A helpful tool we’ve created to guide you through some of the insurance terms that are often used.
A handy jargon buster to help you understand some health insurance terminology.
Obesity is diagnosed when a person has a Body Mass Index (BMI) of over 30.
Obesity is linked to a number of health conditions, which means that insurers providers are likely to offer higher premiums to offset their costs. Being medically obese could limit the number of conditions covered by your insurance providers – ask your Towergate Health & Protection advisor if this is a concern for you.
An occupational health scheme is introduced by employers to provide workers with advice and support on wellbeing and health matters.
Occupational therapies are treatments designed to help people re-gain the ability to perform everyday physical activities, including walking, eating, dressing and bathing.
Most insurance providers would cover occupational therapy following an illness or injury, but always check your policy documents to fully understand the plan you’re on.
In the world of private medical insurance, oncology can involve diagnostic tests, radiotherapy, chemotherapy and hospital charges incurred whilst treating cancer. Some insurance providers even look to help with post-cancer recovery, including access to support services and cover for the cost of wigs.
An Open Referral is when you agree to only have private health insurance cover when you see certain pre-approved hospitals or consultants.
Open Referral allows your insurance company to better manage their costs, as they know in advance how much each of the pre-approved centres and specialists charge. Because of this, it could lead to lower premiums on your policy. On the other hand, some argue that Open Referral limits your choice on who you can see for medical care.
Out Of Pocket is the amount you pay – the cost isn’t covered by your insurance policy.
This could be the cost of your excess when making a claim, or co-insurance fees.
Where the patient has treatment in a hospital or clinic, but does not require medically supervised recovery and goes home straight after the treatment or after seeing a consultant or other medical professional. Not all private health insurance policies will cover out-patient treatment so seek advice from a broker if you require this.