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What is individual health insurance?
Individual health insurance can cover medical expenses for illness, injuries and some medical conditions. Unlike private medical insurance offered as a benefit through an employer, you arrange this yourself and it can give you fast access to medical care.
What does individual health insurance cover?
It depends on the insurance policy and level of cover you choose. The most basic private medical insurance plans might cover the price of hospital or acute treatment only. More comprehensive plans may also include:
- Outpatient treatment – such as blood tests, scans and consultations with specialists
- Cancer treatment
- Physiotherapy and osteopathy
- Mental health treatment
- Dental care
- Eye care
- Maternity care.
How does individual health insurance work?
You pay a monthly premium to your insurance provider. Then, if you fall ill and need treatment that’s covered by your policy, your insurance provider will pay out. This payment should cover the cost of the treatment needed but you’ll usually have to pay an excess – an amount you agree to pay towards your claim.
Say you have an increasingly painful knee and it’s affecting your daily life, you visit your GP and they make a referral to an NHS hospital. But it could be weeks before a consultant can see you – and potentially even longer to get an operation.
If you have individual health insurance you can contact your insurance provider and potentially access an appointment sooner, within the private healthcare system. You may be able to see a specialist more quickly and have the procedure you need in a shorter time frame, getting your life back to normal faster. You could also have access to specialists and medications that aren’t available on the NHS.
How do I access my individual health insurance?
Simply go to your GP as normal, but let them know that you have private medical cover. They will then be able to give you all the options available and advice on where to go for treatment. If you want more time to decide where to go, ask your GP for an open referral letter. Some comprehensive medical insurance policies might also give you access to a private GP.
How to make a claim
To make a claim, contact your insurance provider directly and provide them with all the details of your treatment. If your policy covers the private treatment you need, your provider will then approve your claim – minus any excess you have already agreed.
Do I need individual health insurance?
Individual health insurance is a personal choice. It gives you access to private medical treatment so you don’t need to rely on the publicly funded NHS.
Some reasons people choose to invest in private medical insurance include:
- Less waiting time – private healthcare often comes with shorter waiting lists, so you be able to get your treatment faster.
- Access to specialist services – you may even have access to treatments that aren’t available through the NHS.
- Private hospitals – with private medical insurance you’ll enjoy a quieter environment and home comforts to help make your recovery more comfortable.
What do I need to get a quote?
To find you the most suitable health insurance quotes, we need to know the answers to a few questions including:
- If you’re looking for individual, joint or family health insurance
- The level of cover you want
- The maximum excess you want to pay.
We also need to know a bit more about you and how to get in touch with you.Start a quote
Frequently asked questions
What’s the difference between individual health insurance and joint health insurance?
Joint health insurance covers you and your partner on a single policy, while individual health insurance is just for you.
If you’re buying health insurance for yourself and your partner, you may find a cheaper deal with less admin to keep on top of if you go for a joint policy. However, opting for two individual health insurance policies might let each of you tailor the policy to your own needs – a good idea if you both want different types of cover from your health insurance policy.
What individual health insurance is best for me?
That really depends on the level of cover you feel you need. With private medical insurance, you have a range of options – from basic cover, which is cheaper but may not cover you for as many treatments or tests, all the way through to the most comprehensive level of cover.
Some plans will only cover treatment within a hospital, for example, while others will offer you treatment as an outpatient.
A great way to weigh up your options is to compare a range of health insurance quotes. You’ll see what’s included in each and begin to get an idea of the costs involved at the different levels. Then you can see which private medical policies are best suited to your needs and budget.
How can I lower the cost of my premium?
There are options to make your health insurance more affordable – but always balance them against the value and peace of mind you may get from a more comprehensive policy.
- A higher excess means cheaper premiums – if you choose a higher voluntary excess you’ll pay lower monthly payments. Just make sure you can afford the excess, if you need to make a claim.
- Insurance providers can offer discounts for healthy lifestyles – stay fit and live well, and the good news is that you might be able to get a cheaper policy.
- Health cash plans are often a cheaper option – these plans pay you a cash sum when you visit a medical professional, such as an optician or dentist.
What else do I need to know before I buy individual health insurance?
- You can’t go private for everything – even the best individual health insurance has limitations. Accident and emergency treatments aren’t covered, for example.
- You can only use certain hospitals – when you buy a private medical insurance policy, you’ll typically choose a list of hospitals and treatment centres where you’ll be eligible for treatment. The broader the selection, the higher your premium will be.
- Insurance providers set maximum amounts for certain procedures – if you choose a specialist whose charges are higher than that limit, you’ll need to cover the difference.
- You won't always get treatment in a private hospital – you could be put in a private patient unit within an NHS hospital or on an NHS ward rather than in a private room.
What's not covered by individual health insurance?
Private medical insurance typically won’t cover you for any pre-existing medical conditions or chronic illnesses you have before taking out your policy, such as arthritis or diabetes.
Private health insurance generally also excludes:
- Accident and emergency admissions
- GP visits
- Cosmetic surgery
- Mobility aids
- Organ transplants
- Infertility treatment
- Preventative treatment
- Treatment related to drug abuse or self-inflicted injuries.
Can I still use the NHS if I have individual health insurance?
Yes, having private medical insurance doesn’t affect your right to use the NHS. You can choose whether to use the NHS services for free or use your policy to get access to private treatment, depending on what’s the right option for you at the time.
Do I need a medical?
You don’t normally need to have a medical check to get private medical insurance. In most circumstances, your insurance provider will simply ask you some questions about your general health and any pre-existing medical conditions. It’s very important you answer honestly. If you don’t, your provider could cancel your policy or refuse to pay out in full.
Find out more about applying for private medical insurance
Compare individual health insurance quotes
We can help you find a range of affordable health insurance policies that suit your needs.
When you compare health insurance with us, we’ll ask you a few questions and show you a list of policies, with the important features highlighted. It makes it easy to choose a private medical insurance policy that’s right for you.
How much does individual health insurance cost?
The cost of private medical insurance depends on the level of cover you need, as well as other factors, such as:
- How old you are and where you live
- Your medical history and any health conditions you suffer from
- Your general health and lifestyle – especially if you smoke
Find out more about the factors that affect the price of private health insurance and the steps you can take to reduce the cost.Start a quote
What our expert says
“With individual health insurance, you can cut NHS waiting times and get access to private specialist treatment when you need it most.”
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^For the period 1st June to 31st August 2021, 8944 people responded to the recommend question. 8,226 responded with a score of 6 or above, therefore 92.0% are likely to recommend.
**Correct as of June, 2022.