Does private healthcare cover women’s health issues & the menopause?

As we age, we all know that it becomes more likely that we’ll experience health issues related to aging such as bone, heart, gynaecological, cancer or breast issues. 

And if you’re in your 40s, 50s or even 60s now might be the time that you begin to wonder if having a private healthcare plan is worthwhile.  

Liz Dorfman talks all things private healthcare and menopause! 

So why take out a private healthcare plan? 

We asked Liz Dorfman, an Insurance Broker who specialises in private healthcare, to investigate what’s out there on the market for women’s health. 

What do private healthcare policies offer for women’s issues? 

The good news is that the rules are the same across all insurers. They all cover consultations, investigations and treatment for acute symptoms such as bleeding, pain, bloating etc.  

But, if these ailments are pre-existing in the five years before taking out a plan they would not be covered – unless you have had two ‘clear years’. A clear year means no treatment, advice, medication or symptoms. 

When is the best time to take out a plan?   

Don’t wait until you get sick! Unfortunately, if you get sick it is too late as that ailment won’t be covered. 

The best time is always now because any new conditions which occur after taking out a plan are covered. Sadly, I have lost count of the number of times I have quoted for clients who then think about it for too long and get sick! 

Is the menopause covered with health insurance? 

The menopause is not an acute condition, but some of the symptoms might be acute such as bleeding, pain, and even low mood. Therefore, any new gynaecological acute medical issues would be covered by an insurer.   

Further reading: Explore The Latte Lounge Menopause Resources area for information on symptoms, treatment options and more.

Are any health insurers covering menopause? 

Yes!  Big news at the moment is that two of the insurers have made positive changes (Vitality and Bupa). For example, if you have a private healthcare plan with Vitality you can access their new menopausal service and will have access to 1 to 1 videos with a menopause practitioner (who can send you recommendations to share with your GP), symptom support and peer support. Any woman who has a plan with Vitality (group or personal) is eligible to access this menopausal support!   

Do note if you are making a claim it is recommended that you specify exactly what acute symptoms you have i.e. (pain, bleeding etc). Don’t simply ask for tests to understand your body as the insurer most likely will decline your claim.  Always make sure your GP writes a clear letter mentioning symptoms rather than asking for a diagnosis of the menopause.  

Who are the best insurers for women’s health?   

All of the insurers will pay for eligible treatment so there is not a single best insurer for women. The NHS is wonderful but as we all know the waiting lists are extremely long (more so now).  So if you can afford to have a private healthcare plan you will be guaranteed to be seen and diagnosed quickly. 

Ok, so how do I go about choosing private healthcare?  What are some of the things I should consider as a women in my 40s, 50s and beyond?  

There are many factors to consider that are specific to your needs – for example budget, current health and where you live.  

There are many ailments we all could get as we get older. Our health today is not always a predictor of our health tomorrow. But if you are worried about new symptoms you most likely, will be seen and diagnosed quickly within a week if you have a plan in place.  On a personal level I was ill over 1 ½ years ago and had to have two operations within two months of each other. Having a policy meant I was diagnosed and treated quickly and could get on with my life. .   

Is it worth having taking out a private healthcare plan? Do insurers always honour claims? 

Yes, insurers do pay for eligible claims. The rule when you take out private healthcare for the first time is that any health issues in the past five years are not covered for at least two years and would only be covered again if you have had two clear years of no treatment, advice, medication or symptoms.    

I already have a private healthcare plan in place – can I get it cheaper elsewhere? 

If you have a private healthcare plan in place and have stayed with the same insurer for many years, there is a strong possibility another insurer may allow you to transfer on a ‘no worse terms basis’ for a lower price. All it takes is a 5 minute review.  

The best thing about my job is the number of times I get a client more benefits and a lower premium –all because they had a five minute free initial review.   

Are there any tips for choosing healthcare cover that you can reveal that only a broker would know?   

If you buy directly from an insurer, they will offer you options to reduce your costs.  However, the insurers don’t always emphasise the negatives of your choice. They are not offering advice but rather providing information. If your claim is rejected and you don’t understand why or have queries about your plan, you have to deal with the insurer on your own.   

If you bought your plan through an independent broker, the premium is the same as if you bought directly from an insurer.  But a broker will fight your corner and also tell you where you stand.  

Any other words of advice? 

Remember, the small print is important. All insurers say they provide cancer cover (when you have chosen this option as it is optional for some insurers).  But the definition of cancer cover varies from insurer to insurer.  If you buy your private healthcare on your own, you risk missing some important things (unless you have a lot of time to devote to choosing cover). But an independent broker will certainly know the most important information to guide you according to your needs and budget.   

And finally, are all Insurance Brokers the same? 

No. Not all Insurance Brokers have access to the whole market (some are tied to one or two insurers so can’t give independent advice).  

But an Independent Broker reviews the whole market, has relationships with all the insurers and can help you when the chips are down  

Some brokers are better than others (just like some doctors are better than others) – the best brokers know the different angles of all insurers and can find the best route forward for you! 

We hope this answered all your questions about private healthcare and menopause.

About Liz

Liz Dorfman owns Liz Dorfman Ltd trading as LD Health Solutions, which is an Independent Broker specialising in healthcare insurance. Liz Dorfman Ltd is authorised and regulated by the Financial Conduct Authority. 

If you are considering health insurance or would like to find out if you could get your current health insurance cheaper elsewhere visit Liz’s website or phone her on 01923 241258 or email her now. You can also read more about Liz on our website.