private health insurance

What is a Guided List of Consultants? Explanation of private health insurance.

Private health insurance gives you quick and affordable access to private treatment. Your choice of consultant and hospital will depend on the cover offered by your health insurance policy. In this guide, we explain how the Guided List of Consultants works so you can make an informed choice about your options.

How does selecting a consultant work?

Whether you have private healthcare through your health insurance or opt for NHS treatment, you will usually be able to choose the consultant who treats you. Your health insurance provider will let you know which consultants are covered by your health insurance policy. Each health insurance plan also has a list of hospitals detailing which private hospitals are covered by your insurance. Your insurer will let you know which hospital list is included in your policy.

Unlimited access or smaller pool

There are several different ways you can choose your consultant. Your policy may give you free choice or offer the option of guided consultants. Your preference will affect the price of your health insurance policy and the level of adviser you choose. If you have a free choice of consultant, you can tell your insurer who you would prefer to see. We’ll explain more about how guided consultant selection works soon. Health insurers usually choose guided consultants who are experts in their field and who can also keep their costs within the financial limits set by your insurer.

How much does it cost to see a private consultant in the UK? Our price research in 2023.

How does guided consultant selection work?

To access private healthcare with a managed consultant list, you will usually first need to see your GP and ask them for an open referral. You can then contact your private health insurance provider to start the application process.

Choose from a shortlist of hospitals and consultants

When you opt for Guided Consultant Choice, your insurance providers will offer you a shortlist of private hospitals and consultants when you contact them to initiate a claim. They will ensure that the consultants suggested deal with your disease or condition and have specialist training in that area. The number of consultants on the list offered by the insurer varies from insurer to insurer. Some offer a choice of several hospitals and then let you know which consultants are available when you select your preferred hospital. Others will simply offer you two or three consultants to choose from. You can book your first appointment or treatment date when you choose.

private health insurance
private health insurance

What are the advantages of guided consultants?

A guided list of consultants may be the right choice if you are happy to take your health insurer’s advice on who treats you. Here are the two main benefits of including a guided consultant option in your private health insurance plan.

1. You can lower your health insurance premiums

Health insurance companies offer you many ways to customize your coverage and ensure that the cost of your health insurance stays within your budget. You can opt for basic cover without any extras or include an excess policy or a 6-week waiting option in your policy. Our research has shown that health insurance policies with a guided consultant option are usually 20% cheaper than those with unlimited access, so choosing this option can save you money on premiums.

You can see our research on the average cost of health insurance here.

2. Afford more comprehensive coverage

If you’re on a tight budget, opting for a guided consultant selection could give you more comprehensive coverage. For example, you can add outpatient treatment coverage to your policy. Outpatient care offers some of the best health insurance benefits. For example, consultation appointments and diagnostic tests are paid for giving you a private diagnosis rather than waiting for an NHS diagnosis. All health insurances cover hospital treatment, such as surgery. However, outpatient insurance may also pay for your treatments if you do not need surgery but would benefit from physiotherapy.

3. A guided list of consultants makes it easier to choose a consultant

You will probably want unlimited access if you have strong opinions about which consultant you want to see or which private hospitals you prefer. However, if you just want to access treatment quickly and don’t mind who you see, guided counselor selection can help. Your insurance company will do its best to narrow down your choices based on the amount of treatment costs. Your insurer will then give you a short list of names to choose from. The list will include consultants who offer the treatment you need at your local hospital. Ideally, you have been advised of the right list of hospitals before choosing a policy so that you know that your health insurance plan includes hospitals close to your home or workplace.

Your health insurance company can still offer advice to help you narrow down your choice of consultant if you ask them to. They will have information about individual consultants based on feedback from previous customers. You can also do some research to see which one you like better, but generally the choice is quicker and easier.

private health insurance

What are the advantages of unlimited consultant access?

An unlimited selection of consultants allows you to choose your consultant based on your needs. Seeing the best consultant in your area can be a priority for you. Factors such as the location and facilities of the hospital may also influence your preferences. Many insurance companies have a network of private hospitals around the country, so you can get treatment close to home or travel further afield to make it easier for your family to visit you while you’re in hospital.

A guided list of consultants usually includes restrictions on financial treatment. This may not cover the costs of the most experienced consultants, particularly if they offer treatment in central London hospitals, where treatment costs are higher. British Medical Association guidelines suggest that unrestricted access should be preferred wherever possible. If your policy offers a free choice of consultants, this will increase your chances of seeing the specialist you want.

1. Greater flexibility

Unlimited access to counselors allows you to choose your preferred treatment provider. While a wider selection of consultants may mean you spend more time researching, this may not always be the case. Of course, you may appreciate the opportunity to thoroughly research your options before making a decision.

2. Access to more treatments

There are various reasons why you might want to see a particular consultant. You may have had your first appointment with an NHS consultant and want to make sure you see them for your private treatment. Equally, your doctor may have recommended treatment that requires specialist medical training and is only available privately or through certain consultants. Private health insurance often provides access to new treatments not currently available on the NHS. Free consultant selection can be crucial if you need treatment by a surgeon with experience or training in a particular cutting-edge procedure.

3. Go with a personal recommendation

Alternatively, if you’ve done your research, you may have a preferred consultant based on third-party reviews or your knowledge of their success rates with a particular procedure. You may even have received a personal recommendation from family members or friends based on their treatments and overall experience.

4. Greater choice of treatment locations

A free choice of consultant may also allow you to have your treatment at a more convenient location. A variety of factors affect your health insurance costs, including your personal characteristics and medical history and the location of the hospital. If you want to provide treatment close to your home or workplace, you may need a hospital in the city center. Private hospitals in cities tend to have higher costs, which may exclude their consultants from the guided-choice list, meaning you have to travel further afield. Although you may be willing to travel for surgery, attending pre-operative assessments or follow-ups may be more expensive or inconvenient.

5. Shorter waiting time

Health insurance provides quick access to private healthcare so you can get back to your life. As patients face long NHS waiting times for elective treatment, quick access to healthcare is one of the most significant benefits of health insurance.

Your private health insurance can ensure that you get treatment faster. However, your choice of counselor can also affect how long you wait for private treatment. Free choice may allow you to choose a consultant with excellent expertise, but whose fees are outside the cost guidelines required for inclusion on the list of managed consultants. As a result, they may have a shorter waiting list than other specialists who charge less. Although you might spend longer researching different consultants and hospitals before choosing, your health insurance will still give you quick access to treatment.

Your health insurance provider can also be a good source of information and guidance if you’ve narrowed down your options but would like support making your final choice.

Get professional advice

Deciding whether to opt for a managed list of consultants or unlimited access to the consultants of your choice can involve consideration of many factors. Your budget and the health insurance you need will greatly influence your choice. Equally, you can customize your coverage with your choice of hospital list and how much choice you want to have in relation to the consultant who treats you.

A specialized health insurance broker can help you understand and navigate your health insurance options and find the right policy for your needs. At myTribe, we offer guides to help you understand private health insurance and make an informed choice. When you contact us for a comparison quote, we’ll connect you with a highly rated broker who will provide tailored advice to guide you through your options.

Waiver: This information is general and what is best for you will depend on your personal circumstances. Talk to a financial advisor or do your own research before making a decision.

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