How does a six-week option work?
Selecting a six-week option when taking out private medical insurance means that, instead of claiming on your policy, you will use the NHS if it can deliver inpatient or day patient treatment within six weeks of referral. Some providers offer a four-week option which works in the same way. Neither affects your outpatient benefit, meaning you can still see private consultants and have scans and tests during this time.
For example:
If you are diagnosed with cancer or a heart condition, the NHS will typically offer some form of treatment within six weeks. This means that in the vast majority of cases you will not receive private treatment. For example, you may need to have cancer/heart surgery under the NHS, or perhaps be unable to access drugs that would usually be available privately.
However, you’ll usually get private treatment for things like hip and knee replacements, plus other non-urgent conditions. This is because NHS waiting times are likely to be longer than six weeks.
What are the pros and cons of a six-week option?
At first glance, it’s clear that the six-week option is a good way to save money, as it reduces the chances of you needing to make a claim. That means that providers will lower your premiums, and you’ll pay less for your insurance.
However, the six-week option can prevent you from being seen by your chosen consultant. If the doctor that diagnosed your condition doesn’t have appointments available under the NHS, or doesn’t work as part of the NHS, this may lead to delays while you are assigned to a new consultant. It’s also possible that they’ll want to run their own diagnostics pre-treatment, which isn’t ideal if you took out private health insurance in order to be seen quickly.
You also need to remember that you could end up using NHS facilities when you don’t want to. For example, after a stroke or heart attack, you will probably have a long stay in an NHS hospital rather than a private one.
The six-week option can cause disappointment if it isn’t fully understood. Check whether it’s a good idea to add it to your policy by calling us for free expert advice.
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Should I add a six-week option to my private health insurance policy?
If you are looking to save money, and are happy to receive treatment for cancer or heart problems on the NHS, then the six-week option could be right for you.
Insurers generally do not cover you for a condition that you have received advice or treatment for in the last five years. It is common for insurers to cover a condition after a two-year period if you have not sought advice or treatment for it and you have a policy in place for those two-years.
So if you are treated for something that falls within the six-week period, further treatment, rehabilitation and recovery will not be covered by the private health insurance provider. While you will be treated by the NHS, there is no guarantee you will have the same speed, access and choice as you do with your private health insurance policy.
Which private health insurance providers offer a six-week option?
Currently Aviva and AXA Health offer a six-week option. We can compare quotes from all of these providers to get you the best policy for your needs. Saga currently provides a four-week option and, although we don’t offer their policies to our clients, we can review existing Saga policies. Just give us a call and we will advise you.
Can I remove the six-week option from my policy?
Yes, although this is considered an upgrade, so it will be subject to medical underwriting questions. You will usually be asked if you have anything planned or pending with a medical professional other than your GP. If so, your insurer may not remove the six-week option, or they may place a moratorium where only new conditions are eligible for the benefit.
If removing the six-week option is still a priority then you could consider Vitality Health’s “switch and save” offer, where they match or increase your cover levels and beat your current or renewal premium. As they have no six-week option, they will adjust your premium accordingly, which is unlikely to be much more than you are paying your current insurer.
Please contact us to discuss your options if you want to remove a six-week option.
How can I tell how long the waiting list is for a treatment?
The NHS will advise you on how long the waiting list is for a specific referral or treatment. You can find this information in the NHS app using their e-Referral Service. This waiting list is often subject to change, and can increase or decrease in duration. You may also be able to benefit from a cancellation by another patient that brings a potential appointment or treatment forward.
The current maximum waiting list time for non-urgent, consultant-led treatments is given as 18 weeks by the NHS. This is from the day your appointment is booked through their system. However, these waiting lists can extend longer than this period, and your second and third appointments may not be subject to the same maximum waiting time.
While the six-week option can help you save money when it comes to urgent treatments that the NHS prioritise, you should evaluate your options for other kinds of treatment that won’t be prioritised. This is where the real benefit of a private health insurance policy can be felt – getting you access to treatment when you need it.
Do I have to use the NHS if I take out a six-week option?
You will have to use a NHS provider if the treatment you require can be booked in within the six-week period from referral. If the treatment is unavailable on the NHS in that time, then you will be treated through whatever method your private health insurance policy provides. But you will have to attempt to receive treatment from the NHS first.
If you have a question about making a claim and whether it falls within the six-week option period, then you should contact your private health insurance provider for details. The team at Clarity Health Insurance are also available to assist with making a claim should you require advice on how best to proceed.
