Group private medical insurance

Group private medical insurance is meant to supplement, not fully replace NHS medical care. Some medical conditions will not be covered by PMI.

PMI can cover a range of costs, including physical and mental health treatments, dental care, optical appointments, physiotherapy, cancer treatment and more. Ultimately, employers choose the level of protection they want to provide for their workers, but cover is split into two main categories:

With outpatient cover

• Covers the costs of healthcare where a patient doesn’t need a hospital bed, for example diagnostic tests and scans
• Also covers costs where a patient needs a hospital bed overnight, for example post-surgery, plus day-patient treatment, where a patient needs a bed just for the day

Without outpatient cover

• Only covers costs where a patient needs a hospital bed overnight and where a patient needs a bed just for the day

Within the limits of these main categories, plans will typically cover:

• Acute conditions – short-term illnesses or injuries that respond quickly to treatment which leads to a full recovery
• Hospital charges and specialist fees – such as radiographers, surgeons and consultants
• Treatment for exoskeletal conditions – back, neck, muscle disorders
• Cancer cover – including chemotherapy, radiotherapy 
• Diagnostic services – such as x-rays, MRI, ECGs, CT-scans and more

Digital GP services

Many group private medical insurance plans offer a digital GP service. This provides phone or video GP appointments (usually 24/7) at short notice. This service means employees do not need to wait for an NHS GP appointment, they can discuss their medical conditions with a doctor outside of usual office hours, resulting in fewer days off work, or employees having to use unpaid leave to see their doctor.