Medex Protect is an annually renewable medical excess and shortfall protection plan, designed to sit alongside a PMI plan. The logic is that insurers offer big discounts for excesses, but that then moves the risk to the customer. This plan can cover such excesses. In addition, if what the insurer is prepared to pay for treatment is less than the specialist or hospital is charging, that shortfall is also covered (on the group version of the plan).
The plan is available to individuals or groups and offers three levels of cover. For a single individual person within a group scheme the options are:
* 150 Plan. Covers excesses up to £150 and shortfalls up to £250, within an annual cover limit of £400. The plan costs £45 a year.
* 250 Plan. Covers excesses up to £250 and shortfalls up to £250, within an annual cover limit of £500. The plan costs £57 a year.
* 500 Plan. Covers excesses up to £500 and shortfalls up to £500, within an annual cover limit of £1,000. The plan costs £114 a year.
Members must be UK resident and aged 18 to 80. Claims (there is not a limit to the number of claims, just the total paid on claims) are settled directly with the customer’s provider of choice and each member covered has their own annual maximum. Premiums are not age-dependent (unlike PMI premiums, which tend to go up with age).
For individuals, just excesses are covered (presumably the anti-selection risk with insuring shortfalls would be too great to cover that too) and the options are:
* Option 1. Covers excesses up to £250, with up to two claims a year and an annual cover limit of £250. The plan costs £40 a year, with the customer paying the first £100 of any claim.
* Option 2. Covers excesses up to £500, with up to two claims a year and an annual cover limit of £500. The plan costs £80 a year, with the customer paying the first £100 of any claim.
* Option 3. Covers excesses up to £1,000, with up to two claims a year and an annual cover limit of £1,000. The plan costs £150 a year, with the customer paying the first £100 of any claim.
Individual customers must be under age 75.
Commission is 10% initial and renewal.
What They Say
Director Jason Dunks said: "Medex Protect offers a very simple, easy to understand product, that gives clients a straightforward way to reduce their total spend for their health insurance. It has been well received on this basis, as they can immediately see the benefits and cost savings from the outset."
What We Say
"Excesses have long been a popular way to reduce PMI premiums, but they do so by passing on risk to the customer. One partial way round that has been to take out a health cash plan to sit alongside the PMI plan but that may not be ideal, for a number of reasons, and the cash plan may not pay out on a PMI claim event anyway.
"This plan offers a highly specific solution, that works in slightly different ways for individuals and groups. For individuals, it just covers excesses, and the customer pays the first £100 too. For groups, shortfalls are also covered and there is no co-payment.
"The concept is clever in that Medex Protect does not need separate underwriting because, in effect, the plan only pays out if the underlying PMI plan pays out. So, the PMI provider effectively does all the underwriting/claims work, with Medex Protect there to help with any shortfall or excess once the claim is agreed.
"As PMI premiums are invariably age dependent in some way, the fact this plan isn’t (and that PMI excesses usually result in a percentage premium discount) should generate bigger savings as time goes by. In turn, for employees, that also generates a P11D saving.
"Of course, the plan is only worthwhile if it will generate savings long term, so brokers will want to see any premium increases being manageable. Also, the plan does have limits, so someone claiming very regularly could quickly run out of cover. However, for most people, that should be a relatively small risk. The group plan also provides usefully wider cover than the individual plan does, especially as many PMI claims can involve shortfalls."