Case study

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Ruth, 26, is a magazine designer living in London. Although in good health, she suffered from ME for...

Ruth, 26, is a magazine designer living in London. Although in good health, she suffered from ME for two years in her teens, and contracted malaria while on a gap trip around the world. While she is generally in good health, her ME flared up slightly four years ago when she was completing her degree. She would like to buy PMI for £50 or under. What would you recommend for her?

Phil Taylor, Health Assured PMI

Based on Ruth being 26 and in good all round health we would offer the PruHealth PMI Plan. Using its unique Moratorium underwriting together with some lifestyle questions, Ruth would qualify for a 25% discount in her first year as well as having all her previous conditions (except those specifically excluded by the plan) covered in two years time.

Prices would start from £35.93 for Core Cover increasing to £43.77 for Essential Cover and, finally, Comprehensive Cover with a £250 excess at £49.63, covering all but three hospitals in the UK.

Ruth would also have the opportunity to engage in PruHealth's unique Vitality programme where everyone can benefit from a healthier lifestyle. Do a few simple things, like eating well and taking a bit more exercise and policyholders can lower their premium when they come to renew their health insurance policy. Doing these things can even increase the discounts on Mark Warner holidays and Champneys Health Resorts.

Some of the savings would be that if the policyholder does not claim they will receive a no claims bonus of 25% of this year's premium towards the cost of next year's cover; and by taking part in the Vitality programme and making an effort to actively look after their health throughout the year, this no claims bonus could increase to 50%, 75% or even 100%. So, by leading a healthy lifestyle, policyholders could help reduce the cost of next year's health insurance cover.

Dave Priestley

Dave Priestley, PruHealth

As a young working woman, now is the ideal time for Ruth to consider private medical insurance (PMI) and her previous medical conditions need not be a barrier to joining PruHealth. Under the two-year flat moratorium option, Ruth would automatically be covered for Malaria or ME after two years of continuous membership. Alternatively, if she opted for full medical underwriting at the point of joining, it is unlikely any pre-existing restrictions would be imposed. Regardless of the underwriting option Ruth chooses, as both Malaria and ME are technically chronic conditions PruHealth would not cover the cost of ongoing maintenance. However, it would cover any acute flare-ups.

Given her budget, PruHealth would recommend its Essential plan with National and London hospital cover at a monthly premium of £43.77. A first year Vitality discount of 25% for answering five questions about her health is included. The Essential plan gives covers all eligible hospital inpatient costs and full cover for outpatient diagnostic tests, and a further £600 towards other outpatient services such as consultations and physiotherapy.

By taking part in the Vitality programme and engaging in healthy activities, Ruth could also reduce her future premiums. Depending on her status level, and whether or not she claims, Ruth could put up to 100% of her current premium towards the cost of her following year's cover.

Jason Pettit

Jason Pettit, Bupa UK Membership

There are a couple of options that would be suitable for Ruth. Any treatment directly relating to her ME and malaria would be excluded from cover on all of Bupa's private medical insurance (PMI) schemes.

If Ruth has an active lifestyle then one of Bupa's more comprehensive PMI options, such as Heartbeat Health Care Select 2, would be appropriate. With a £150 annual excess, the cost would be within budget at around £43 a month and would make sense for a 26-year old who is generally in good health.

However, she may prefer to look at a less comprehensive level of cover, such as Heartbeat Health Care Select 3, which would cover her for the larger costs of medical treatment - diagnostics and inpatient or day-case treatment - but not for outpatient costs prior to any private inpatient or day-case treatment covered by the scheme.

She could supplement this PMI cover with a cash plan option, providing a range of cash-back benefits towards a range of everyday health costs. After an initial 13-week waiting period, a cash plan would include some cover for outpatient consultations or alternative therapies, including eligible treatment relating to her pre-existing conditions, as it does not carry the same underwriting basis as Bupa's PMI schemes. The cost for this PMI option with a cash plan would be around £42 a month.

Costs are based on individual circumstances and we have assumed Ruth is a non-smoker.

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