Peter, 35, and his four-year-old daughter Beth are about to relocate from London to Aberdeen after Peter was offered a job as an oil and gas technician. His new salary is £85,000. Peter is in good health; however, Beth suffers from asthma, for which she has been hospitalised on numerous occasions. Peter is looking to buy private medical insurance that would cover both him and his daughter and preferably her condition too. What recommendations can you make?
PHIL TAYLOR, PREFERRED MEDICAL
Beth has asthma, a chronic condition that is not typically covered by private medical insurance (PMI). In some cases an acute episode, such as an attack, would be covered, but in an emergency Beth would be taken to an NHS accident and emergency (A&E) department.
Peter is moving to an ideal location for such a service: the new Royal Aberdeen Children's Hospital offers a dedicated paediatric A&E unit, which specialises in respiratory medicine.
Peter does not want an excess or shared responsibility on the policy. Assuming the requirement is for a comprehensive scheme with no limits on outpatient benefits, his key decision is which hospitals he would want to have available on the plan.
If he is content to limit the choice to Scottish hospitals, the new Norwich Union Solutions plan with the 'signature' hospital option is excellent value at only £41.35 per month. This plan offers full outpatient cover, and also includes therapies and an optical/dental option. The BMI chain's Albyn Hospital in Aberdeen is on the list.
If Peter requires a wider range of hospitals, I would suggest he considers the innovative Pruhealth Comprehensive plan. Comprehensive medical insurance is available for £67.91, which could reduce in future years if Peter gains vitality points and is not a regular claimant.
An added advantage is that Cannons Health & Fitness clubs, which is a Pruhealth partner, has a club in Aberdeen, which could also be good for Peter's social life in a new area.
NYE JONES, AXA PPP HEALTHCARE
In assessing Peter and Beth's needs, it is important to consider where they stand in terms of cover for treatment of her asthma. Because medical insurance is designed primarily to provide cover for treatment of new conditions that arise after members join, investigations and treatment related to Beth's asthma would be excluded from cover; so too would outpatient drugs such as inhalers. It is also worth bearing in mind that, by and large, private hospitals are not resourced to receive emergency admissions, so should Beth suffer an acute attack she would be admitted to the A&E department of her local NHS hospital.
That said, assuming Peter gives Beth a break by steering clear of cigarettes, he would get a preferable premium. In the same vein, he would also be rewarded with a lower premium for taking care of himself.
Turning to cost, if Peter prefers the convenience of a full refund policy for him and Beth, our Premier plan would cost £66.25 a month. On the other hand, if budget was a priority, Assure, which covers the essentials - including hospital and surgical treatment, scans and chemo- and radiotherapy - would cost £36.57. With these, we would cover the cost for Peter to stay in hospital with Beth if she was admitted as a private patient.
To help people make savings, we offer no-claims discounts, a range of voluntary excesses and 'six-week' policies that pay for private care straightaway when the NHS cannot treat the policyholder in under six weeks. For example, our six-week versions of Premier and Assure with a £200 excess would cost £33.05 and £17.63 a month respectively.
ANNE OWEN, CLINICARE
Peter requires peace of mind that should his daughter require further admissions to hospital in respect of her asthma he has a policy that will cover her for this. This inevitably increases the risk factor for any insurer and it is difficult to fully assess that risk, given the nature of the condition and the fact that she has already required several hospital admissions.
We could offer Peter our most comprehensive policy, Clinicare Carte Blanche with hospital banding C, which would provide more than adequate cover for any hospital in the Aberdeen area.
This policy would offer Peter the availability to visit a consultant without referral by a general practitioner, which would speed up the process of making sure Beth has a specialist assessment as soon as they move to the new area.
In order to cover for this and for any future hospital admission that may be required, the total premium would be loaded. The standard premium for Peter and Beth on the above policy would be £2,260.20 annually, and with the additional loading in respect of Beth's condition the premium would increase to £4,520.40. Additionally, Peter would have the availability to reduce this amount by up to 50% by opting for an excess.
Peter may have organised general practitioner cover prior to the move, in which case we could offer him Clinicare Classic, where Beth would be required to be GP-referred, at a total cost of £3,049.88 including the loading.
He would of course have the same availability to reduce the premium by opting for an excess option: the NHS cash benefit would be £150 and accompanying parent stay £80.
