Frequently Asked Questions

How are PatientChoice Policies different from other medical plans?

PatientChoice policies put you in charge of your healthcare, giving you choice and control, when you require an operation or medical procedure.

Armed with a budget of money to spend policyholders needing an operation or medical procedure can choose to have private or public medical care and be rewarded no matter what the choice - with money to pay for care if private treatment is chosen or a cash lump sum if the NHS is used.

In addition, PatientChoice provides, at no extra cost, a treatment sourcing service to do all the work for you such as finding a specialist, organising appointments and even arranging admission to a private hospital

Who can enjoy the benefits of PatientChoice?

  • You may join PatientChoice if you are between the ages of 18 and 80 and providing you are a resident in the UK for a minimum of 180 days a year. Applicant's children may be covered providing they are between the ages of 1 and 21 years (or 25yrs if they are still in full-time education).
  • Newborn children can be added to the policy on their first birthday.
  • Once you're a member, you can stay covered for the rest of your life even if you are over 80.

What is not covered?

The Hospital Treatment Plan

The Hospital Treatment Plan does not cover accident and emergency care, pregnancy-related procedures, organ transplants or the cost of cosmetic surgery. The cost of consultations, CT, MRI or PET scans aren't specifically covered, however, the policy benefit will likely help contribute towards associated costs should you need an operation.

PatientChoice Access

PatientChoice Access does not cover accident and emergency care, pregnancy-related procedures, organ transplants or the cost of cosmetic surgery. The policy provides additional cover for consultations, CT, MRI and PET scans up to the policy limits. Please note that there is a £100 excess per person per year in this section.

Do you take into account my medical history?

If you are taking out a medical insurance policy for the first time our policies are offered on a moratorium basis This means that any conditions that existed in the three years prior to you becoming a PatientChoice policyholder will not be covered until you have had a two year symptom-free and advice-free period as a PatientChoice policyholder. This approach means that we will only consider your medical history when you need to make a claim, saving time and effort when you apply and allowing you to become a PatientChoice policyholder with the minimum of fuss.

How does a moratorium work in practice?

The following examples are designed to aid your understanding of moratorium underwriting.

Example 1: A one-off pre-existing condition that will be covered after 2 years
Mrs Jones, aged 45 years, had an ovary removed 2 years ago and now wishes to become a PatientChoice policyholder. Since her operation Mrs Jones has had no further follow-up from her gynaecologist nor seen her GP for ovary related advice, nor had any symptoms related to her original ovarian problem.

In this instance Mrs Jones will not be covered for anything related to ovarian problems for the first 2 years of the policy.

Example 2: An on-going pre-existing condition that will be covered 2 years after treatment/follow-up is complete
Mr Willis, aged 55 years, had bowel cancer diagnosed and treated 4 years ago but has 6 monthly follow-up specialist reviews to check he has been cured. His last check up was 1 month before becoming a PatientChoice policyholder.

In this instance Mr Willis will not be covered for anything related to bowel cancer for the first 2 years of the policy. But if Mr Willis has another routine check up for bowel cancer 5 months after joining PatientChoice then he will have to wait a further 2 years from this last consultation date before any procedure related to bowel cancer can be covered.

Example 3:
Mr Simpson, aged 67, has high blood pressure and raised cholesterol. He takes medication for both conditions and this controls both the blood pressure and cholesterol levels.

In this instance Mr Simpson will never be cured of his condition and will always require treatment to control it. As a result it is very unlikely that he will ever be covered for conditions related to high blood pressure and cholesterol problems, such as heart and vascular treatments.

Will the benefits be sufficient to cover my costs if I need a procedure?

PatientChoice has been designed to cover the costs of most common medical procedures.

In general terms, a patient needing a procedure costing £5,000 will usually be given a benefit of £6,000 to make sure the cost of the procedure is sufficiently covered. All of the procedures covered are banded into 9 different benefit categories ranging from £750 to £25,000.

There can be no guarantee that the benefits offered by PatientChoice will cover the cost of your procedure but the benefits have been designed to do so. If fact, the average amount of money left over from the budget after private treatment is more than 1 £500.

If the cost of the procedure is more than the benefit entitlement then you will be responsible for paying any top-up required yourself. But by using the fixed-price approach negotiated by yourself or our treatment sourcing service on your behalf, you should know before you have any treatment what the cost will be and what your top up will be if required. In addition as PatientChoice is about 'choice' you can always revert to treatment in the NHS and receive cash if you do not want to pay a top-up. 1. Based on claims data up until end Dec 2005.

What if I suffer complications while having an operation and need further surgery at the same time?

As many policyholders will be having private treatment under a "fixed-price" package, any complications will be covered within the fixed-price quote.

If policyholders are not having their treatment under a fixed price package, PatientChoice will provide cover for the extra procedure providing it is an operation that we would otherwise provide a benefit for as per our schedule of procedures.

Are there any restrictions on where I can get treated?

Policyholders are free to obtain treatment at any hospital in the UK or private hospitals abroad as agreed by PatientChoice.

Where can I get further details from?

PatientChoice products can be bought directly from us. All you have to do is telephone 0800 012 2000 for an application pack. Alternatively you can purchase PatientChoice through most insurance intermediaries and Independent Financial Advisors (IFA's).