We all get concerned for that day when we might face an unexpected medical emergency. Many take out private medical insurance to ensure they get access to quality treatments and care should they suffer a sudden condition.
However, there seems to be a blind spot in how insurers handle emergency care should you need immediate assistance. This guide will help prospective policyholders understand how emergency care works in private medical insurance.
Many prospective policyholders research a health insurance plan and wonder why they have trouble finding components that cover emergency care. After all, unexpected illnesses and injuries are a primary concern for those who want costs
covered for private health care.
Generally, insurers will not cover the costs of emergency care. The policies exist to help protect private health care costs for those concerned about sudden illness, injury, or medical condition. But there are reasons
why policies don’t pay out for emergency care.
We can explain by breaking down the definition of emergency care.
Emergency care is urgent medical attention that treats patients before entering the hospital to stabilize their conditions. The most common emergency scenarios are those who have had an injury or struggle with a
sudden illness with no immediate diagnosis.
Either the patient will take themselves to an A&E (accident and emergencies) or get transported by an ambulance. Emergency treatment will usually take place in an NHS hospital.
Private health insurers don’t cover emergencies given the sudden and sometimes complex conditions. However, that doesn’t mean that private medical insurance doesn’t help should you face an emergency medical situation.
Emergency care costs in a private hospital do not get covered. You will likely find yourself in an NHS hospital. But there are many situations in the medical facility that can make your emergency stay more comfortable than a standard
Once your condition is stable, you can move to private rooms, seek advice from specialists, and get advanced medicines not usually available on the NHS. That coverage can serve as the difference to a more speedy
recovery or assurance that you’ll get well looked after in the event of a medical emergency.
So how does private health insurance work in an emergency?
We compare plans from the leading health insurance providers
There are varying scenarios of what will happen should you have private medical insurance in an emergency. It depends on the coverage level, but we can outline a general emergency event with private health insurance.
Should you suffer an emergency illness or condition, the policyholder will contact emergency services to take them to an NHS hospital, or they will take themselves if able. After your condition is stable, your private medical
insurance may cover the costs of a private room, quicker treatments, and advanced medicines.
In some instances, you’ll be able to transfer to a private hospital for treatment or operation should your insurer sign this off from your policy. The costs will get covered by the insurer pending your level of coverage.
It’s vital to remember that insurers can differ in covering emergency health scenarios. Discuss your policy with your provider to get a clear understanding of how it covers emergency scenarios.
We’ve established that a private medical insurance plan will not cover emergency medical services because of the NHS presence. However, you may wonder if there are alternatives to NHS A&E as private hospitals are your preference.
The NHS is an excellent service and is free, which is a positive. But there are instances where the emergency units may see high volumes of patients, which might cause concern. You may not get caught immediately or have access to
treatment right away.
Private hospitals have walk-in urgent care centers that patients may visit in an emergency. Though it’s important to highlight that these services are not free, neither are the costs covered by private medical
insurance. The units also may not be open 24/7 like NHS hospitals.
The urgent care centers are likely to offer diagnostic tests and emergency treatment much quicker in a more comfortable environment. They are ideal for minor cases of illness and injury. But should the condition be significant or
life-threatening, the NHS A&E would prioritize your case, putting you at the top of the list in any case.
So what about private ambulances? Are they covered should you need urgent care?
There are instances where your insurer will pay for a private ambulance to take you to and from the hospital. However, emergency ambulances fall under emergency care and do not get covered.
The most common scenario where a private ambulance gets covered by your policy is transferring an NHS hospital and a private one. You’ll get stabilized at the public facility and moved to a private one for treatment.
Not all insurers offer private ambulances in policies. Should they do, the services are usually part of the more comprehensive coverage plans. Please speak with your insurer to understand whether they get included in your policy.
So, let’s summarize emergency medical care should you have or consider a private health insurance policy.
Emergency care does not get covered by most insurers.
Once stabilized, your private health insurance can make your emergency care more comfortable.
That includes a private room, treatments, and access to drugs unavailable on the NHS.
In case of an emergency, you will contact emergency services on the NHS to take you to the hospital.
Private hospitals have urgent care centers, but you will have to pay for these.
Private ambulances may get covered for hospital transfers, but not in an emergency.
A health insurance policy compliments care in an emergency but do not replace the NHS.
Should you have any questions, queries, or concerns about how your private medical insurance handles emergency care, get in touch with your insurer or broker. They will guide you on what happens should you face a medical emergency and
how the policy helps your condition.