Private healthcare is medical services that you access outside the National Health Service (NHS) and are funded through private means.. People usually choose private healthcare due to shorter waiting times, choice of provider and enhanced comfort. But did you know there is a difference between Health Insurance and a Discretionary Healthcare Scheme?
Take a look below at the differences between private Healthcare Insurance and a Discretionary Healthcare Scheme, which includes how they provide cover and make decisions on claims.
Private Healthcare Insurance
Healthcare Insurance is a policy that is legally obliged to pay some or all of certain medical expenses, as described in the policy documents. You pay regular premiums (monthly or annually) with costs often based on factors including your age, medical history and level of required cover. Underwriting and exclusions can apply, this means your health history is assessed to evaluate an application for private health insurance. Insurers decide whether to accept the application and may exclude certain medical conditions.
Health Insurance policies are regulated by the Financial Conduct Authority (FCA) and covered by the Financial Ombudsman Service (FOS) if disputes arise.
Discretionary Healthcare Scheme
With a Discretionary Healthcare scheme, cover is determined on a case-by-case basis to see what help is right for that member. To make decisions fair the scheme usually has a set of rules that guide which treatments are covered and which are not. However, being a discretionary scheme means treatments that sit outside the set of rules may still be authorised.
Unlike private insurance, there are no payments for ‘extra’ cover. All the members pay is a subscription, depending on their age, into the scheme to provide cover when it’s needed and a member contribution (similar to an excess) when they make a claim. There may be instances where a member needs to self-pay, if the limits of their membership do not cover the treatment needed. These schemes can be cheaper than private insurance and are not always FCA regulated. Many are run by mutual societies, charities or trade organisations.
The Police Mutual Healthcare Scheme
The Police Mutual Healthcare Scheme is a discretionary scheme, set up by the Police for members of the Police family to help with the cost of private medical treatment when you need it. It allows you access to treatment at a range of private UK hospitals and facilities and can reduce time spent waiting for diagnosis or necessary medical procedures.
There are no medicals, but pre-existing conditions (in the five years prior to joining the scheme), radiotherapy & chemotherapy treatments, dental treatments, emergency treatments and cosmetic surgery are not covered.
To find out more or to get a quote click below
PMHC Limited, trading as Police Mutual, is registered in England and Wales No. 03018474. Registered office: Brookfield Court, Selby Road, Leeds, LS25 1NB.