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Private Medical Insurance

What is it?

These are policies which provide you and/or your employees with the option of private medical care as an alternative or in addition to the care provided through the Gibraltar Health Authority.

Rather than waiting for GHA treatments, Private Medical Insurance (PMI) allows the insured to bypass the queues for the treatment of curable, short-term medical conditions, meaning that your employees' absences from work due to illnesses can be kept to a minimum.

The company pays monthly or annual premiums (there may also be an element of employee contribution), the cost of which may be determined by the insured's personal circumstances (e.g., sex, age, previous medical history) and the type of cover chosen. Premiums are reviewable each year.

The advantage of PMI is that the place for treatment can be chosen from a list of international hospitals. As well as avoiding GHA waiting lists, the insured can usually choose a date and time for treatment which is convenient for both themselves and the company.

PMI is relatively flexible. The number of claims made each year is not usually limited. The place of treatment and the level of cover required would determine the premiums paid.

What is covered?

Typically, PMI policies will not cover pre-existing conditions, long-term or chronic conditions, HIV/AIDS-related conditions, cosmetic treatment, outpatient drugs and dressings, among other things. There are generally two types of policy to choose from: a comprehensive policy and a low-cost/budget policy. 

As a comprehensive policyholder the insured could expect:

In-patient treatment

  • Hospital charges, including accommodation, nursing care, meals, drugs and dressings.
  • Specialist fees.
  • Tests, including X-rays, CT scans and MRI scans.
  • Radiotherapy/chemotherapy.
  • Psychiatric treatment.
  • Out-patient treatment.

Out-patient treatment and benefits

  • Consultations with a specialist.
  • Nursing at home.
  • Private ambulance.
  • Complementary medicine.
  • Minor surgery.
  • Hospice care.

Costs can also be kept down by agreeing to pay a share of the claim cost or by being less constrained in the choice of hospital.

PMI insurers may offer no-claims bonuses to limit premium increases or reduce the costs, providing an incentive to avoid minor claims. Some insurance companies will settle the medical bills directly with the hospital or consultants rather than you having to pay and then claim the money back.

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