Paul Shires, director of global business development at Westfield Health, discusses a cost-effective alternative to private medical insurance
Waiting for surgery can be a long and stressful time. Hospital Treatment Insurance (HTI) makes private surgery and medical treatment more accessible. While it is understandable that NHS hospitals prioritise emergency cases, those requiring less urgent treatment have to wait in discomfort.
If we go back to the beginning, it’s clear that there’s a huge gap between traditional private medical insurance, which is typically very comprehensive, and health cash plans, which were developed to meet gaps in NHS provision and fund everyday healthcare at an affordable cost.
At Westfield Health, we didn’t want to be a Private Medical Insurance (PMI) provider, but felt that there was an opportunity to support the healthcare sector and the patients.
Chronic diseases related to the heart, diabetes, cancer and strokes – once diagnosed – are well catered for on the NHS. Where companies often struggle is when their employees require knee surgery, a hernia operation or a new hip – the kind of orthopaedic non-urgent surgical procedures which may be rescheduled in NHS hospitals to make way for more urgent operations.
Having identified this disconnect, we developed a product that would help patients to get their surgery quicker, and help the NHS by relieving the demand on their resources. Covering non-urgent surgical procedures, HTI costs less than traditional private medical insurance.
The HTI product range has now evolved to include consumer insurance, so this is now offered as an affordable option to the person in the street.
We have two new consumer HTI products.
Access Surgery covers more than 60 common non-urgent surgical procedures categorised into four classifications. This level of cover includes up to £1,000 in outpatient services, with allowance for a maximum of three surgical procedures in any consecutive 12-month period, and a maximum benefit of £100,000 during the lifetime of the cover.
Access Surgery Premier covers a more comprehensive range of surgical and medical procedures. Again, the plan provides up to £1,000 for outpatient services. Policy holders can also benefit from post-operative physiotherapy.
As with Access Surgery, there is an allowance for a maximum of three surgical procedures in any consecutive 12 month period, but the maximum benefit for the lifetime of the cover is £250,000.
The administration is very straightforward. On the corporate side, it’s really easy – there’s one fixed price for everyone, regardless of age (although we do take pre-existing medical conditions into consideration).
As an employer, there are some great benefits:
- Your employees return to work sooner
- Cover is affordable, from as little as £5.55 per employee per month
- The price is the same for all staff on the same level of cover
- You can cover different groups of staff at different levels
Your employees also benefit:
- Prompt access to private treatment for non-urgent procedures
- Consultations and surgical procedures can be carried out by most private UK consultants and hospitals (although there may be some exceptions)
- Treatment can be received at an NHS hospital
- Each treatment is classified into predefined bands, each with a maximum private treatment package value, or cash payout for NHS treatment
- There is no excess to pay
For Access Surgery and Access Surgery Premier – the consumer plans – applications are made online by the individual, with initial premiums based on their age.
Premiums can be adjusted by removing outpatient cover or applying a £100 excess to their plan. Similar to the corporate paid plan, policyholders can choose where they are treated, and receive treatment up to the value of their package.
When the policyholder accesses the service, our dedicated team guides them through the whole process from GP referral, consultation and diagnosis through to surgery and post-operative physiotherapy where the cover allows.
Whether cover is corporate-paid or funded by the policyholder, we’ve achieved our objective of providing an affordable insurance product that makes private surgery more accessible to the majority of the population.