The NHS provides comprehensive treatment to anyone, Private health insurance regardless of their ability to pay. Yet if you want to opt for private care, it can be costly, so that’s where health insurance comes in. It covers planned consultations, treatments and operations – be it hips, cataracts or ears. Yet it’s a lifestyle choice, and it ain’t cheap. This guide explains how it works, what to watch out for and how to keep costs as low as possible.
1-min read on finding private health insurance
Many can save £100s by comparing policies to find the cheapest one. Here’s a quick lowdown if you know what you’re doing and just want to find a cheap policy (alternatively, for more help, read our full guide below).
1. Use comparison sites to benchmark prices, if you know what you want (and don’t need advice). You’ll get multiple quotes from one form, but you’ll need to compare the cover yourself to find the best policy for you (and do note that existing medical conditions WON’T be covered).
We’d suggest checking both comparison sites if you’ve time:
ActiveQuote (the link takes you to details of its £110 cashback offer)
Assured Futures (the link takes you to details of its £90 cashback offer)
2. If you need specialist advice, for example, you have complicated medical conditions, a broker can recommend a policy. This usually takes longer, but should return a much more bespoke quote. Some (not all) brokers charge a fee, but this must be disclosed upfront. You can find a broker via the trade body AMII.
Put simply, private health insurance – or private medical insurance (PMI) – is a policy that covers the cost of private medical care should you become unwell. It works alongside the NHS, and often gives you access to shorter wait times, a choice of location, and treatments only offered privately.
You pay a monthly sum to the insurer, then it pays for certain private treatment you may need during the policy, such as consultations or surgery.
What does and doesn’t it cover?
Health insurance is designed to cover you for non-routine tests and treatment for acute conditions. These are those that are serious but curable and usually short-lived, which start after your policy begins.
Therefore many chronic conditions (often incurable, long-term issues such as arthritis or asthma), as well as those that exist before you take out a policy, are excluded as standard.
The exact range of medical treatments covered will vary by policy and price, though here are some examples:
Tests or surgery as an inpatient (where you need to stay in hospital)
Hospital accommodation and nursing care
Consultations, tests and therapy as an outpatient (no stay required)
Medicine or drugs not available on the NHS
Basic plans usually cover essential treatments, whereas comprehensive cover can also include specialist therapies or medicines.
Typical conditions that are covered include musculoskeletal problems (for example, short-term back pain), digestive system conditions (such as gastroenteritis), heart and circulatory diseases (for example, coronary heart disease) and eye and ear conditions (such as an inner ear infection).
If your tests lead to a diagnosis of a chronic condition, the initial tests are usually covered, but the long-term treatment isn’t. For example, if you developed symptoms of diabetes and your GP referred you to a specialist to diagnose the issue, your policy should cover this. However, if you are then diagnosed with diabetes, any treatment, medication or check-ups would no longer be covered, and would instead pass to the NHS.
It’s different from a critical illness insurance policy. Private health insurance pays for medical treatment to get you better, while critical illness pays out a lump sum to help offset any loss in income. A critical illness could be defined differently by each policy, but could include Alzheimer’s or presenile dementia, cardiac arrest, deafness, loss of speech, paralysis of a limb, stroke or brain injury.
Should I get health insurance?
Any policy is optional, so you’ll need to weigh up whether the monthly cost is worth it for you. But here are some key points to consider:
The NHS may be sufficient for your needs. Even with private health insurance, you’ll still use the NHS for services such as your GP or A&E. Equally, if you get a serious illness, you won’t necessarily receive treatment more quickly by being covered by a health insurance policy than you would under the NHS.For less serious cases, the benefits of a policy can include being referred to a specialist for treatment, as you may have a wider choice of times or locations by going private, over sticking with the NHS. So paying for healthcare could be considered a luxury.
Consider self-insuring. You don’t need insurance to go private – you could opt to pick up any bill yourself. Rather than paying a monthly premium to an insurer, instead pay that amount into a top savings account. If you need treatment, you can dip into your ‘insurance fund’. Plus you’ll keep the cash if you don’t claim.However, be aware that it’ll take time to build up cash and the treatment for certain conditions can be expensive. For example, carpal tunnel release on one wrist is often about £2,000, cataract surgery on one eye around £3,000, but a hip or knee replacement starts around £10,000. So a combination of treatments could potentially run into £100,000s.
You could combine self-insuring with a private medical insurance (PMI) policy with a high excess. That way you pay less for the policy, and pay for cheaper expenses yourself, yet you’re covered for the more expensive procedures, such as major surgery. Read more on how PMI excesses work.
Check if you’re already covered by your employer (though there is a problem here). If you or a partner is employed, it’s always worth checking if your employer(s) offer individual or family private health insurance. This can sometimes be a no-cost standard benefit (though you may pay tax on it) or an option you can choose to pay for, often via your payslip.Firms’ bulk-buying power often means they can negotiate big discounts, so find out the cost and cover, then compare it with the cheapest plans that match your needs.
There is a ‘but’ though… If you need treatment, claim, and then later decide to leave your employer, will you be able to continue your membership with the healthcare firm on the same terms? If not, you may then be stuck without being able to get a new insurer to cover an existing condition (or need to pay huge premiums every month to keep it covered).
