What is self-employed health insurance?

Self-employed health insurance is private medical insurance (PMI) which covers acute health conditions to protect you and your business. These are conditions that get better or are cured with treatment, for example, a broken bone.

Do I need health insurance if I’m self-employed?

NHS care is free for anyone classed as ‘ordinarily resident’ in the UK. This fundamentally covers anyone who has the legal right to live here. So, if you run your own business and are ordinarily resident, you don’t need to pay for private healthcare. However, private medical insurance is worth considering if you want the peace of mind and speed of treatment that private cover often provides. For example, PMI usually offers GP access 24/7 and helps you avoid lengthy NHS waiting lists if you need surgical treatment. If you’re self-employed, quick diagnosis and treatment could get you back to work faster, ensuring your business doesn’t suffer.

What does self-employed health insurance cover?

PMI primarily covers the diagnosis, treatment, and care of acute conditions, for example, hernias, cataracts, and broken bones. Cancer and mental health cover is often included, but this will differ depending on the provider. You’ll also be able to choose additional features related to the type of care and treatment you receive. As you’d expect, the more options you choose, the higher your private medical insurance policy premiums will be. Features and benefits that PMI policies often include: GP access 24/7 Diagnostic tests and consultations Treatment Mental health support Stress management support Therapies such as physiotherapy, acupuncture, and osteopathy Choice of hospitals Choice of consultant You’ll also usually be given the option of adding others to your policy, such as a partner or children, although this will increase what you pay. Some providers will let you add a health cash plan to your policy (these can also be bought separately). Cash plans help pay for routine health appointments, for example, the dentist or optician.

What isn’t covered by self-employed health insurance?

Private health insurance doesn’t normally cover chronic or pre-existing conditions. Chronic conditions are illnesses that currently have no cure and are managed with medication or therapy, such as diabetes, arthritis, and asthma. If you’ve been treated for a particular illness before, this will usually be classified as a pre-existing condition and excluded from your policy. For example, if you’ve had treatment for anxiety, this won’t be covered by your policy unless you go without symptoms for a certain period of time (typically two years). After that period, your health insurer may decide to cover you for it. It’s also worth noting that PMI doesn’t cover emergency treatment, which is available from the NHS. You also aren’t covered for pregnancy unless there are complications, for example, miscarriage, pre-eclampsia, or a retained placenta.

What other types of insurance should I consider if I’m self-employed?

If you’re considering all your options, insurance products you might find beneficial if you’re self-employed include: Life insurance If you pass away, life insurance pays your beneficiaries a lump sum. It’s up to you who your beneficiaries are, but it’s typically dependents such as your partner or family. In most cases, life insurance payments go towards large loans or expenses, such as a mortgage or university fees. Critical illness cover Critical illness cover provides a one-off payment if you’re diagnosed with a condition or illness specified in the policy. When you buy the policy, you’ll agree on the payment amount. The more it is, the higher you can expect your premium to be. Insurers will also base your policy cost on factors such as your age and medical history. Income protection Income protection provides regular payments if you cannot work because of illness or injury. Payouts can be up to 75% of your usual salary, as it’s tax-free. Most policies will only pay out for a certain length of time, for example, one or two years; however, some policies can also last until you retire. Income protection is not the same as critical illness, although the two are easily confused. The difference is that income protection provides regular payments until you get back to work (or retire), while critical illness only provides a one-off lump sum.

How much does health insurance for the self-employed cost?

The cost of private medical insurance depends on several factors. Most providers will consider your location and age, but other consider your overall health, and occupation. The type of policy you choose will also have a big influence on premiums – the more features you have, the more you can expect it to cost. If you decide to buy a business private healthcare policy instead of a personal policy, it could also mean you’re eligible for tax relief. This is because PMI can be deemed a business cost, as your health is likely to directly impact your business. To help you get the most out of your policy, speak to the insurer or ask your broker about tax-efficient PMI plans.

What are the main benefits of self-employed health insurance?

One of the biggest benefits of private health insurance is that you’ll be able to access medical advice and treatment when you need it. Most policies include access to a GP or nurse via video call seven days a week, enabling you to discuss any health concerns as soon as possible. PMI also means you avoid lengthy surgical waiting lists. Not only that, if your policy allows you to choose the hospital location, you can also ensure that you’re treated close to home. Another advantage is that while cancer can be considered a chronic condition, it’s often covered in PMI policies (unless it’s pre-existing). If your policy does include cancer care, it may also give you access to treatment that isn’t currently available on the NHS.

Is private health insurance tax deductible in the UK for the self-employed?

If you run your own limited company or are a sole trader, you’ll need a business health insurance policy for it to be considered tax deductible. As an insurance broker, we’ll be able to take you through the options available to you.

Can you buy PMI if you are self-employed and have a pre-existing condition?

If you’ve got a pre-existing medical condition, you should still be able to find private medical insurance; just bear in mind that those illnesses will typically be excluded. The good news is that after a certain amount of time (usually two years) if you have no recurrence of your pre-existing condition, your insurer will often reinstate cover for it. This will enable you to make a claim for treatment in the future.

Can you pay monthly for private healthcare if you are self-employed?

Yes. In most cases, you’ll be given a choice of paying for cover monthly or annually. It’s worth knowing that paying monthly could cost slightly more if your health provider adds interest.

Can you claim dental expenses if you are self-employed?

As a general rule, dental care is not included as part of PMI. Instead, you’ll need to add dental insurance to your private healthcare plan (if it’s an option) or consider a separate dental policy. As with any type of insurance product, it’s important to check what’s covered by your dental policy. For example, cash plans cover the cost of routine appointments and may offer limited help with the cost of treatment.

Does private healthcare cover pregnancy?

19/02/2024 Blog Alan Boswell Group

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Private medical insurance (PMI) is designed to get you back on your feet if you suddenly become ill, but how does it work when you become pregnant?

Whether you have your own PMI policy or have cover as an employee benefit, we look at what you can expect when it comes to PMI and pregnancy.

Can you get private health insurance for pregnancy?

As a general rule, private health insurance does not cover pregnancy. Policies generally don’t cover birth or post-natal care either, so it’s something to bear in mind when you’re weighing up the cost of private medical insurance.

However, you may be covered if certain complications crop up and affect your (the mother’s) health. For example, if you need an emergency caesarean.

In the UK, most babies are born in NHS-run hospitals, midwife-led birthing units, or at home. There are some private birthing facilities, but you’ll usually need to pay for these services separately as PMI doesn’t normally cover them.

What childbirth complications does PMI cover?
Does PMI still provide cover after pregnancy?
Does PMI offer a cash payout after the birth of a child?
Can I add a newborn to an existing PMI policy?
FAQs

What childbirth complications does PMI cover?

Private medical insurance varies by provider, but you can expect to be covered for complications, including:

Pre-eclampsia
Eclampsia
Ectopic pregnancy
Emergency caesarean section
Gestational diabetes
Miscarriage
Retained placenta
Stillbirth

Policies will typically cover both in-patient and day-patient treatment, but details, including any limitations, will be written in your contract.

Does PMI still provide cover after pregnancy?

Pregnancy won’t affect your policy if you already have PMI, and you’ll still be covered for any acute conditions. For example, if you broke a bone and needed treatment and physiotherapy, PMI should cover this (subject to your policy).

Don’t forget that most PMI policies will also cover pregnancy complications such as gestational diabetes and pre-eclampsia. But you won’t be covered for an illness or condition that develops because of an otherwise ‘normal’ pregnancy. For instance, if you develop haemorrhoids or varicose veins, routinely experienced in pregnancy, these may not be treated under PMI.

Does PMI offer a cash payout after the birth of a child?

Some PMI policies will pay out a one-off cash benefit when you have a baby. The amount will depend on your policy, but it could be up to £100 per child.

Can I add a newborn to an existing PMI policy?

This will depend on your provider, but some will let you add a newborn for no extra cost (either for a limited number of days or until your policy is renewed).

FAQs

Does any private health insurance cover pregnancy?

Private medical insurance doesn’t normally cover pregnancy, birth, or post-natal care. But you should be covered if any complications affect your health – for example, miscarriage or pre-eclampsia. Policies typically cover emergency c-sections, too.

Is pregnancy a medical condition for insurance?

Pregnancy isn’t classed as a medical condition from an insurance perspective, and you typically won’t be covered unless there are complications.

Does PMI cover termination?

Broadly, PMI doesn’t cover termination, but it’s worth double-checking your policy to find out if there are any exceptions – for example, it may be covered if continuing with a pregnancy would have a devastating impact on your health.

Does PMI cover fertility treatment?

PMI policies generally won’t cover fertility treatment, although some may offer limited options. For instance, you may be entitled to consultations to find out the reasons for infertility but not be covered for any treatment (such as IVF).

Help choosing your PMI options

While PMI doesn’t cover routine pregnancies, it can help you quickly access treatment and care should the unexpected happen (whether you’re pregnant or not).

You can also expect a choice of hospitals, enabling you to arrange care close to home. Facilities in a private hospital may also be more comfortable compared to those in a general ward. Nevertheless, with the number of options and providers available, choosing a policy can take time and effort.

You can speak to a member of our medical insurance team for tailored advice on 01603 967955.

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