PRIVATE MEDICAL INSURANCE (PMI)
Paying for your care with private medical insurance
If you have private medical insurance, either your own or one your employer gives you, you may be able to use it to see us. Your care is led by a consultant psychiatrist from your first appointment through to treatment. This page tells you what to check on your policy, what your insurer needs to give you, and how to send it to us. It should take about ten minutes.
THREE THINGS PEOPLE ASK FIRST
Which insurers can I use?​
This depends on what you're wanting support with, and on what your insurance policy covers. The best course of action is to read your policy documentation or call your insurer to find out more.
Do I need pre-authorisation?​
Almost always, yes. Insurers want to approve mental health treatment before it starts, and they give you a code or a claim number when they do. Without it, your insurer may refuse to pay and the bill would come to you. Some policies also ask for a GP referral letter first, so check that at the same time.
What is and isn't covered?​
Cover is set by your policy, not by us. Most policies cover assessment and treatment for conditions like depression, anxiety, OCD, PTSD and bipolar illness. Most exclude ADHD and autism assessment, and many limit the number of therapy sessions each year. Health cash plans work differently again: they pay back a set amount per appointment rather than the whole cost. Your policy documents will say.
HOW IT WORKS
1​
Check your policy
Find your policy or membership number and look for outpatient mental health cover. Three things decide whether insurance will work for you: whether mental health is included, whether you have an excess to pay first, and whether the treatment you need is excluded.
Seven things to look for, or to ask them:
​
-
Outpatient mental health cover, and any yearly limit on it
-
Your excess, the amount you pay before the insurer pays anything
-
Exclusions, especially ADHD and autism assessment
-
Whether pre-existing conditions are left out
-
How many therapy sessions are approved, if any
-
Whether you can choose your own psychiatrist, sometimes called "out of network" or "reimbursement"
-
Whether what you have is a health cash plan or an employer scheme rather than full insurance, as they pay differently
Only your insurer can tell you what your policy covers. We cannot check it for you.
2
Ask your insurer for an authorisation code
Ring the number on your policy documents and say you want to be seen by a consultant psychiatrist. They will ask a few questions, then give you an authorisation code or claim number, and often a limit on how many sessions are approved. Write it all down.
"I would like to see a consultant psychiatrist about my mental health. Can you tell me what my policy covers, and give me an authorisation code?"
3
Send it to us with your enquiry
Contact us, give us your insurer, your policy number, and the authorisation code if you have one. Send it once your insurer has confirmed your cover. If you are still waiting on a code, finish that call first: they can usually give it over the phone in one go.
4
We confirm and book you in
We check that we can invoice your insurer on the details you have given, tell you plainly if anything is missing, and offer you an appointment with a consultant psychiatrist, in Epping or online. We reply within 2 working days.
WHAT WE TREAT
Care you can usually claim for
Your policy has the final say. This is what insurance usually covers with us.
Conditions​
-
Depression
-
Anxiety
-
OCD
-
PTSD
-
Bipolar illness
-
Personality disorders
Appointments​
-
First psychiatric assessment
-
Follow-up reviews
-
Medication started and monitored
-
Letters and reports for your GP
Treatments​
-
Psychological therapy
-
Deep rTMS for depression and OCD
Deep rTMS needs its own authorisation from your insurer. Ask about it by name.
PLEASE READ BEFORE YOU ENQUIRE
ADHD and autism
​
Private medical insurance almost never pays for an ADHD or autism assessment. Insurers treat them as developmental conditions rather than illness, so they sit outside most policies. We would rather tell you now than take your enquiry and turn it down.
​
There are two other ways to be seen by us for ADHD or autism, and both are open to you today.