A Guide to Private Health Insurance in the UK

The NHS provides free healthcare to the majority of UK residents.

Health insurance can help cover the costs of medical bills if treatment is private. This allows the individual to choose the level of care they receive and how it will be provided.

Private health insurance is not a mandatory requirement. Nevertheless, unless the NHS is an acceptable option, private medical treatment can be especially costly. This is especially true for serious and complex condition

What does it cover?

Like any other insurance policy, the type of coverage you can expect will depend on the policy your purchase.

A basic policy will typically cover the costs of most tests, surgeries and other in-patient treatments as well as day-care surgery

Other policies will extend their coverage to include out-patient treatments as well as fees for specialists and consultants. These policies may also partially cover the costs of your expenses for staying at an NHS hospital overnight.

What isn’t covered?

There are some conditions and treatments that healthcare insurance will not cover including:

• pre-existing medical conditions
• organ transplants
• costs of a natural pregnancy and childbirth
• cosmetic surgery for personal reasons
• Sports injuries or injuries related to war and war-like hostility
• Chronic conditions

You may find a policy that covers mental health and sports injuries but these are not typically included in the policy.

Do you need it?

This is really a matter of personal decision.

Because there is free medical service from the NHS, there will only be a few reasons that you need private care:

–           You want to avoid the long waits associated with NHS medical treatment.

–           You would rather not use public medical treatment and would prefer to use private treatment whenever possible.

–           You would like to be covered for medications and treatments that are not included in the NHS treatment plan. These may include specialist treatments or treatment for sports related injuries. You will need to carefully read the policy to be sure you are getting the treatment you need.

Who doesn’t need private medical insurance cover?

Private medical insurance is not needed for:

–           Anyone satisfied with the NHS for your care

–           Those with medical insurance from their employer.

–           Those concerned about the health of their children — children receive priority in the NHS.

–           Your resources only allow for basic insurance like homeowners, car and possibly life insurance if you have dependants.

–           You have accumulated debts and no way to pay them all off — it would be better to put your spare cash to pay off your debts.

–           You can cover your own individual treatments — if you can pay out of pocket for your private medical treatment, this may be cheaper than taking on regular premium payments.

Pros and cons

Note: The following pointers will depend on the insurance policy you buy.

Pros:

–           Specialist referrals — You can ask your GP to refer your case to a specialist who can provide an expert opinion and even recommend specialist treatment.

–           Get the scans you need when you need them — if the NHS is taking a long time to get you’re your scans or won’t provide them, you can use coverage to pay for this medical need.

–           Reduced Waiting time — you can use your insurance policy to save time that would be spent waiting for NHS treatment, if the waiting time would be over 6 weeks.

–           Select your hospital and surgeon. In theory, you can use your insurance policy to select the surgeon and hospital that fits your time and location — something not possible for the NHS.

–           Get a Private Room — you can use your insurance to insure you use a private room, as opposed to staying in an open ward that accommodates all sexes. 

–           Access Specialist Drugs and Treatments — some specialist drugs and treatments have not been sanctioned by the Scottish Medicines Consortium (SMC) or the National Institute for Health and Clinical Excellence in England and Wales (NICE). 

–           Physiotherapy — you will access your physiotherapy much faster by using medical insurance as NHS treatment could take a while.

Cons

–           You might find better care with the NHS — those suffering from heart disease, stroke or cancer can find priority treatment working with the NHS. NHS hospitals can be every bit as good as private hospitals or better even.

–           It is Costly! Your typical insurance premium for a small family — two adults over 40 and two kids under 10 — will run as high as £700 to £1,800 per year. The cost of premiums also go up each year. This means that by the time you are older and really need insurance coverage the premiums may be too high to afford.

–           Chronic Conditions are not covered — Diabetes, cancers and other conditions deemed incurable will not be covered by your policy.