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What is private health insurance?

Private health insurance, also known as medical insurance, is a policy designed to cover the cost of private healthcare.  

It typically covers the cost of private medical treatment for health conditions that develop after your policy starts. Different types of policy offer different levels of cover, so prices can vary considerably.  

Some policies give you fast-track diagnostics and treatments, or even treatments not available on the NHS. You can also choose who you want your policy to cover – whether that’s just you, or you and your partner, or your family. You’ll pay a monthly Direct Debit to your insurance provider, then claim when you need to. 

Do I need private health insurance?

Private health insurance is a personal choice that lets you access private medical treatment if you don’t want to rely on the publicly funded NHS. Reasons people choose private healthcare include: 

  • Faster treatment – you could avoid potentially longer NHS waiting times.
  • Access to specialist treatment – you’ll generally find a wider range of treatments, covering everything from sports injuries to cancer, some of which aren’t available on the NHS. Just make sure your policy offers the cover level you want.
  • Private hospitals – you’re likely to enjoy more privacy and a quieter environment, along with home comforts to aid your recovery. 

How does private health insurance work? 

Private health insurance works in much the same way as any other insurance. You pay a monthly or yearly fee, known as a premium. You’ll also agree an excess, which is your contribution to any claim. In return, you can claim for the cost of private medical treatment, rather than paying for it yourself or accessing it on the NHS. 

How to get started with private health treatment

If you have a policy and develop a health problem, see your GP as normal but tell them you have private cover and ask what options are available. They can recommend a specialist or private treatment centre – or you may want to choose your own. If you’re not sure who to see or where to go for treatment, ask your GP for an open referral letter. Some comprehensive medical insurance policies give you access to a private GP to begin diagnosis and make any necessary referrals or provide a prescription as part of your claim.

How to make a claim

Start by contacting your insurance provider, who’ll tell you what to do. If your NHS GP has given you a referral letter, you’ll need to share this with your insurance provider. If your policy covers the private treatment you need, your insurance provider will approve the claim, and take you through your options. They’ll make you aware of any limits on your policy and can help you find the right consultants, if you’re not sure where to go.

What does private health insurance cover? 

Some private healthcare policies only cover treatment, while others cover treatment and diagnosis. This could include everything from inpatient and outpatient treatment to blood tests or physiotherapy. Depending on how comprehensive your policy is, it might include:

Treatment only

Provides cover for inpatient treatment only. Some policies include a small level of outpatient cover, such as heart or cancer treatment, but you’ll need to check the policy for details.  

Treatment and limited diagnosis

Provides full cover for eligible treatment and cancer cover, with limited cover for consultations, diagnostic tests and scans. Physiotherapy may be included, but this will depend on the policy.

Treatment and full diagnosis

Some policies include extras like complementary therapies, maternity care, mental health cover and dental cover. But some insurance providers will make you pay extra to access these benefits. You may have access to support lines with nurses and counsellors, who can answer your questions, 24/7. Other policies give you wellness advice and health-related discounts.

Other benefits

Some policies include extras like complementary therapies, maternity care, mental health cover and dental cover. But some insurance providers will make you pay extra to access these benefits. You may have access to support lines with nurses and counsellors, who can answer your questions, 24/7. Other policies give you wellness advice and health-related discounts. 

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What are the benefits of private medical insurance? 

Private medical insurance usually gives you:  

  • Reduced waiting times – meaning faster access to consultants, tests and treatment.
  • Specialist referrals – be treated by experts in their field.
  • Choice of surgeon and hospital – you can usually choose a specialist and hospital that suits. you. However, your insurance provider may pick one for you.
  • Private rooms – enjoy a more comfortable stay, with facilities like TVs and en-suite rooms.
  • Recovery and aftercare – get fast access to treatments such as physiotherapy.
  • Specialist treatments – possible access to treatments and drugs not available on the NHS. 

Private health insurance isn’t a replacement for the NHS – you’ll still have the right to use free NHS treatment if you want. But it can give you more options if you get sick, including faster treatment than you might find on the NHS.    

Because you can choose when and where you’re treated, private healthcare can be invaluable if you’re self-employed or have inflexible working hours. Read more about health insurance for self-employed people.  

The downside of private healthcare is that it can be expensive, and chronic illnesses aren’t usually covered. 

How much does health insurance cost? 

How much you pay for your health insurance will depend on a number of factors, such as:  

  • Your age – as you get older you’re more likely to develop health issues, which will be reflected in higher premiums. 
  • Your postcode – you may have to pay more for your private health insurance if you live in London or other major cities, where hospitals and private treatment centres tend to be more expensive. 
  • Your cover level – comprehensive cover is more expensive than a basic plan, while optional extras could also push up your premium. 
  • Your excess level – paying a higher excess could bring down the price of your premium. Just make sure you can afford it if you need to make a claim.  

You might be offered a no-claims discount, which will reduce your premium every year you don’t make a claim. However, the cost of your premium will rise as you get older, so in reality you may not notice much of a difference.  
  
Some insurance providers will give you a discount on your premium or offer cashback, if you can show you’re generally fit and healthy.  

When you compare health insurance with us, you can choose from different options to find the cover you need, at a price that fits your budget.

What types of health insurance policies are available?

Getting the right health insurance for your needs is half the battle. First, you should decide why you want it and who you want it to cover. 

  • Individual health insurance – get fast access to medical care if you become ill or injured, avoiding NHS waiting times. You’ll probably get more choice of consultant and hospital, too. 
  • Joint health insurance – covers both you and your partner. This is often cheaper than taking out two separate policies, but not always. 
  • Family health insurance – covering your whole family under the same policy is likely to be cheaper than buying each family member individual cover. 
  • Child health insurance – enjoy the reassurance that if your child becomes ill, they’ll receive fast treatment in private hospitals and clinics. 

Before you start comparing policies, check if you already have private health insurance through your employer.  

What to consider when choosing private health insurance 

Here’s what to keep in mind when comparing health insurance quotes:

  • Cover level – some insurance providers have tiered pricing levels. A comprehensive policy will cover most eventualities without a cost limit. Cheaper policies set a cap on how much you can claim for, which will vary, depending on the treatment.  

  • Hospital location – some hospitals, such as those in London and other major cities, may charge more, so your postcode could affect the policy price. It’s worth considering how far you’re willing to travel for treatment.  

  • Perks – there might be incentives, such as discounts on gym memberships or on other policies you take out with the same insurance provider.  
  • Exclusions – if you choose a basic policy, make sure you’re comfortable with any exclusions. You could find the policy only covers limited outpatient treatment or doesn’t include it at all.  
  • Cost – your health insurance is likely to get more expensive as you get older, so don’t be surprised if your premium rises after each birthday. This is partly due to inflation, but also covers advances in technology and testing. And as you get older, it’s more likely you’ll need to make a claim.  

How can I cut the cost of private health insurance?

Here are some ways to reduce the cost of your health insurance:

Pay a bigger excess

But make sure this is realistic and affordable, because you’ll need to pay it before any claim can be processed.

Settle for reduced outpatient cover

Having less outpatient cover, or none at all, could reduce your premiums. 

Agree on a reduced hospital list

You’ll have access to a more limited range of hospitals, so make sure there are suitable options. 

Agree to a ‘six-week option’

Some insurance providers won’t let you make a claim if the NHS can treat you within six weeks.

Author image Mubina Pirmohamed

What our expert says...

“The cost of private health insurance can vary a huge amount, depending on which plan or insurance provider you choose. 
 
The best way to get the cover you need is to shop around and compare quotes. Don’t automatically assume that the most expensive plan is the best for you.” 

- Mubina Pirmohamed, Insurance expert

What do I need to get a health insurance quote?

To find you a suitable quote, we’ll need to know a few details, including:  

  • How many people you’re looking to insure – do you want individual health insurance, joint cover or a health insurance plan for the whole family?
  • The level of cover you want
  • How much excess you want to pay
  • Where you live 
  • Whether you smoke.

Once we have the information we need, we’ll put together a list of quotes for you to choose from.   

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Compare health insurance quotes

In the UK, we’re lucky to have the NHS, but there’s no denying that access to private care through health insurance can be reassuring. It’s especially useful if you’re self-employed and need to be treated quickly and at a hospital that’s convenient for you.  
 
You can compare quotes with us now and complete your application online. Or, if you’re still not sure about what policy might suit you best, our colleagues at Assured Futures can help you understand your options. You can also apply offline if you prefer. Call Assured Futures on 0808 141 1334.  

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Frequently asked questions

Does health insurance cover pre-existing conditions?

You can still take out private health insurance if you have a pre-existing condition, but it’s unlikely to be covered under your policy. For instance, if you have asthma, most policies would cover private treatment if you needed a hip replacement but not asthma treatment. 

Some providers cover certain pre-existing conditions if they see them as minor, or think the symptoms are unlikely to reoccur, but it’s best to speak to the insurance provider to be sure.

What won’t private health insurance cover?

Private medical insurance is designed to complement NHS care and doesn’t usually cover pre-existing medical conditions or chronic conditions such as asthma, diabetes, high blood pressure and arthritis. If these affect you, make sure you know what your policy covers and that you’re happy with any exclusions. 

You won’t be covered for cosmetic surgery, fertility treatment or injuries caused by dangerous activities. And you’ll still need to use the NHS for accident and emergency treatment.

What optional extras can you get with private health insurance?

In some cases, you can tailor the policy to your needs and budget. You could include add-ons like:  

  • Dental care  
  • Eye care  
  • Physiotherapy 
  • Complementary medicine 
  • Mental health support  
  • Pregnancy or maternity services.  

Do I have to review my health insurance every year?

Some insurance providers automatically renew your private healthcare cover so you don’t need to do anything. But it’s a good idea to compare policies when yours is ending, to make sure you’re still getting the cheapest deal for the cover you need.

Can I add other people to my private health insurance policy?

In most cases, yes. With joint health insurance, you can add your partner to your plan, while family health insurance lets you add your children to your policy. Some plans might offer free cover for newborns until the next renewal, although cover limitations may apply, so check with your insurance provider if you have a new baby. But remember to shop around to find the right deal for you and the people you care about.

Is there an age limit for health insurance?

You’ll usually need to be over 18 to take out your own policy, but anyone younger can normally be added to a family policy. There can also be an upper age limit for private health insurance. Even if there isn’t, you’ll typically pay more the older you are.

Is it better to pay monthly or annually for health insurance?

Like many insurance products, you can save by paying for health insurance annually, rather than monthly. But it depends on your insurance provider. They should tell you which way works out cheapest.

Do I need private health insurance if I’m covered through work?

If the organisation you work for offers private health insurance as part of your benefits package, you probably don’t need extra medical cover. But you might find there’s a limit on the cover you receive or it may not cover your whole family. It’s worth remembering that any insurance you get through work will only cover you for as long as you work there and will end as soon as you leave.

Will I need a medical exam to get covered?

No. If you don’t have any pre-existing conditions, you don’t usually need a medical to get cover. You’ll just need to fill out a medical history form and choose your level of cover. Some health plans may offer you a general health assessment if you want one. 

If you have a pre-existing condition, you might need to give the healthcare provider permission to access your medical records or contact your GP.

Do I need a GP referral to access private healthcare?

Not always – you can get private treatment without a referral from your GP. However, some insurance providers won’t cover your treatment without a GP referral, so check first if you’re planning to claim.

Will my policy cover me outside of the UK?

No, health insurance policies are designed for cover in the UK. If you need cover abroad for a short trip, choose a travel insurance policy with good medical care to cover you for accidents and emergencies.

If you’re living or working abroad, or have a holiday home overseas and spend part of the year there, you may want to consider international health insurance.

Some providers offer private health insurance plans for home and abroad, but you may have to pay more for your premium.

What’s the difference between health insurance and critical illness cover?

Private health insurance takes care of your medical treatment if you get ill, while critical illness cover offers extra help if you develop one of the named critical illnesses – for example, it can cover loss of income if you’re unable to work. These policies fulfil different needs so might offer different payouts. Private health insurance is often a one-year policy, while critical illness cover is usually bought for the long term.

More on critical illness cover

How are health insurance premiums taxed? Are they tax deductible?

If your company provides you with private health insurance, it’s considered a ‘benefit in kind’. This means that it’s not tax deductible and you’ll have to pay tax on any insurance premiums as reported in the P11D your employer will give you.

There are some exceptions for small companies, for example, where it could be considered a business expense. Your insurance provider should be able to tell you if you’re eligible for this exemption, or you can check with HM Revenue & Customs. 

How does the excess work?

When you buy a policy, you can choose how much excess you pay – that is, how much you’ll contribute to the cost of treatment if you make a claim. Depending on your insurance provider, you could set your excess at zero, £100, or even £1,000.  

The higher your excess, the lower your premium is likely to be.

You’ll usually pay an excess on a claim once per person, per policy year – although some providers charge each time you claim. Others may offer you both options. Always read your policy terms and conditions so you know when you’ll have to pay an excess. 

What is a pre-existing condition?

A pre-existing condition is anything you’ve had medical treatment for. Common conditions include diabetes, heart disease and asthma. Most insurance providers count any condition you’ve had symptoms or treatment for in the past five years, even if you were diagnosed more than five years ago. 

Not all providers set the limit at five years though, so read your policy documents carefully and compare the options before buying. 

How can I find the best UK private health insurance?

To find the best health insurance for you, it’s always worth comparing a variety of policies. You can then see which offer the features you need, at a price you can afford. What’s best for someone else might not be right for you, so you’ll need to consider your personal circumstances and what you want from your policy.