Entries in category PMI

Vocational Rehabilitation

Vocational rehabilitation is a process of rehabilitating people who have encountered life changing injury due to any accident or trauma in their life.  The rehabilitation centers are available all over United Kingdom to help the patient reach their goal of rehabilitation. A research conducted independently shows that about 91% of the people complete their program completely and out of which 56% are back to work or ready to work while 35% of them actively seek for jobs. The vocational rehabilitation service has some key principles to be followed:

  • There is a need for the people to intervene early so that people can be saved from losing their work or can get back to work easily and early
  • The vocational rehabilitation centers should provide case management service of good quality for those who need help in the professional front.
  • These centers should understand the importance of social-bio and psycho approach of understanding people’s need to get back to work.

The main job to identify people who need vocational rehabilitation is that of the employer. This is very important to correct sickness and act on it proactively by providing flexible working hours which will be cost effective as well as effective. The various techniques to be used in the vocational rehabilitation include:

  • Appraisal, assessment, evaluation of program and research
  • Setting of goal to rehabilitate vocationally
  • To provide advice on health and promotion so as to support the people to return to work.
  • Giving career counseling, providing placement services, providing job analysis and job development.
  • One of the most important techniques is evaluation of functional and work capacity.

There are various groups of people who provide for vocational rehabilitations and include:

  • Physiotherapists
  • Occupational therapists
  • Psychologists
  • Disability management advisors
  • Case managers
  • Job centers along with personal advisors and
  • Employment support workers.

A skilled workforce is required to provide a well-structured and useful vocational rehabilitation provisions. The help of employers, occupational health professionals and human resource management is providing better and useful vocational rehabilitation services. Employers should take special care in providing an environment which is good for the mental as well as physical health of the employees. Most of the mental health problems are work related and hence it prevention at the work place itself will help a great deal in vocational rehabilitation process. Vocational rehabilitation is very necessary in today’s stressful life.

Private Medical Insurance

United Kingdom is one of the very few places in the world where there is facility of Universal health services for free. So, it is definitely a big question as to why a person will like to have private medical insurance. However, a survey conducted by Max Bupa says that the main reason as to why people go for PMI is to avoid long and hectic waiting list and also to ward away superbugs like MRSA and to make sure the hospital they get the treatment in is clean. PMI helps the insured in avoiding the long waiting list of NHS and the consultation or any other short term treatments is done on fast track. You have the facility of getting treated in any NHS hospital or private hospital with this coverage.

The Private medical insurance covers general treatments including consultations, surgery, hospital care and nursing facility but does not cover any kind of addiction or incurable diseases. There are a few policies like comprehensive policy that gives you some additional services like coverage for personal accident or complementary medicines. There are two kinds of terms and conditions called moratorium and fully underwritten.

  • In case of moratorium there is just an exclusion of coverage for pre-existing condition that too which has been there for a set years.
  • In fully underwritten plan you need to disclose the whole medical history so that they can decide on what will be covered and what won’t be covered.

Certain things that must be kept in mind while taking a private medical insurance are:

  • That PMI does not cover all the diseases or the services that is provided by NHS. For example PMI does not cover accidents or any emergency treatments.
  • If suffering with any serious illness, NHS will give you faster and better treatment then through PMI.
  • It is not that the treatment provided through PMI will be without any constraints and you can get the treatment anywhere you like. Read the documents carefully before taking any plan.
  • Through PMI it is not necessary that you will get treated at a private hospital. There are all the chances of you ending up in a NHS hospital ward rather than in a private room.

Taking up PMI is not essential and can be the last thing in your priority list. However, taking up PMI does give you the peace of mind and is a good investment if you have surplus money.

PMI Mini FAQ

When you plan to take up a private medical insurance, many questions would pop in your mind before you take up a plan. These question need to be answered so that you can make the right decision. Many of the insurance website has put a FAQ page which answers all of the most commonly asked questions by the customers. If still some of your questions are left unanswered then you can always ask the insurance agent to clear all the doubts. Some of the frequently asked questions regarding private medical insurance are:

  • What is PMI or Private Medical Insurance?
    Private medical insurance allows you to get immediate and treatment in private hospital. It helps you avoid the long waiting list of NHS. The policy is designed such that it covers the treatment of any acute condition after the policy starts. Acute illness is defined as a disease condition which can be treated and the patient can return back to his normal health condition after the treatment.
  • Through PMI can the insured use hospital that he wants and the time he wants?
    The private medical insurance allows you to get treatment in private hospitals. However, there is no surety that you will land up in a private room of a hospital; you may be admitted in the ward of NHS hospital. Well! Most of the companies have a list of hospitals and clinics where you can get prompt treatment and at the time convenient to you.
  • What is excluded from the policy?
    Most of the policy provides its customers the facility to treat acute conditions once the policy term starts. The policies from different companies have their own exclusions and once you going through the documents provided by them will come to know about it. If the company asks for medical reports of the person getting insured then it may add limitations to the benefits provided by them.
  • Is PMI offered to persons with pre-existing conditions?
    Yes! Most of the companies do offer insurance to people with pre-existing conditions but do put some limitations. Some of the policies do exclude all the pre-existing conditions to be covered for the first two years of the insurance.          If the patient passes the two year period without occurrence of pre-existing condition even once then the whole policy is reset and the any occurrence of the pre-existing condition after two year period is considered as a new claim.

PMI FAQ

UK is one of the very few places which provide medical service is provided for free and hence the need for medical insurance is not required. However, in UK people take up private medical insurance to avoid the long queue of people waiting to get the service done. PMI helps the insured to get the medical service provided promptly and in a private hospital as well. However, one should go through the document and the term and conditions laid by the company very carefully as not all the medical services are covered by PMI like, emergency service or any incurable diseases. When you plan to take up a PMI lot of questions may arise in your mind which needs to get answered. Most of the companies have FAQ page which will answer most of your queries and the one which are left answered can be got from the agent of the insurance companies. A few of the frequently asked questions and their answers are mentioned below:

  • What is PMI or Private Medical Insurance?
    PMI or private medical insurance is a health insurance policy which allows you to get prompt medical treatment for acute conditions without waiting in the long queue of NHS health services. However, PMI does not replace all the medical services covered by NHS and hence one should be very careful and read all the documents carefully before taking up the plan.
  • What is meant by acute condition?
    Acute medical condition is a condition which occurs suddenly and can also be treated completely and that too quickly. For example if you broke your leg. You can easily go to a private hospital and get admitted in a private room and get all the treatment until you are back on your feet or job.
  • What is meant by chronic medical condition?
    A chronic medical condition is one in which the patient is affected by the disease for long duration of time and there is sheer chances of the symptoms recurring. Unlike acute condition it cannot be treated quickly.
  • Acute condition – can it be considered under pre-existing conditions?
    Many insurers do not cover for the acute condition that arises due to a pre-existing condition. An example for the same is that if an acute condition arises if the insured has diabetes, it will not be covered by the insurer. You can get Private Medical Insurance if you are disables but any illness that arises due to disability will not be covered by the insurer. However, the insurer will have to show that the restriction imposed by them for not covering any illness due to disability is not unreasonable and unfair.
  • What all illnesses are considered pre-existing?
    Any illness that you are having before taking up the PMI policy will be considered a pre-existing illness or condition. The most common pre-existing conditions are cancer, heart diseases and diabetes are the most common pre-existing conditions but some policies also cover serious asthma, hay fever and high cholesterol as pre-existing condition.
  • Is private medical insurance provided to people with pre-existing condition?
    Yes! PMI is offered to people with pre-existing conditions but not without limitations. Some companies do not cover any pre-existing conditions while some may cover it with some limitations. A few companies may allow coverage for pre-existing condition if the symptoms of the disease do not occur for a set period of time, say for 2 years and after that the claim for the disease may be covered as a new claim. However, most of the policies never cover cancer if it is pre-existing and hence it is advised that you ask your broker to get the right policy for you.
  • Under PMI will I be covered for drugs and prescriptions related to pre-existing condition?
    No, generally the insurer does not cover for drugs and prescriptions arising as a result of pre-existing condition. There is an option of you going for health cash plan which is not insurance but is a help towards the expenses incurred due to treatments and prescriptions.
  •  Other than pre-existing conditions, will I be covered completely?
    Any acute condition that may arise as a result of pre-existing conditions will not be covered by most of the companies. However, any other disease condition which is not related to pre-existing condition will be completely covered as it would cover for any normal insured person.
  • Will the premium for PMI be more if I have a pre-existing condition?
    No, generally the premium would be the same as it would have been without pre-existing condition. However, the benefits of the insurance will be with some limitations. One should keep in mind that the premium for PMI will increase with time and is not only for people with pre-existing condition, but because of the new technologies, inventions and discoveries in medical field.

PMI Costs

In United Kingdom where the universal health services are for free, private medical insurance is a luxury and not a necessity. There are mainly three reasons as to why a person would take up private medical insurance in UK. The first and foremost reason is that he wants to jump the long queue to get treated for any non-urgent treatment of a disease. Secondly, to choose who, when and where to get treated and last but not the least to enjoy the comfort and convenience in getting treated in a private hospital and in a private ward. The PMI allows you to get treated in a hospital of your choice and at a time convenient to you after a referral from your general physician but this comes with a high price tag. The PMI’s are very costly.

A comprehensive medical plan is very costly and considered a luxury and believed to be taken by only affluent people or those who are lucky enough to get through their companies. However, recently some of the leading insurers have come up with policies that are low costs and is within the reach of general people who would like to have PMI but without paying much price for it. However, most of these plans are designed as to complement the services provided by NHS rather than a total alternative of it.

The policies are of two types:

  • Comprehensive plans are designed so that it is affordable to many. However, the insurers cut on various cover options to cut down the premium. The policy holders or one looking for it should go through the terms and conditions carefully to know what is covered and what is not.
  • Standard plans are expensive and may cover all or most of your medical needs.
  • One should know before taking a PMI that they will not be covering emergency services and a few services of the sort.

There is a way one can cut the premium cost and this is by having an excess. Say for example if a 46 year old healthy person looks for PMI the premium would be say GBP 95.75 for an insurance company named AXA and its PPP’s Standard comprehensive plan. With an excess of GBP 100 your premium amount may decrease to GBP 88.32 and for GBP200 excess it will cut down to GBP 80.87 for a month. Such kind of offers are made by many insurance companies and you need to shop around to get the one which suits your needs the best.

Medical Underwriting

Medical underwriting as the name suggests is a term used in the health insurance and refers to the use of health and medical information of the person to allow or deny the coverage after the evaluation. One of the important roles of medical underwriting is that it is used in deciding whether to provide the coverage or deny it, it also helps in deciding the premium to be taken for a policy. The health insurance underwriting helps the insurer to know about your pre-existing condition that you have or had in tha past and how to cover it. This helps the insurer to deny any claim to be made for an ailment that has happened in the past. Health insurance is coverage for any ailment in the future and not that has happened in the past.

Medical underwriting is of two types:

  • Moratorium Medical Underwriting and
  • Full Medical Underwriting

Moratorium medical underwriting is one in which the person seeking coverage does not need to provide any kind of health information. However, the insured will have to accept that any condition for which he has been treated in previous 5 years will be excluded from their policy as covered. Thus it is the best policy if you never had any kind of ailments or have a history. In case of full medical underwriting the person looking for coverage has to give a full medical history of his and may have to answer a lengthy medical questionnaire which would generally be a part of the application. The insurer will go through this information and then decide on what to be covered and what need to be excluded. This is generaly considered good for those people who have a pre-existing condition and want to clearly define their condition and exclusion if any.

The advantages of Moratorium underwritings are:

  • It helps in quickly setting up a policy as no medical information is required
  • If the insured does not have any medical history for 5 years it will not have any exclusions
  • It allows coverage for pre-existing condition if no symptom or treatment for the same happens in two year period after the star of the policy.
  • The Advantages of Full Underwriting are:
  • It is very transparent as it allows you to know beforehand whether a particular ailment will be covered in your policy or not
  • You can have coverage for minor ailments even if you have suffered it in 5 years’ time.

Critical Illness Insurance

Critical illness insurance provides insurance to the insured against any defined critical illness disease mentioned in the policy. The policies do offer life and critical illness coverage combined. Not all the insurance coverage covers all the critical illness conditions, however, the guideline in the industry say that if you have to call yourself a critical illness insurance company you have to cover,

  • Cancer- it should cover only the advanced cases of cancer
  • A severe case of heart attack
  • If stroke causes permanent symptoms in the patient

However, most of the policies cover for more of the critical conditions than just the above three. The basic plans for critical illness insurance also cover for major organ transplants, coronary bypass surgery, kidney failure and multiple sclerosis. If you take up some of the comprehensive plans it may cover some of the serious conditions which include permanent loss of hearing, loss of sight or any kind of permanent of disability. Some of the critical illness insurance policies do cover for the loss of limb.

Before taking up critical illness insurance one should know that not all critical illnesses will be covered and only those mentioned in the policy or the disease which qualify as critical as per the definition in the policy will be covered. It means that even some form of cancers which do not qualify as severe will not be covered. Some of the disease condition as per the policy may not be covered if you have reached certain age. For example, Alzheimer’s disease won’t be covered for people in whom it has been diagnosed after the age of 60.

A few other conditions which will not be covered by most of the critical illness insurance include:

  • Any injury caused by the self
  • Use of drugs or alcohol
  • If you flying privately, means for normal passenger flights it will be covered
  • If you are hurt while engaging in dangerous sports or any such kind of time pass
  • HIV is also not covered by most of the policies until unless it has contracted due to blood transfusion or due to any kind of physical assault. It may be covered if HIV was due to working at an emergency service, armed forces or any medical profession.

Only a few policies payout as soon as a disease is diagnosed and most of them require the insured to survive for 28 days with the disease.

Advantages of Private Medical Insurance

In UK the universal medical services are free and NHS provides the service for free. However, the patients have to wait in a long queue to get the treatment done. New advances in the medical science and new technologies are no doubt prolonging the life but it is becoming dearer is also a fact. The growing population and also people living longer are putting extra pressure on NHS.  People are now opting for private medical insurance. Private medical insurance in UK is not a necessity; however, listed below are a few advantages of having a PMI:

  • No waiting in the queue – The waiting time between referral and treatment have now decreased to 18 weeks at NHS. However, with PMI you will not have to wait and can get immediate treatment for an acute medical condition.
  • With PMI you can have peace of mind that in the worst situation when you need immediate attention you do not have to wait and can get admitted to any private hospital as referred by your physician. Many people in UK take up PMI as a result of the issues of MRSA in NHS hospitals.
  • Freedom of making a choice- At NHS you does not have a choice of selecting your facility or the consultant. However, with PMI you have the freedom of choosing your own hospital and consultant to get the treatment for your ailment. However, some policies do have restricted lists of facilities where you can get the treatment.
  • Get Private Room Facility – In NHS you may end up in a mixed-gender ward. However, based on your plan you can avail a private room with ensuite bathroom if you have a PMI.
  • With PMI you do not have restriction on the visiting hours in the hospital
  • Personal care will be provided to you and will not have medical students attending along with the consultants to read your medical condition.
  • There will be continuity in your treatment as you will be treated by the same consultant throughout your ailment or stay at the hospital.
  • Your insurer may provide you with a team of doctors that specializes in the treatment of a particular disease like an oncologist and his team for treatment of cancer to provide you the necessary advice.

There are some cons as well of having PMI and you should weigh benefits with disadvantages before taking up any PMI plans.