Health Insurance – It's Important To Know What's Not Insured!


Around 7 million people in the UK are covered by health insurance, the majority being covered through their employers. The problem is that few have really studied their policy documents and many misunderstand what is covered. And perhaps just as important, what isn't. If you expect health insurance to pay all your health costs, you're mistaken.

Health insurance is designed to provide protection for curable, short-term health problems and allow policyholders to jump the NHS queues to see consultants, be diagnosed, receive surgery or be treated. That sounds fine, but before you buy you need to appreciate the treatments and situations that fall outside the scope of the cover.

But first a word of warning. This article does not relate to any specific policy and the terms and conditions issued by individual insurers do vary. So please ensure you also check your policy documents. After reading this article, you'll know what to look out for!

Sorry – it's a chronic condition

If a condition can be cured and is not a long-term problem, your insurance company will classify it as acute and should meet the cost. If your problem is incurable or it's a problem that, despite appropriate treatment, will be with you for a long time, then your insurance company will classify it as chronic - and no, you won't be covered.

But drawing a firm line between what is acute and what is chronic is fraught with problems, and leads to the biggest area of conflict between insurer and policyholder.

Everyone agrees that diabetes and asthma are chronic conditions as you're likely to suffer from them for the rest of your life. So those sorts of condition are not covered.

Problems arise when the medical team initially considers a patients' illness to be curable, but the condition subsequently deteriorates and the doctors change their mind, it's now become incurable. This can happen especially in the treatment of some types of cancer.

In these circumstances, the condition is initially defined as acute and is therefore insured, but deteriorates and becomes chronic - and outside the terms of cover. This is possible as insurers retain the right to reclassify a condition from acute to chronic during treatment.

Sorry - it's too long term
The insurance company will not pay out for long term treatment. But you need to check your policy documents to see how they define “long-term”. You can find the situation where a course of drugs extends for say 12 months, but the insurer will only pay for ten months.

Sorry – it's preventative
Your insurance is designed to pay for the treatment and cure of conditions when they arise. It is not designed to pay for treatments that are used to prevent an illness.

Again, the problem of definition arises. Sometimes it is arguable whether a treatment is preventative or a cure. Take the drug Herceptin for example. This drug can be used in the early stages of breast cancer. Research shows that Herceptin can halve the incidence of cancer returning for women who have a particularly virulent form of the cancer known as HER2. In this situation, is Herceptin offering a cure or is it a preventative?

Insurance companies are split on the debate. Norwich Union, WPA, BUPA and Standard Life Healthcare will pay for Herceptin for HER2 patients whereas Legal and General and Axa PPP will not.

Sorry – the drug is not approved
Two of the main attractions for taking out health insurance are: to jump the queues at the NHS, and to get the latest treatments and drugs. But there's a rider.

Unless the drug has been approved for use by the NHS in England and Wales, by the Institute for Health and Clinical Excellence, your insurer is unlikely to approve its use. The problem is that the Institute's brief is not simply to decide whether a drug works, but to carry out a cost/benefit analysis to ensure that the benefits to the nation outweigh the financial costs of using it in the NHS. Not an easy brief - and one that has placed the Institute under scrutiny for the extended delays in drug approval.

The compromise hit on by the Financial Ombudsman is that if a health policy won't pay for the use of experimental treatments, then it should meet the cost of an approved conventional treatment with the policyholder footing the bill for the balance if the experimental treatment is more expensive.

Sorry – it's a pre-existing condition

The basic principle is that if you are already suffering from a condition when you start a policy, then that condition “pre-exists” the policy and any claims for its treatment are invalid.

For this reason, insurance companies insist you complete an exhaustive questionnaire before they agree to insure you. After all they need a clear picture of your medical condition before they quote. For many applications, the insurer will, with your approval, also write to your GP for specific details of your medical history. They like to have a complete picture.

So lets say some years ago you injured your knee playing football. It appeared to recover but now it turns out that you have a torn cartilage and need an operation. The insurer could argue that this is a pre-existing condition and you have to pay for its' treatment.

Some insurers try to accommodate these grey areas with a moratorium provision within your policy. These provisions typically say that so long as you have been symptom free for two years relating to any condition you've suffered from within the last 5 years, then they will pay for subsequent treatment. Not all policies have these moratorium provisions and the time periods do vary between insurers. You should carefully read your policy.

Sorry – its not covered

Health Insurance is an annual contract – just like your car insurance. So when it comes to renewal, your insurer is at liberty to review not only your premium but also change the conditions on which your cover is provided.

Therefore, if your policy comes up for renewal mid way through a course of treatment, it's possible to find that your new policy no longer covers that particular treatment. This means that you will have to foot the bill for the balance of the treatment.

Furthermore, with ongoing advances in medical research, more and more conditions are becoming treatable. This progress has the effect of shifting back the dividing line between chronic and acute conditions.

This hits the insurers' pocket in two ways. With more conditions being reclassified as acute, the number of claims is increasing. And there's also a trend for new treatments to cost more – Herceptin being a good example. The net result is that the insurers are finding themselves having to pay out far more. This is inevitably passed back to you through increased renewal premiums. And in an attempt to reduce their risk exposure, insurers have a tendency to adjust their definitions and exclusions. This means that you must read your renewal notice closely before you decide to renew.

So when you are considering Health Insurance, be aware that everything is not always black and white. And if you've got insurance and need treatment, always contact your insurer without delay and get them to confirm that your treatment is indeed covered


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Dental Insurance & Why It’s Important For Your Family


It may often go overlooked, but dental insurance is something that every individual needs to think about. In the event of a sudden toothache, the need for a regular checkup or cleaning and even possibly oral surgery, dental insurance is a must. Coverage is available from a variety of sources, including some employers and national insurance providers.

Dental insurance is more affordable than medical insurance and can often result in low monthly payments for those who have to seek out the coverage themselves. The amount of insurance that is selected will determine what type of deductible, if any, the patient is responsible for.

It may be surprising, but many people develop problems with their wisdom teeth. In the event that they do not develop as they should, they may become impacted underneath the gums and need to be surgically extracted. This procedure is very expensive and requires a certain amount of followup care, which can really add up without dental insurance. There are a number of other reasons that someone would unknowingly need dental care, including an accident that requires

Unlike life or health insurance, the cost of dental insurance isn’t particularly affected by age. While it’s true that a patient’s past oral health may be in question, it is much easier to get than other types. Prior to being accepted by a dental insurance provider, the patient may be required to undergo an oral checkup and x-rays in order to determine any previous or current conditions that may require treatment. In most instances, a new dental insurance policy will not cover previously known conditions. In other words, you could not find out that you have an impacted wisdom tooth and then sign up on a new dental plan to get the coverage for a procedure. The patient is required to disclose any previously known condition(s).

Dental insurance can be purchased as an individual plan or for the entire family. In order to make sure that a particular dentist accepts a specific dental insurance, the patient should inquire about the office policy prior making an appointment or arriving for treatment. The worst time to learn that a dentist doesn’t accept your dental insurance is after receiving treatment and immediately prior to getting the bill. In order to avoid the headache, make sure that the dentist will accept your provider’s coverage ahead of time. In some instances, insurance plans are only accepted at specific locations.


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Travel Insurance - is it important?


Before planning your summer vacations,think at great length if it needs to buy a travel insurance. There are situations that can make you cancel your ttravel,or to return to your house before time or to force to look for yore medical attention while traveling.





Travel insurance can give you extra protection that you needs. Before buying the cover, review the policy of your medical insurance or home, to avoid any confusion. For example, expensive articles like the camcorder, your personal computer or jewelry shop can be places setting by the insurance of your home, if they were robbed while in travels. In case that the airline loses your registered luggage, they have the obligation to reimburse your suitcases ( by a certain amount of money). Or if you become ill or suffers some injury while traveling, your personal medical insurance can cover the amount with your medical costs.





In agreement with the Magazine of the Consumer (Consumer Reports) travel insurance policy includes several types of protection. Be sure to read what it is written in the small letter: These establish if your travel insurance covers what you need. The policies and insurance agencies vary in their cover, so make sure to ask. Some of the different types of insurance available include:





Cancelación/Interrupción of Travel (TCI) - If your plans are altered suddenly and you must cancel or give by finished your travel before time, TCI will cover you by all this. But only it will reimburse you in case that you have a reason including in the list of the insurance, like for example, injury, disease, death or of a member of the family, of a partner or fellow traveller. Some travel insurance policies will include some reason for medical type solely and others will not cover preexisting medical conditions. It is important to read what it is written with the small letter.





Transfer by medical emergency - If takings vacations type venture or to moved away from a hospital center that counts the necessary thing yet, would be good idea to buy this type of cover. If the suitable treatment is not available in a local hospital,You will be transferred to the appropriate medical facility that is nearer.





Loss of luggage - This cover reimburses to you by the lost of one or damage to your luggage.Make sure to make a list of everything, because if you lose your suitcases, they will reimburse to you part of the content. BBB, altogether with the Magazine of the Consumer, advise the following thing to do:





Read what it is written in the small letter. Know exactly what type of cover is or is receiving.Considers to acquire travel insurance of a separate company, instead of buying it from your travel operator or cruises. Secure even more, paying with a credit card. The protection by loss of luggage is necessary solely if it takes in your suitcases, articles with a greater value to $2,500. Verify the policy of your house insurance .


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Life Insurance & Why It’s Important For Your Family


It’s sad to think about, but life insurance is something that everyone needs to consider. In the event of an unfortunate loss, an individual often wants to have the peace of mind in knowing that his/her family will be financially secure.

Life insurance can be obtained in a number of ways, including from a national insurance provider, various credit cards and/or certain employers. Depending on the amount of coverage, which is usually available in varying amounts, monthly payments will range from being affordable to very expensive. The amount of coverage that is selected will determine how much a family will receive if their loved one should pass away.

It is important for many individuals to purchase life insurance so that their loved ones will not have to worry about money in addition to being upset over their loss. When bills begin to come in and utilities are due, this can be a very difficult time for anyone who is also dealing with the loss of a family member. This is especially true if the loss was that of the family’s provider, which often means that little or no income will be coming into the household. A life insurance policy will help to ease some of that stress by providing financial help to the family that is left behind. In order to make sure the proper beneficiary is noted on any life insurance policy, the holder must make sure to provide all of the requested information to the insurance provider.

If life insurance is obtained when the policy holder is young, it will be very affordable. The more time that passes and the older an individual grows, the more expensive the policy will be. In addition, anyone with known health problems will likely pay a much higher life insurance premium if they are fortunate enough to find a carrier to provide them with a policy. As unfortunate as it is, many life insurance companies will not provide coverage to anyone known to be in poor health. The wellness, or lack thereof, relating to a patient will likely be determined by a mandatory physical. While not all carriers require this procedure, some will before confirming coverage. This is their way of making sure that the policy holder is in good health before issuing any type of coverage.

On a final thought to life insurance coverage, it is not a pleasant thing to discuss or even consider. It is, however, a necessary part of every family’s life.


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