What does health insurance cover?
From doctor visits to specialist care - here's what UK health insurance really covers.
What does health insurance cover?
Health insurance is more than just a ticket to faster hospital appointments. It can open doors to a wide range of treatments and services, many of which the NHS might not cover quickly or fully. Let's dive into what you can expect from private health insurance in the UK.
Core health insurance cover
When you buy health insurance, the core benefits mean you don't have to wait months for important tests or treatment. Here's what to expect:
- Inpatient treatment - covering hospital stays, surgery, and specialist care
- Outpatient care - consultations, tests, scans, and follow-up appointments without staying over
- Diagnostic tests - MRIs, X-rays, blood tests to get to the root of health issues
- GP and specialist referrals - access to private GPs and specialists without NHS waits
- Cancer treatment - many plans include faster diagnosis and treatment options for cancer
- Mental health support - therapy sessions and counselling are increasingly included
- Choice of hospitals - you usually get to pick where you're treated, often with private rooms
Tip: Extras may include dental and eye care, therapies, mental health support, home nursing or recovery, and sometimes cash payments for hospital stays or emergency care abroad.
What about non-standard extras?
Many people want to know if health insurance covers more specific or less common treatments. Here's a look at some key areas:
- Dental implants - usually not included in basic plans, but some insurers offer optional dental cover that might include implants or major dental work
- Breast reduction - often excluded as it's considered cosmetic, though some plans cover it if it's medically necessary and recommended by a doctor
- Weight loss treatments - rarely covered unless linked to a medical condition. Most insurers exclude cosmetic surgery like liposuction
- Existing medical conditions - many insurers exclude pre-existing issues or add waiting periods, though some offer limited cover or higher premiums
- IVF treatment - usually not included as standard but sometimes available as an optional extra or through specialist fertility cover
- Testosterone replacement therapy (TRT) - TRT is often excluded, except for an initial diagnosis
- Pregnancy and maternity - almost always excluded except for high end or specialist plans, as the NHS handles maternity care
Tip: What's included varies widely by provider and plan, so it's vital to check your policy details and the small print.
Summing up
Health insurance gives you quicker access to a broad range of treatments and specialist care that can be slow on the NHS. Core plans focus on inpatient and outpatient care, diagnostics, cancer treatment, and growing mental health support. Extras are often available as add-ons, but many are excluded altogether. Always read the policy carefully and consider what treatments matter to you.
Frequently Asked Questions
Does private health insurance cover routine dental work?
Most basic health insurance plans don't include routine dental care like check-ups or fillings. Some insurers offer optional dental cover that may include major treatments like implants. If dental care is important to you, it's best to look for plans with dental add-ons or consider a separate dental insurance policy.
Can I get cover for pre-existing conditions?
Cover for pre-existing conditions varies a lot. Many insurers exclude them or require waiting periods before you can claim. Some may offer limited cover or charge higher premiums. Being honest about your medical history when applying is essential to avoid problems with claims down the line.
Is IVF treatment included in health insurance?
IVF is rarely covered under standard health insurance policies. Some insurers offer it as an optional extra or through specialist fertility plans. Because IVF can be expensive and complex, if this treatment is important to you, look for plans that include or cover fertility treatments specifically.
What about cosmetic procedures like breast reduction or weight loss?
Cosmetic treatments are mostly excluded unless they're medically necessary. Breast reduction might be covered if it's recommended by a doctor for health reasons like chronic pain. Weight loss surgeries and cosmetic procedures such as liposuction are typically not covered by standard health insurance.
Does health insurance cover pregnancy and childbirth?
Pregnancy and childbirth are almost always excluded from private health insurance plans. The NHS provides these services, and insurers usually don't include maternity care. If you want private maternity care, you'll need a specialist maternity insurance policy separate from general health cover.
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The details shown are for illustration only and may not include all lenders or products. Actual rates and terms depend on your circumstances and the lender’s assessment. Information was correct at publication but may change at any time.
