Millions are choosing the private health route

Whether it is anxiety over waiting lists or wanting to have your choice of consultant at a time convenient to you, millions choose to pay for private health cover. For the self-employed, it may be vital to return quickly to the world of work whilst employers see such a benefit in similar terms, improving productivity with better staff satisfaction and retention.

One in five adults does not believe that the NHS will be there for them in their time of need. Health care is a major issue in next week's election. 29 per cent expect they will have to pay towards their NHS treatment in the future.

Healthcare was one of the major planks of Barack Obama's Presidential campaign. In the US, 46 million people – equivalent to the population of Spain – cannot afford health insurance or have decided not to buy it and therefore have no guaranteed access to such provision.

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In the UK, absence through sickness costs 20bn annually. With an ageing population, chronic diseases – like cardio-vascular disease, cancer and type 2 diabetes – occur more frequently. Cancer alone may account for up to 17 per cent of claim costs this year.

Just over 7.5 million are covered by private medical insurance (known as PMI) or employer-provided health trusts. Last year the number of individual subscribers rose for the first time since the 1990s by 1.6 per cent to 1.12m.

When considering an insurance company for your health cover, ask:

n if clinical pre-authorisation is required;

n how far you will be directed to specific hospitals or consultants;

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n what cover restrictions apply including whether treatment can be at a time and place to suit you;

n if costs will be settled directly by the insurer.

Bupa says the top reasons for claiming are joint disorders, cataracts, back disorders and cancer.

Aviva says its top list is orthopaedic, oncology, gastrointestinal, head and neck, cardiology, women's health, dermatology, urology and psychiatric.

Usually there is no limit to the number of claims that can be made although some benefits have financial limits.

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Only one-fifth of those insured, claim on their health cover. Instead of forcing claimants into too tight a straitjacket, some insurers are incentivising individuals to look after and improve their health.

Instead of filing health insurance details away, hoping they will not be needed, consider a policy with an incentive – either by lifestyle or financially. Prudential offers the former through its Vitality incentive programme. It combines lower premiums with discounted access to gyms, health screenings, smoke cessation groups and health monitoring.

The Pru's range of leading private hospitals in Yorkshire include BMI Duchy in Harrogate, Spire Methley Park and Spire Leeds, BMI Thornbury in Sheffield and the Nuffield in York.

A no claims discount that can reduce the premium in future years if you remain claim-free is offered by some insurers, such as Saga. The NCD can amount up to 66 per cent online with Aviva, formerly Norwich Union, and are reviewed annually.

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Jacqueline Priestley, from Otley, chose PMI after having to wait 19 months to have an operation on the NHS. "Never again," she says, selecting instead Aviva which "offered the best benefits for what we had to spend". With her husband and son, they have a combined policy. Mrs Priestley says: "The last thing we would ever give up is private health insurance."

National Friendly splits your monthly premium between running the scheme and a personal deposit account. Its comprehensive cover for 18-70 years includes consultations, surgery, recognised alternative therapies, cancer and heart treatment.

It guarantees fixed premiums for five years with monthly rates starting at 40. If you opt for an NHS hospital, you can claim cash back for overnight stays or day case treatments.

Exeter Friendly, founded in 1927, is another mutual with no

shareholders. It offers unlimited cover for such key areas as in-patient and day-patient treatment, cancer, out-patient treatment and manipulative (such as physiotherapy and podiatry) but also private ambulance and home nursing.

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It has a private GP helpline 24 hours a day to give help and advice and will pay 250 a night if you opt for free in-patient NHS treatment.

With all PMI providers, one crucial element to check is if there is either an upper age restriction or a disproportionate jump in price from a certain age.

Look for policies appropriate for your age and circumstances. AXA PPP, for instance, have plans to meet key life stages, such as 'Essential Health Care' for those facing the pressure of mortgages and young families.

It bridges the gap between conventional health and protection cover by providing up to 250,000 in benefits if struck down by heart disease, cancer or a stroke.

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Similarly, their low cost policy for the over 55s covers four common conditions affecting older people: heart and eye conditions, joint replacements and hernia repair.

Bupa, with over three million members, offers five different levels of cover so that there is one to suit each budget. It claims to offer the most extensive cancer cover in the UK which is important with more than 5,000 people being diagnosed with cancer each week.

Typical monthly Bupa premiums – including eight per cent health plan discount for new members – are 72.21 for 55-years-old, 83.83 at 60 years and 107.38 at 65 years, for both sexes.

Many insurers offer plans where you can expect to be treated on the NHS but after that designated period, private healthcare commences. If a six week delay is acceptable, it can trim premiums by about one-third.

Children can enjoy the benefits of PMI.

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This might be tonsil removal after frequent sore throats or urgent work on a school sports injury which requires specialist surgery.

Bupa, with access to over 35,000 specialists, offers child health from 22 a month. If a child under 12 has to stay overnight, Bupa will cover the cost of a parent staying, too, even if they are not insured. AXA PPP offer a 9.99 a month policy called 'First Healthcare', which is reduced to 8.99 per child for two or more (up to 18 years).

Currently there are special offers available, many linked to lifestyle.

A free pharmacy check is available to new Aviva customers under its 'Healthier Solutions' policy. It is also offering up to 15 per cent discount on renewal premiums.

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The AA is a newcomer this year to PMI with three levels of cover arranged online through AXA PPP. The first two months are free for AA members with one year or more continuous membership and one month for non-members or new members.

n Contacts: Aviva 0800 1585183, Bupa 0800 600500, Exeter Friendly 08080 556575, National Friendly 0800 0096407, Prudential 0800 0121328, Saga 0800 857857.

'I've sat in nhs waiting rooms for too long'

Kathleen Sherwood, pictured, a retired teaching assistant from Dalton-on-Tees in North Yorkshire, pays 720 annually for private medical insurance.

She used to have a policy with Norwich Union, now called Aviva, but "premiums jumped by a third without notification upon renewal".

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Instead Kathleen, 60, opted nine months ago for National Friendly, formerly National Deposit, with no excess. She has already had two claims: a medical one involving two consultations for around 300 and a small dental one (for a crown which came loose). Her husband, Ian, 61, used to have private medical cover when he was a Barclays Bank manager which used to be taxed as a benefit. He now has his own policy with National Friendly, which was established in 1868.

"I would not be without PMI," says Kathleen. "As long as I can afford it, I will have it. I've sat in NHS waiting rooms far too long."

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