Skip to content

Experts warn of common health insurance ‘blind spots’ that could mean you’re not covered

Private health insurance is a minefield, and there is always the fear that even after weeks of extensive research, your policy won’t cover you if you become unwell or have an accident.

Over 90% of Americans have medical insurance and it’s becoming increasingly popular in the UK. To make the process a little easier, medical insurance experts have shared some of the “blind spots” that are often missed. Familiarizing yourself with them will make sure you don’t get caught out.

Female medical practitioner reassuring a patient
Female medical practitioner reassuring a patient. Credit: ljubaphoto (Getty Images)

5 common health insurance ‘blind spots’

The experts from the medical insurance comparison site Usay Compare say you must be aware of these five things when taking out a new policy.

1. Coverage limits

The first thing to look at in detail is the coverage limit, the total amount of money you are covered for. It’s usually a huge amount, but some have annual or lifetime caps on certain benefits, such as smaller limits per condition. This leaves you thinking you have millions to spend when you don’t.

2. Exclusions

Another thing that catches people out is exclusions on certain things. Many insurers have a list of specific treatments or conditions they will not cover, so you must pay extra close attention to the policy wording and find one that covers all your needs.

3. Pre-existing conditions

One of the most common things private health insurance places exclusions or restrictions on is pre-existing conditions. Any illness you had before you took out the policy is pre-existing and must be declared to ensure you are still covered.

Health insurance helps patients get the medical care they require
Credit: PhotoAlto/Frederic Cirou (Getty Images)

4. Out-of-network costs

If you go to a doctor who has not agreed on a contract with your insurance provider, they could charge you out-of-network costs. This means you have to pay the full amount with no help. So, it’s important to find a healthcare provider that uses your insurance network.

5. Overlooked policy rules

Finally, be aware of any policy rules that are needed to validate the insurance. Some require pre-authorisation or referral for specialist care and will refuse to pay out if you become unwell or have an accident.