• PMIGenie

Out-Patient Benefit

This option on cover is perhaps the most varied amongst insurers - so it's important you know what you're covered for before claiming.



First you need to think about why you want healthcare cover. If it's so that you can be seen quickly by a professional for a consultation, out-patient benefit is a must - but how much do you need? And what exactly is covered?

Each insurer is different - so read the small print because something that you assume is covered, might not be.

Cover levels


Most insurers will offer some out-patient benefit even if you set the benefit to £0. Often these things include surgery, scans & radio and chemotherapy. Out-patient benefit must not be confused with in & day patient. Where there is no solid definition for any, rule of thumb is that in-patient is when you stay over night, day-patient is using a bed all day in a hospital and out-patient is seeing a consultant and follow up visits for scans. You can chose; number of visits per year, monetary amount with extras or overall total. This is where you should take the excess into consideration too - it may seem like a good idea to have a £500 excess, but combine this with a £500 out-patient benefit, means you'll have no benefit but still be paying for it!


The level of cover resets at each policy renewal, so always think carefully what you'd be claiming for. If you're happy to pay for your initial consultations, it can be prudent to have no benefit as this will lower the cost. But if you expect to be seen privately upon a GP referral, you will need some cover. With an average consultation visit costing around £200, it can add up quickly, so if you choose to limit the cover, bare this in mind.

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