Private Medical Insurance (PMI)

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Private Medical Insurance (PMI)

Private Medical Insurance is good for your business

Did you know over 137 million days were lost to sickness absence in the UK in 2016? And the number of NHS patients waiting over 18 weeks to begin treatment increased to 9.4% in Sept 2016 – that’s more than 348,000 .

Investing in Private Medical Insurance (PMI) for your workforce can be a sound business decision as well as a commitment to staff welfare. It helps your team beat NHS queues, get better and back to work.


What is PMI?

PMI provides a greater degree of flexibility in healthcare, providing quicker access to treatments and a wider selection of care locations, specialists and treatment facilities. It can supplement the services and care of the NHS, which can benefit both individuals and businesses.

Individuals can take out PMI for themselves and their families, and are important for sole traders who cannot afford to miss work due to lengthy NHS wait times. For company schemes, employers cover the cost of the policy and can designate the range of cover.  For example, a business may choose to provide its employees with a major medical expenses policy that would cover only surgery. Company-paid plans can help reduce absenteeism costs and attract top performers. Finally, Group PMIs involve a collective of individuals who belong to a shared organisation, such as a trade union, who pool their resources and purchase a policy for everyone in the group.

Each PMI scheme eliminates risk, provides policyholders with peace of mind, and lets them choose their own cover limits from the following:

Premier or comprehensive plans offer the broadest range of cover and have the fewest restrictions on how large of an amount can be claimed. 

Standard plans are less expensive but impose limitations on what can be claimed such as the annual amount claimed and the number of days used for treatment

Budget or six-week plans are the cheapest and provide policyholders with limited cover dictated by exceptions. They typically restrict cover to the more important or expensive types of treatment. 


What Does PMI Cover?

PMI exists to provide a method to pay for the customised treatment of short-term, curable conditions. In general, most policies do not cover chronic illnesses, such as diabetes and multiple sclerosis, nor medical expenses for routine pregnancy and childbirth. The following can also be covered:

Inpatient hospital charges

Inpatient specialists’ fees

Outpatient charges

Home-nursing charges

Cancer drugs not covered on the NHS

Cash benefits, if the received treatment is free of charge under the NHS

Minor surgery carried out by the policyholder’s GP

Private ambulance

This list is not comprehensive but highlights the most common treatments and services that are covered.


What Does PMI Exclude?

PMI was not designed to address all of a policyholder’s maladies. Instead, there is a specific structure to identify what is covered. Here are some exclusions that are typically present in all PMI policies:

Pre-existing conditions

Superfluous cosmetic surgery

Drug or alcohol abuse treatment

Hormone replacement therapy and gender reassignment

Elective termination of pregnancy and vasectomy/sterilisation  

Maternity cover 

While this list is not reflective of all treatments and services that are generally covered, it does highlight the most commonly excluded.

PMI provides policyholders with the freedom to choose when, where and how their maladies are addressed. Contact Prima Protect today to discuss how a PMI policy can benefit you and your dependents or employees.

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