Health insurance guided

Choosing a guided option when purchasing health insurance may help reduce your policy’s cost,  without affecting what you’re covered for or the quality of service you may receive. Not all UK health insurance providers will offer a guided option, and in some instances, it may not be the right choice for you. We’ve covered this topic in detail to help you understand whether guided health insurance is worth considering for your private health needs.

What are guided options in health insurance?

Some UK health insurance providers offer a guided option which is a cost containment option that limits flexibility for you to choose specialists and hospitals. Guided options are available to both personal and business customers looking for an alternative policy option. Guided policies vary in the way that your provider will choose which consultants and/or hospitals you’re covered for. As a result, the cost of your policy may be reduced without you having to sacrifice policy benefits.

Health insurance providers offering a guided option may have made arrangements with consultants and hospitals in advance. These arrangements may allow them to save on their costs when their policyholders claim through these avenues, which is why they can pass the savings on to you.

How will a guided option affect your health insurance policy?

At a glance, if you’re considering guided health insurance, here’s how it will affect you when compared to other policy types:

• The cost of your policy will be reduced.
• Your provider will choose which consultants can treat you.
• Your provider will choose which hospitals you can be treated at.
• Your policy benefits won’t be affected.
• Your referral and claims process may differ.
• You’ll only be able to choose from providers who offer a guided option.

Which health insurance providers offer guided options?

Several UK health insurance providers offer a guided option on their health insurance products. You may be given the option to purchase a guided option when creating your plan, but this depends on the policy you’re purchasing and whether the provider offers this in the first place. We’ve listed some of the major UK health insurance providers that provide a guided option to help you assess your options.

AXA Health

• Often referred to as the AXA Health Guided Option.
• Access the full directory of AXA hospitals.
• Choose between 3 specialists AXA have recommended when you’re referred for treatment.
• You’ll use the Fast Track Appointment Service when you need to see a specialist.
• You must ask your GP for an open referral.
• Available for personal and business health insurance policies.
• Your medical costs are covered in full when using their preferred specialist subject to your chosen plan benefits, ensuring you will not experience shortfalls from consultants.

AVIVA

• Often referred to as AVIVA Expert Select.
• You’ll be offered a choice of hospitals to be treated at, which may be between 4-5 facilities on average.
• You’ll be given a choice of medical specialists to choose from.
• You must ask your GP for an open referral.
• Available for personal and business health insurance policies.
• Your medical costs are covered in full when using their preferred specialist subject to your chosen plan benefits, ensuring you will not experience shortfalls from consultants.

Bupa

• Often referred to as Bupa Guided Care.
• Only available on Bupa By You and Bupa Fundamental policies.
• You’ll be offered 2 or 3 consultants from their open referral network to choose from. BUPA work with over 19,000 registered consultants.
• 90% of policyholders won’t have to travel for longer than 45 minutes to see a consultant in their network.
• You’ll also be covered to use the Direct Access service, which gives you the option to speak to specialists over the phone for cancer, muscle, bone, joint and mental health problems.
• You must ask your GP for an open referral.
• Your medical costs are covered in full when using their preferred specialist subject to your chosen plan benefits, ensuring you will not experience shortfalls from consultants.

Vitality Health

• Often referred to as Vitality Health Consultant Select.
• You’ll be helped with choosing a consultant for your medical problem.
• Consultants are chosen from the Alliance Health Group, which is an independent group of consultants that offer private treatment in the UK.
• Vitality aims to find you a consultant that is within 40 minutes of your home location.
• If you’re unhappy with your consultant, you may be able to change to an alternative specialist within the Alliance Health Group network.
• Available for personal and business health insurance policies.
• You must ask your GP for an open referral.
• Your medical costs are covered in full when using their preferred specialist subject to your chosen plan benefits, ensuring you will not experience shortfalls from consultants.

The Exeter

• Often referred to as The Exeter Guided Option
• You will be given a shortlist of specialists to choose from based on your health needs and location.
• You must ask your GP for an open referral.
• Your medical costs are covered in full when using their preferred specialist subject to your chosen plan benefits, ensuring you will not experience shortfalls from consultants.

How do guided options claims work?

The claims process varies per provider, but they may all follow a similar structure, such as the following:

1. You visit or speak to a GP and request an open referral if needed for your medical condition.
2. You then need to contact the provider of your health insurance policy.
3. Your provider will review your health needs and location and offer you a consultant or list of consultants to choose from.
4. After confirming with your provider, your appointment will be booked.
5. All costs are handled by your provider, which may include future visits or treatments that are required for your condition.

Is a guided option right for you?

Whether a guided option is the right choice for you depends on many things, but ultimately, it may boil down to a few personal factors:

1. Do you want lower costing premiums?
2. Are you happy to reduce your flexibility to choose specialists and hospitals and for your provider to choose these for you?
3. Do you have no preference over which hospitals you’re treated at?
4. Are you interested in a specific provider, and do they offer a guided option?

If you’re still undecided, comparing health insurance options may help you to make a decision. This is a free service that you can use to compare multiple options against one another, with the aim of finding the most suitable policy for you within your budget.

Compare guided health insurance policies

We offer a free comparison service if you’d like to explore the various guided health insurance policies available to you. This is a no-obligation service, and we aim to find the most suitable policy for you at a competitive price. Complete the comparison form below, and a member of our team will be in touch with you to learn more about your needs and discuss your options.