Information on Shopping for U.K. Health Insurance

Ian C. Langtree - Writer/Editor for Disabled World (DW)
Published: 2009/03/18 - Updated: 2025/02/05
Publication Type: Informative
Topic: Disability Insurance - Publications List

Page Content: Synopsis - Introduction - Main

Synopsis: The most important part of choosing a good health insurance policy for you and your family is to ask the right questions.

Why it matters: This article provides a thorough guide to selecting an appropriate U.K. health insurance policy, emphasizing the importance of asking critical questions to ensure the plan aligns with individual needs and budgets. It advises obtaining and reviewing the complete policy document to understand service access, financial obligations, and appeal procedures. The piece also discusses evaluating the network of healthcare providers, understanding any limitations on provider choices, and ensuring that contractual obligations do not interfere with treatment decisions. Additionally, it highlights the importance of understanding the insurer's policies on medical record confidentiality and the scope of coverage, including provisions for catastrophic illnesses. This guidance is particularly valuable for individuals, including those with disabilities and seniors, seeking to make informed decisions when purchasing health insurance - Disabled World (DW).

Introduction

The following list of topics can help you compile a list of questions to ask your health insurance provider so that you get the right policy at the right price. The worst possible time to find out what your health insurance does and doesn't cover is when you need to claim against the policy. One of the most important parts of choosing a good health insurance policy for you and your family is to ask the right questions to discover which plan fits your needs and budget best.

Main Item

1. Your health insurance policy documents

Ask for a copy of your health plan document so that you can read it through. Even if you're buying your health insurance through a group, such as your employer, you're entitled to have a copy of the complete policy for yourself. Does it explain how to get services and how to appeal coverage decisions with which you don't agree? Does it make clear what your financial responsibilities are? Make a list of questions that arise during your reading so that you can ask them of your health insurance provider.

2. Professional providers and expertise

Many health insurance policies limit you to choosing from a pool of hospitals and professional providers. Are there limitations on the professionals from whom you can seek care? Is there a list of providers that you can reference? Are there provisions for using a health care provider that is not on the approved list.

3. What limitations are on your health care providers?

Be sure that your health insurance provider has not placed contractual obligations on your health care providers that may interfere with or influence treatment decisions. Are your providers allowed to discuss all of your treatment options with you, even if they're not covered on the plan? Do they pay the provider the same amount regardless of the treatment that they prescribe? Does the plan offer rewards to the providers for keeping their costs low.

4. Can you appeal decisions?

Every health insurance company should have a formal appeal and grievance procedure to allow you to complain or request a reconsideration of decisions made about your care. Is the appeals procedure clearly defined? To whom can you complain if you're not satisfied with a decision, or an appeal? Is there a formal grievance procedure and a way to report plan physicians and providers if you have a complaint about your care.

5. Are your medical records kept confidential?

You have a right to expect your medical records and personal details to be kept confidential. Ask your insurance provider about their confidentiality policy. Will your medical records be shared with anyone without your specific permission? What information from your medical records is provided to the payer? In general, the insurance company has no right to receive anything more than diagnosis, prognosis, length of treatment, type of treatment, and cost.

6. Choice of providers

How much choice will you have in the providers that you choose? Are your choices restricted in any way? What credentials does your insurer require of professionals associated with the plan, or for payment by the plan? Will your plan cover alternative or complementary treatments if they are prescribed

7. Who will make treatment decisions?

Who will be involved in making your treatment decisions? If it will be anyone other than your health care provider? Do they have the appropriate training to make medical decisions.

8. Will I be covered for catastrophic illnesses?

Many health insurance policies do not cover the so-called "catastrophic illnesses" like cancer, stroke and heart attack. You may need other insurance cover to insure yourself against those.

Author Credentials: Ian was born and grew up in Australia. Since then, he has traveled and lived in numerous locations and currently resides in Montreal, Canada. Ian is the founder, a writer, and editor in chief for Disabled World. Ian believes in the Social Model of Disability, a belief developed by disabled people in the 1970s. The social model changes the focus away from people's impairments and towards removing barriers that disabled people face daily. To learn more about Ian's background, expertise, and achievements, check out his bio.