Mike, 32, is a bus driver and Sarah, 32, is a primary school teacher. They have an 18-month old daughter called Jemma. Mike's father and grandfather have both had a major heart attack, but Mike is leading a healthy lifestyle and his blood pressure is normal. Sarah is healthy and hasn't suffered any health problems in the past. They are both nonsmokers. They want to take out private medical insurance but their budget is limited and their main priority is Jemma. What are their options?
Susie Colley, West Country Healthcare
While this young family has a limited budget for private medical insurance (PMI), there are a number of options open to them.
One is to reduce the premium by applying an excess.
Another alternative is to reduce the premium by applying a co-payment, where Mike and Sarah would pay a percentage of each claim until they reached a pre-agreed amount, at which point the provider would pay the remainder of the entire claim.
Mike and Sarah could also reduce the premium by restricting the availability to all hospitals, or by taking a six-week waiting policy.
This means that if a client has to be admitted for either day case or inpatient treatment, they will have to use NHS facilities if available within a six week period.
However, if the wait is longer than that, they are admitted immediately into the private sector.
Finally, Mike and Sarah should also consider policies offering discounts for nonsmokers and/or attendance at gyms.
As there is no difference in the age of the parents, there would be no advantage in splitting the cover.
Consequently, the family premium would be applied.
However, Mike and Sarah should be advised with regard to additional products such as critical illness (CI) and income protection plans.
As Mike's family history is not good, he clearly may have a genetic trait for cardiac disease.
Therefore, other options must be considered, as the ramifications if he were to have a heart attack would seriously undermine their finances.
If a comprehensive PMI is taken with one of the cost saving options then some of their allocated funds for this policy could be put towards a CI plan.
Nye Jones, AXA PPP Healthcare Even with a growing family and increasing demands on their resources, Mike and Sarah still have plenty of affordable choices to help them to meet their healthcare needs.
As healthy non-smokers, Mike and Sarah would both benefit from lower premiums if they took out one of our premiums, which takes into account people's health and lifestyle.
Our low price Assure plan with a £200 excess would cost around £45 a month and would cover them for hospital inpatient and day patient treatment as well as for outpatient scans and chemotherapy and radiotherapy.
The cost could be cut further by choosing our six-week option, which pays for private care straightaway when the NHS cannot treat the policyholder in under six weeks.
A useful advantage of this choice is our decision to exempt a number of treatments from the six week test, including tonsillectomies, insertion of grommets, adenoidectomies and correction of squint, which tend to affect children.
If Mike and Sarah wanted to increase their cover to include additional outpatient benefits they could opt for Key 6 with no excess.
At around £50 a month, this would provide £300 each for consultations, complementary practitioners' and clinical practitioners' charges and additional diagnostic tests.
Alternatively, Mike and Sarah could consider our Essential Medical Protection policy, which, at around £33 a month, provides a one-off fund for private treatment for each member of up to £250,000 over two years should they be diagnosed with cancer, a heart condition, or a stroke, or if for one year they should require treatment following a road traffic accident.
Anne Owen, Clinicare Sarah and Mike require the peace of mind that if any health problems should occur, either to themselves or their daughter Jemma, they will be able to seek professional help without delay.
With this in mind, the plan that would best suit their needs would be Clinicare's Club policy with a hospital band C.
This offers a full refund for all eligible inpatient treatments within our schedule of surgical procedures as well as generous cover for many outpatient treatments.
In addition to this, it provides worldwide travel insurance cover should the family encounter any medical problems while overseas.
Clinicare Club also includes an advice and information line, which provides access to trained counsellors who can listen to their problems and help them find suitable sources of further help if required.
As Sarah and Mike are fit and healthy but at the same time have a limited budget, they could reduce the basic premium by opting for an excess of £100.
This means that they would have to pay the first £100 of any claim per person, per plan year.
By including an excess, Sarah and Mike receive an 8% discount, which brings their premiums down to £94.
80 per month.
They would of course be required to complete an application form detailing their medical history, and the fact that members of Mike's family have suffered heart attacks would not be taken into account when assessing his personal risk.
Sarah and Mike would naturally be concerned if Jemma had to be admitted to hospital as she is so small, but under the Club policy there is an allowance of £80 available for either parent to stay with her should she have to stay overnight.
This is invaluable to parents of young children as it provides an essential comfort factor for the whole family.
