Westfield Health’s hospital treatment insurance (HTI) plan Access Surgery is now available to consumers and voluntary employee benefits schemes. At the same time, Westfield has also looked to uprate the plan.
Two versions are available – Access Surgery and Access Surgery Premier.
Access Surgery Premier is the most comprehensive version and includes:
* Payment for most surgical procedures, except heart or cancer related treatment (although treatment for suspected cancer up to diagnosis is covered). Procedures are split into ten bands, each with its own cash limit. If the limit is exceeded (although they are regularly reviewed) the customer pays the balance.
* If free NHS treatment is chosen instead, the customer can claim a (smaller) cash payment.
* Up to three surgical procedures a year are covered.
* Maximum lifetime benefit is £250,000.
* An optional £1,000 pot to pay for outpatient treatment.
* Customers can save even more by choosing to have a £100 annual excess.
* A two year rolling moratorium is used to exclude pre-existing conditions.
Access Surgery is similar in concept but more basic and covers:
* Treatment for 63 common non-urgent surgical procedures.
* There are four medical bands and classifications, each with its own limit.
* The maximum lifetime limit is £100,000.
Someone age 31-35 could pay £24.08 a month for Access Surgery Premier with outpatient cover and a £100 excess. For the basic Access Surgery plan the premium is £15.30 a month.
What They Say
Director of global business development, Paul Shires, said: "We introduced our existing HTI product to the market in 2012 and it has since held a strong market position. This new addition extends the offering further to consumers and corporate leavers looking for affordable and accessible private surgery and medical treatment.
"The NHS continues to face one of its most challenging periods in its history and people are becoming more aware of the long waiting lists for surgical procedures – particularly for non-urgent procedures, which HTI covers.
"There are currently 3.1 million people waiting for surgery in the UK and the average wait for the seven most common procedures through the NHS is 13 weeks – the ageing and growing population will only add to this pressure.
"Behind these facts and figures are real patients with real illnesses – a delay in surgery means longer periods of suffering for patients."
What We Say
"In an ideal world, all your clients would be able to afford and maintain private medical insurance (PMI). But we do not live in a perfect world and PMI is now beyond the financial reach of many people, while persistent above inflation price increases (coupled with higher premiums as you age anyway) mean that even some who can afford PMI can quickly move to a position where they can no longer afford it.
"When Westfield took over PatientChoice a few years ago it moved into the hospital treatment insurance area too (what was initially called major medex back in the 1980s) and has now developed the concept to appeal to both individuals and voluntary employee benefits schemes (although not flexible benefits schemes).
"When comparing such cover to ‘full’ PMI, it is easy to be critical. After all, Access Surgery – even the more expensive and comprehensive Premier version – can offer narrower cover. So, for example, it does not cover cancer or heart treatment, has significant outpatient limits, has a lifetime limit, and does not cover all surgical treatments (the full list of what is covered is available online).
"Should we ignore it then? No, far from it - what it does do, it does well.
"My advice would be to first consider it alongside a health cash plan. That will provide even wider cover and add in helplines and other important but hard to value benefits. Second, look too to adding critical illness cover – that will add a pot on diagnosis of not just a heart attack or major cancer but dozens of other conditions too. Just relying on the NHS is now also an option, as it targets heart and cancer much more effectively than before.
"Buy it on its own and the narrowness of cover could be an issue. But, and it’s a very big ‘but’, this narrowness enables Westfield to offer monthly premiums significantly below even budget PMI cover. Moreover, Westfield says it has not increased premiums on its HTI plans at all since launching them back in 2012 (with the exception of price rises for higher IPT rates). Of course, that can’t be guaranteed to continue forever, but it does indicate that this very different style of ‘budget PMI’ offers sustainability (especially useful now that IPT is going up yet again) and can open up new markets that PMI simply can no longer reach – if it ever did.
"So, if what these plans offer is acceptable to your clients, it could be an ideal solution. That won’t be very client, but that was never the intention anyway."