starts with Core Cover. This gives you access to our Vitality GP service, a 24/7 helpline; and in-patient and day-patient hospital treatment. You can then choose from a range of Cover Options, such as Out-Patient Cover, Mental Health Cover and more.
You can control your costs by picking a higher plan excess. You can also save on your renewal premium by doing healthy things to raise your Vitality status.
You can control your costs by picking a higher plan excess. You can also save on your renewal premium by doing healthy things to raise your Vitality status.
Can I add or remove bits of my cover anytime or just when I renew?
You can only change your cover at your annual renewal date.
Can I add people to my plan?
You can add your husband, wife, partner and dependent children to your plan at any time during the plan year. You can add any number of dependent children, providing they are 25 or under when they first join the plan and live at the same address as you.
Is there an age limit?
You need to be aged between 18 and 79 at the plan start date. You and anyone on your plan must have been resident in the UK and registered with a UK GP for at least six months prior to your cover start date. Anyone covered on the plan must live in the UK for at least 180 days in each plan year. You can only get Worldwide Travel Cover providing everyone on your plan is age 64 or under when they join the plan.
Can I have different levels of cover for different people on my plan?
For personal plans, everyone covered by your plan has to have the same level of cover.
How long does a plan last?
Our plans cover you for 12 months at a time. Your benefits and terms and conditions can change at each renewal date. We do not offer plans lasting less than 12 months.
How does the excess work on private health insurance?
You can set it at zero, £100, £250, £500 or £1,000. Once you’ve chosen it, you can decide to pay once per plan year or each time you make a claim. The higher excess you choose, the lower we can set your starting premium.
The excess doesn’t apply to some benefits - Vitality GP, NHS Hospital Cash Benefit, Childbirth Cash Benefit and Lifestyle surgery (where a co-payment is required). It also doesn’t apply to Dental Cover and Worldwide Travel Cover, where a different excess may apply.
The excess doesn’t apply to some benefits - Vitality GP, NHS Hospital Cash Benefit, Childbirth Cash Benefit and Lifestyle surgery (where a co-payment is required). It also doesn’t apply to Dental Cover and Worldwide Travel Cover, where a different excess may apply.
What is underwriting?
Underwriting means we look at your age, medical history and any previous claims. There are three options:
- With full medical underwriting, we’ll ask you questions about your medical history. We might exclude some pre-existing conditions from your cover.
- With moratorium underwriting, any conditions you had in the past five years won’t be covered at first. They will become eligible once you have gone two years on cover without needing any treatment, medication or advice for that condition.
- Continued Personal Medical Exclusions (switch) Underwriting carries over existing exclusions from your previous insurer. We may add more personal medical exclusions.
What's a personal medical exclusion?
Any exclusions we apply after underwriting are personal medical exclusions. If we apply a personal medical exclusion to your cover, we also exclude any related conditions.
What if I have a pre-existing condition?
In most cases, our plans will only cover you for new conditions that develop after your plan start date. If you have any personal medical exclusions, we won’t cover them.
What support do you give me if I get ill?
Our plans offer a range of support, including fast access to consultants, diagnostic tests, your choice of hospital and more. Our Vitality Care specialist team are also on hand to help with severe cases. For claims like cancer, they’re happy to explain any part of your plan and help you understand any medical advice. We’ll help you get the best from your plan.
What costs are there with private health insurance?
How do I buy private medical insurance?
There are three ways to get our health cover: You can buy health insurance online, call us; or talk to an independent financial adviser.
How can I reduce my premium?
You can pick a higher plan excess . You can also save on your renewal premium by doing healthy things to raise your Vitality status.
Will my premium change?
Yes, your premium will go up each year based on your age and medical inflation. Claims can affect your premium, but our unique approach means that if you make a small claim, it’s a smaller increase.
If you don’t claim, your premium only rises in line with age and medical inflation. If you improve your Vitality status, you can reduce this even further.
If you don’t claim, your premium only rises in line with age and medical inflation. If you improve your Vitality status, you can reduce this even further.
Does it affect my cover or renewal premium if I claim?
If you make a claim, this may reduce the amount of cover available to you in the rest of your plan year. If you renew, your cover limits will go back to their full level at the beginning of the following plan year. Making a claim may also affect your renewal premium for the following plan year.
What happens when my plan comes up for renewal?
When your renewal date approaches, we’ll send you renewal documents which let you know your premium for the next plan year. If you want to carry on with your cover, you don’t need to do anything.
What do I do if I'm leaving my company plan but want to keep my cover?
If you tell us within 30 days of leaving your company, you could maintain your cover on a personal healthcare plan. Your premium could change each year as a result of your age, and the cost of providing healthcare. Your claims will also affect your renewal premium, but you can reduce this increase by improving your Vitality status.
Can I cancel my plan?
You have 14 days from your plan start date, or from when you receive your plan documents, to cancel your plan. You’ll then receive a full refund of your premium (if you’ve not already made a claim).
If you cancel your plan before the end of the 12 month term, we reserve the right to charge an administration fee of £40. Once your cover ends, we won’t pay for any more treatment after that date.
If you cancel your plan before the end of the 12 month term, we reserve the right to charge an administration fee of £40. Once your cover ends, we won’t pay for any more treatment after that date.
How do I claim on health insurance?
How do I make a claim?
Find out how to make a claim with our guide here.
Which hospitals can I use?
If you are a member, you can find your hospital option and more information on your health section in Member Zone. Your consultant may refer you to a private hospital for diagnostic tests or a scan. Please check the hospital they send you to is eligible under your plan. If you decide to go to one that’s not on your hospital list, you’ll need to pay 40% of the cost, excluding your consultants’ fees.
Do I need to pay anything towards my treatment?
In most cases we’ll pay the healthcare provider direct. If you have an excess on your plan, you’ll have to pay this directly to the provider. We’ll let you know exactly when you need to pay this.
How do you deal with chronic conditions?
What is a chronic condition?
A chronic condition is a disease, illness, or injury that has at least one or more of the following characteristics:
- Ongoing or long-term monitoring through consultations, examinations, check-ups, and/or tests
- Ongoing or long-term control or relief of symptoms
- Rehabilitation or for you to be specially trained to cope with it
- Continues indefinitely
- No known cure
- Comes back or is likely to come back.
What happens if I develop a chronic condition?
We’ll pay for any consultations and diagnostic tests to find out the cause of your symptoms, providing your plan covers them. We’ll also pay for any initial hospital treatment you need to stabilise your condition. We’ll talk to you and your GP or consultant if your treatment is keeping your symptoms in check. We’ll ask for your consent first. If we decide to withdraw cover, we’ll always take your current circumstances into account. We’ll never withdraw cover without giving you a reasonable amount of time to make alternative arrangements.
What happens if my condition gets worse?
If you have a chronic condition, it doesn’t mean we’ll withdraw cover forever. If your condition gets worse and it’s not part of the normal progression of the condition, we may cover your treatment.
Ready to apply online?
Call us on 0808 274 1902
Or ask for a call back and we’ll get in touch at a time to suit you.
Lines are open:
Monday to Thursday 9am-6pm, Friday 9am-5pm, Saturday 10am-2pm
Sunday and bank holidays: Closed