Private medical insurance (PMI) can help you bypass lengthy waiting lists, quickly providing you with the treatment you need. But while health cover is usually associated with physical ailments such as hernias and broken bones, PMI can also offer mental health support; here’s how it works.
- Does private health insurance cover mental health?
- What mental health cover does private healthcare provide?
- How much mental health support can I claim for?
- What happens if I have a pre-existing mental health condition?
- Does business health insurance cover mental health?
- How to buy PMI to cover mental health
PMI can provide mental health cover, but it will depend on the provider and level of cover you choose.
Some insurers include mental health support and treatment as standard on all their policies. Others may offer it as an optional extra, increasing the cost of private medical insurance.
Other providers may take a mixed approach and offer some basic mental health services with additional features at a cost.
Why don’t all private health insurers cover mental health as standard?
Insurers set their terms, and while most will offer some limited mental health services, it’s up to them to determine how much they provide.
For example, it’s common for private health insurance to include access to online mental health support as standard. You’ll need to buy additional cover for anything more in-depth, such as in-patient treatment.
Providers will usually offer a range of services. Some may be part of a standard policy, but you’ll normally be able to pay for additional features. Examples of available support include:
- Stress helpline
- Mental health assessments
- Out-patient treatment (such as counselling and therapies)
- In-patient treatment (hospital stays)
Most policies will limit what you can claim for, but it will depend on the terms set out by your insurer and the level of cover you choose.
Typically, you’ll be limited to a certain number of sessions or be limited by cost. For example, you may be entitled to ten counselling sessions or up to the value of £1,500. In-patient treatment (where you need a hospital stay) is usually limited to 28 days. Some policies go up to 45 days.
The more sessions you can claim for, or the higher the amount, the more your policy will likely cost.
Pre-existing health conditions are generally excluded from PMI policies – it doesn’t matter whether they’re physical or mental. That said, it’s important to know that just because you’ve experienced a particular mental health condition, does not mean your provider will exclude all mental health support from your policy.
For example, if you’ve sought advice or had treatment for depression, you won’t normally be able to claim for this condition again until a certain amount of time has passed (usually two years). However, if you developed a different mental health condition, for instance, addiction, you could make a claim for treatment (if your level of cover provides this).
Group health insurance is sometimes provided as an employee benefit. Your workplace will usually manage the terms of cover, so mental health support could be included if it’s part of the policy they’ve chosen.
Depending on how flexible your employer is, you may be able to top-up your level of cover by paying for it yourself, but it would be at their discretion.
Other employee benefits, such as a health cash plan, may also provide mental health cover.
What are the common mental health conditions covered by a group PMI policy?
In a group policy, your cover level will depend on what’s been agreed between the provider and your employer.
If mental health support is part of the benefits package, you can expect to be covered for a range of conditions, such as:
- Depression (including post-natal depression)
- Eating disorders
- Stress (including post-traumatic stress)
Remember that your policy will usually exclude pre-existing conditions (both physical and mental).
Basic mental health cover is often included as standard when you buy private medical insurance. You’ll also have the option to add support to your policy, which will increase your premium.
Either way, providers are usually very clear about what services are provided, particularly if they offer a choice of policy levels.
Is depression a pre-existing condition for insurance?
If you suffer with depression when you take out PMI, it will count as a pre-existing condition, and it’s unlikely you’ll be covered for it.
Depression can also be classed as a pre-existing condition if you’ve suffered from it within the last five years. If this is the case, then your insurance provider can reject your claim.
Does health insurance cover pre-existing conditions such as substance abuse?
Firstly, it depends on whether your insurer includes substance abuse as a condition they will cover. If you’ve experienced substance abuse within the last five years and apply for PMI, it might be classified as a pre-existing condition and excluded from your policy.
However, if you don’t suffer a relapse within a certain period (usually two years), your provider may cover treatment when you renew your policy.
Is anxiety a pre-existing condition?
Anxiety can be considered a pre-existing condition if you have it or have suffered with it in the last five years. If you have, then it could be excluded from your policy. As with other pre-existing medical conditions, if you don’t have anxiety for two years after taking out your policy, your provider may reinstate it and provide cover.
Understanding your PMI options for peace of mind
If you’re worried about the increased burden on the NHS and long waiting lists, private medical insurance could be an option worth considering.
You can choose policies for you as an individual, couple, or whole family. Similarly, if you’re an employer, group PMI can be beneficial when recruiting and retaining staff to help them maintain their physical and mental well-being.
For more information about private health insurance, you can speak to one of our private medical insurance experts at 01603 967955.