Covid-19 Guidance for Employers – Private Medical Insurance

March 2020
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We are aware that despite all our attention being on the Coronavirus pandemic, many of your employees will have other medical needs at this time. Here we answer some of the questions raised. If you have a specific question on your own private medical scheme, please contact your usual LEBC consultant by email. We have implemented our business continuity plan to enable remote working and we are ready to help you at this difficult time. 

Q.1 Private medical hospitals have given over a lot of their resources to the NHS, how will we know whether private medical treatment already booked can go ahead? 

A. It is still very early days since the announcement was made by the Government, but the situation is changing rapidly. Private hospitals may need to carry out urgent NHS surgery and may also be caring for Covid-19 patients in the future.

Naturally due to reduced resources, some appointments may need to be cancelled or postponed based on clinical need in the short-term, as elective surgery will no longer be carried out privately. Members should check with the hospital at the earliest opportunity to see if their appointment has been affected.

If you wish to reschedule your appointment speak to the hospital/clinic in the first instance who will advise you further. If you do reschedule/cancel the appointment, we encourage you to update your insurer to avoid any issues when this is rearranged to a later date.

Most medical insurers have added a Covid-19 section to their website, which will be updated with relevant information relating to ongoing/planned treatment that may be affected. Where possible, many services will be delivered remotely, and you should check the insurer’s website regularly for the latest updates.

Q.2 How do we notify new claims for private medical treatment? 

A. In the usual manner, by obtaining pre-authorisation from the insurer. As many claims still require a GP referral.  As GPs are changing their working practices, this may be difficult, and you should speak to your usual LEBC consultant to establish whether there are any alternative referral methods available to your employees and their insured family members.

Please be aware that members may need to wait longer than usual for a private appointment due to the Covid 19 crisis, as private hospitals are prioritising cases based on clinical need. More severe conditions must therefore take priority, whereas elective procedures for minor conditions are likely to be postponed during this time.  However, your policy will provide a range of other support functions which members can access.

Q.3. As an employer, how can we be expected to continue paying for private medical insurance for our staff when some will not be able to use it for the foreseeable future?

A. As with all insurances, you pay an ongoing premium for cover whether you claim or not. The Covid-19 crisis mainly affects face to face treatment in hospitals/clinics and this is a temporary situation. The value of this insurance will not change, and premiums cannot be reduced due to these unprecedented circumstances, as pending treatment will still be needed once Covid-19 is contained and insurers are expecting a significant rise in claims after this period is over. 

Most PMI policies offer a range of treatment pathways and additional services that members can access via the telephone, web browser or smartphone app. You should make all employees aware of these services, these could prove invaluable for many people during these unsettling times. 

Q.4 We are facing financial hardship as a business and are having to consider some tough decisions. As it will be difficult for our staff to use our PMI scheme over the coming months and need to make savings, what are the implications if we cancel?

A. We fully sympathise and understand it is a very difficult time for many of us however, we strongly suggest not to make any decisions that could have permanent/long-term ramifications, based on what we hope is a short-term problem.

There are many implications involved in cancelling a PMI scheme and in the first instance, you should email your usual LEBC consultant to discuss further. 

Kay Ingram                            
Director of Public Policy

Please remember, no news or research item is a recommendation or advice to buy. LEBC Group Ltd is not responsible for accuracy and may not share the author’s views. The contents of this blog are for information purposes only and do not constitute individual advice. A pension is a long-term investment. The fund value may fluctuate and can go down. The value of an investment and the income from it could go down as well as up. The return at the end of the investment period is not guaranteed and you may get back less than you originally invested.  If you are unsure of the suitability of any investment or product for your circumstances, please contact an adviser. All information is based on our current understanding of taxation legislation and regulations. Any levels and bases of, and reliefs from, taxation, are subject to change. The Financial Conduct Authority does not regulate estate planning, tax advice, wills or trusts.

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