Exclusions
No insurance policy will cover every medical eventuality. There are several typical exclusions to a private health insurance policy. It is important that you check the exclusions for your policy with your insurance provider, to avoid unpleasant surprises. Typical exclusions include:
- pre-existing conditions: prior to your purchasing the insurance
- incurable conditions
- expected conditions: natural side effects of puberty or ageing
- allergies
- deafness
- vaccinations
- preventative screening
- some NHS primary care services: accident & emergency admission, GP services
- dental treatment
- chiropody & foot care
- some drugs: NHS prescriptions, outpatient drugs and experimental treatment drugs
- care abroad: non-emergency treatment abroad
- reproductive care: for regular pregnancies (female policyholders only), fertility treatment and infertility treatment
- abortion: (female policyholders only)
- serious conditions: organ transplant, kidney dialysis, HIV and AIDS
- learning difficulties & behavioural problems
- choice treatments: gender transition, cosmetic surgery and dentistry
- weight-loss surgery
- 'avoidable' conditions: self-inflicted injuries, drug, including alcohol, abuse
- extreme risk: injuries sustained in war, practising a hazardous hobby, sport or occupation
In order to avoid surprises it is important to read the exclusions listed in your health insurance policy booklet, and make sure that you are aware of exactly what you can and cannot claim from your insurer.
Some insurance providers offer tailor-made cover to their policyholders, arranging to cover certain conditions in exchange for a higher premium. You will not usually be able to arrange specialised cover if you only wish to pay for a basic policy; a high level of cover tends to be expensive, and so it is worth comparing comprehensive policies from several providers.
