What is private medical insurance?
Private medical insurance provides access to private healthcare services alongside the National Health Service (NHS). Taking out insurance structure, ongoing access to faster treatment, preferred specialists and hospitals, and a wider range of care than might be available through the NHS.
Your private health insurance plan requires monthly or annual payment to an insurance provider who then covers the cost of your healthcare when you need it. The level of coverage varies depending on your policy and budget, but can include inpatient treatment, day-patient procedures, and outpatient care.
Types of private medical insurance
Before making your decision, consider exploring the various types of health insurance:
Comprehensive cover
The most extensive form of private healthcare coverage, offering full inpatient, day-patient, and outpatient treatment. These policies typically include consultations, diagnostic tests, specialist treatments, and alternative therapies. While premium costs are higher, they provide peace of mind through complete coverage.
Get your quoteMid-range cover
Balances costs by fully covering inpatient and day-patient treatment while limiting outpatient care. Mid-range policies might cap outpatient coverage at a specific amount annually or require cost-sharing for certain services. They're popular among those seeking essential private healthcare without the cost of full cover.
Get your quoteBasic cover
Focuses primarily on inpatient treatment and essential healthcare needs. Basic policies typically cover hospital stays and surgical procedures but may limit or exclude outpatient care. They're designed for people wanting private healthcare access for serious conditions only while managing the cost of your premiums.
Get your quoteSix-week options
These unique policies provide private treatment only if the NHS waiting times exceed six weeks. They offer lower premiums while ensuring fast treatment for procedures and care that may be busier or more in demand. These plans can significantly reduce premium costs while maintaining access to private healthcare when you need it most.
Get your quoteInternational cover
Designed for those requiring coverage both in the UK and abroad. These policies typically offer comprehensive coverage across multiple countries, including emergency treatment, planned procedures, and ongoing care. They can be helpful for frequent travellers, duel citizens, or those working internationally.
Get your quoteModular cover
These flexible policies allow you to build a customised package by selecting specific modules based on your health priorities and budget. Each module covers different aspects of healthcare - such as cancer care, mental health support, or maternity services - which you can add or remove annually. This helps you avoid paying for coverage you don't need.
Get your quoteFamily health insurance
A family health insurance policy offers additional peace of mind. By extending coverage to your spouse, children, and other dependents, you can ensure your entire household has access to prompt private care, a broader range of treatment options, and enhanced amenities - all while benefiting from the cost savings of a group plan.
Get your quoteEmployee health insurance
As a business, providing private health insurance as part of your benefits package demonstrates a commitment to employee wellbeing. Group plans negotiated directly with insurers often cost less per person than individual policies, while giving workers access to fast private care and a wide range of healthcare options.
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Private vs. NHS treatment
When planning your healthcare, you'll should consider the cost and convenience of the primary options:
Private healthcare
Private treatment offers immediate access to specialists, a choice of consultant and hospital, and private rooms. Treatment times are typically scheduled at your convenience, with minimal waiting periods. You'll often have access to medication and treatments not available on the NHS, plus longer consultation times and more personalised care.
NHS treatment
NHS care provides universal coverage without additional cost at the point of use. Waiting times may be longer for non-emergencies, but emergency and critical care are immediate. Treatment is based on medical need rather than ability to pay, and the NHS offers comprehensive coverage across all medical conditions without exclusions for pre-existing conditions.
Health insurance pros and cons
Advantages of health insurance
- Quick access: Private health insurance enables you to bypass lengthy NHS waiting lists for non-emergency treatments and consultations.
- Choice freedom: You have the flexibility to choose your preferred specialist, hospital, and treatment schedule.
- Comfort priority: Private rooms and enhanced facilities provide more comfortable recovery spaces during hospital stays.
- Treatment options: Access to a wider range of treatments and medications, including some not available through the NHS.
Disadvantages of health insurance
- Cost burden: Monthly premiums can be substantial, and costs typically increase with age and claims history.
- Coverage limits: Pre-existing conditions are often excluded, and some treatments may require additional payments.
- Complex terms: Policy terms can be complicated, with various exclusions and conditions requiring careful attention.
- Geographic restrictions: Some policies limit coverage to specific hospitals or regions, potentially affecting your treatment options.
Should I take out health insurance?
The decision to take out private medical insurance depends on your personal circumstances, including your health needs, financial situation, and other healthcare preferences. If you value quick access to treatment, want choice over your healthcare providers, and can afford the premiums, private health insurance can the right decision. It can also be more structured and predictable than simply opting for private care on demand.
If you're comfortable with NHS care and have no specific health concerns, the extra cost might not be justified. Consider factors like your age, health conditions, local NHS waiting times, and whether your employer offers health insurance before making a decision.
Understanding the costs
1. Basic premium costs
Monthly "premiums" (the amount you pay for your insurance coverage) vary significantly based on age, health status, and coverage level. Basic plans might start from £20-30 per month for young, healthy people, while comprehensive coverage can exceed £100 monthly.
Premiums typically increase with age and after making claims.
2. Excess options
Most policies offer varying "excess" levels (the amount you can pay towards the cost of a claim, before the insurance kicks in). You can typically pay between from £0 to £1,000. Higher excess levels reduce monthly premiums but mean larger out-of-pocket expenses when claiming.
Some policies charge excess per claim, while others apply it annually. Consider carefully how this choice affects both your premiums and potential future costs.
3. Coverage limits
Policies often have annual limits on total claims and specific treatment categories. Outpatient limits might range from £500 to unlimited, while overall annual limits can reach £1 million or more. Understanding these limits is crucial for planning your potential healthcare needs.
4. Additional coverage options
Adding features like psychiatric care, dental treatment, or worldwide coverage increases the premiums you pay. Some insurers offer wellness benefits or health screening services for additional costs. Consider whether these additions provide value for your specific situation.
5. No claims discount
Making claims typically affects future premiums through reduced no claims discounts. Some insurers offer protection of no claims discounts for an additional premium. Understanding this long-term cost is important when deciding whether to claim for treatment.
6. Age-related increases
Premiums usually increase with age, often significantly after you reach 50. Some policies have specific age bands where prices increase substantially. You should factor in these potential future increases when planning long-term insurance costs.
Finding and applying for health insurance
Use our checklist to ensure you're on the right track for selecting the best private healthcare for you.
Our expert says:
‘’While health insurance premiums are a significant investment, the right policy can provide peace of mind and better healthcare access when needed. Take time to consider the costs and benefits and of any plan you're offered to make sure it's right for you.”
Frequently Asked Questions
Can I just get private healthcare on demand?
Opting to pay for treatment only when required can be a flexible option with potentially lower short-term costs. On the other hand, you risk facing high, unpredictable expenses if you need extensive or urgent private care.
How does private medical insurance affect my NHS care?
Having private health insurance does not affect your rights or access to the NHS. You're free to make use of both services at the same time, depending on your needs and preferences. The key benefit here is flexibility. You might opt to use your private medical insurance for certain treatments or procedures where you want quicker access or more choice, while continuing to rely on the NHS for routine GP visits, emergency care, or managing a long-term condition.
What happens to my coverage if I develop a chronic condition?
When it comes to chronic conditions, the key difference in NHS and private healthcare is the scope of coverage. Private health insurance is designed to cover acute conditions - those that can be cured or brought under control through treatment. So if you develop a chronic, long-term condition, your private insurance may cover the initial diagnosis and stabilisation of the condition, but ongoing management and monitoring would likely revert to the NHS.
Can I add family members to my policy?
Yes, most private medical insurance providers in the UK offer the option to add family members to your policy. This allows you to extend your coverage to include your spouse/partner and dependent children. Family policies often provide better value than purchasing individual policies for each family member. Insurers often offer discounts when covering multiple people under the same plan. Some may even provide free coverage for children up to a certain age.
How do pre-existing conditions affect coverage?
Pre-existing medical conditions can have a significant impact on the health insurance coverage you're offered. Insurers typically handle pre-existing issues through exclusion: Some policies will simply exclude any treatment related to pre-existing conditions, either permanently or for a specified waiting period (often 2-5 years).
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