In the current recession, healthcare insurance companies are offering excellent health insurance rates and you’ll find significant healthcare savings if you simply do some due diligence before you buy. In the current climate, the rising cost of going to hospital makes healthcare insurance the only viable solution for the escalating healthcare cost. 

If you are like most people, you are probably looking for an affordable healthcare insurance plan, or looking to at least get a better deal in order to reduce what you are currently paying.

Before you buy healthcare insurance, it is critically important to understand exactly what is covered under the policy. Unfortunately, some people don’t take the time to read the terms of their policy, and are under the mistaken impression that whatever they have taken out will cover all of their healthcare costs. It is very often not the case. This is why it’s important to read your policy documents carefully so that you know and understand exactly what is covered.

Justice is the insurance which we have on our lives and property. Obedience is the premium which we pay for it.

William Penn

Chronic Conditions

As long as there is a cure for the condition and it is classed as ‘acute’, your healthcare insurance provider is obligated to meet the cost of treatment. However, if your problem is classed as incurable or is a long-term illness, then your insurance company will most likely classify it as chronic – and you won’t be covered for that specific type of illness. Examples of chronic conditions include diabetes and asthma, because these are illnesses that are likely to remain with you for life.

Classifying other serious illnesses such as some forms of cancer can be a little more complicated. At the early stages of these types of disease, they may be classed as curable. However, as the condition worsens and it becomes incurable and therefore chronic, it falls outside the terms of cover. This is a very realistic scenario, as insurers retain the right to reclassify a condition from acute to chronic during treatment.

Long Term Conditions

Most insurance providers will not pay out for conditions that require long term treatment. However, you will need to double check your contract to verify their definition of the term “long-term”. For example in some cases, the healthcare insurer will only pay for nine months where a course of treatment extends for at least 12 months. This is something to look out for when shopping around.

Pre-existing Conditions

If you are already suffering from a condition that pre-dates the healthcare policy, then the health insurance provider will not bear the cost of treatment for any illness that arises as a result of that condition. For example, let’s say you’re a sportsman, and injure yourself eighteen months earlier. After some treatment, the injury appears to heal.

If a few months later you get another injury that is in any way related to the earlier injury, the healthcare insurance provider could argue that this is a pre-existing condition, and will refuse to pay for its treatment. This is why healthcare insurance providers insist that you complete an exhaustive questionnaire before you are accepted. They need to get a clear picture of your physical condition before they quote.

Some healthcare insurance providers are flexible to a degree on this point. As long as you have been symptom free for a certain period of time, then they may meet the cost of any subsequent treatment. However, the time periods vary between insurers, and you will have to carefully study your policy to get the true picture.

Preventative Conditions

Your healthcare insurance cover is designed to cure. It does not include treatment that is designed to prevent the onset of an illness. Again, the issue of definition is significant, and healthcare insurance companies are split on the debate. For example, Herceptin is a drug that can be used in the early stages of breast cancer. However, studies indicate 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? In the UK, healthcare providers such as BUPA, Norwich Union, WPA, and Standard Life Healthcare will pay for Herceptin for HER2 patients, whereas Legal and General and Axa PPP will not.

Drug Not Approved

Unless the drug has been approved for use by the relevant health authorities, it is unlikely that your healthcare provider will approve its use.

Healthcare Insurance is an annual contract and its terms can change prior to renewal. In effect, at the end of the current term, your insurer can choose to change or vary the conditions on which your cover is provided. So it is possible that a previously covered condition is no longer covered under the new policy. What this means in effect is that you’ll have to foot the bill for treatment of any such conditions. This is why it is essential that you study the terms and conditions of your health care insurance contract to know exactly what is covered.