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Should I get private health insurance?

Updated 10 September 2020

5min read

Nick Green
Financial Journalist

Private health insurance UK

As if anyone needed reminding, the NHS offers excellent care for people across the UK. But private healthcare providers are also available, and some people choose to use these in certain circumstances. However, the cost of these services can be very high. Private health insurance is a way of spreading these expenses over time, so that if you do choose to ‘go private’, it doesn’t break the bank.

Here’s how private medical cover works, how much it typically costs, and what it does and does not cover.

How does private health insurance work?

Private health insurance typically covers a range of acute conditions (i.e. conditions that come on suddenly and have a limited term of treatment), but not chronic conditions (i.e. conditions like diabetes that you may live with all or much of your life). If you need treatment for a new health problem, your insurance can cover the cost of getting private treatment, which can sometimes be thousands of pounds. Private health insurance also doesn’t cover you for a pre-existing condition.

Broadly, medical insurance works in much the same way as other insurance policies. You pay a monthly premium (sometimes annually or quarterly) and claim on your insurance if you need treatment. Each time you claim, you’ll pay a small excess while your insurer covers most of your medical bill. The excess can be anything from £0 to £500.

You can get private health insurance to cover just you or other members of your family.

How much does private health insurance cost on average?

The average yearly premium on private health insurance is around £1,500. This works out at about £125 a month, but lots of people pay much less. The amount you pay depends on your insurer, what’s covered on your policy and your own circumstances and current state of health.

Insurers may offer you cheaper premiums if you’re less likely to become unwell and need to claim for treatment. Here are some of the factors that affect the cost of private health insurance:

  • Who’s covered – There are policies to cover individuals, families or couples, and this will affect the price. Depending on the circumstances of each person, it may work out cheaper to have one policy or to keep several distinct policies.
     
  • Your age – The older you are, the more likely you are to claim on your insurance, making the premiums more expensive. The same happens with life insurance premiums.
     
  • Your medical history – Private health insurance doesn’t usually cover pre-existing conditions, but any conditions you have may suggest you’re at risk of developing further problems. This could make your premiums increase.
     
  • Your family history – If family members have suffered from serious conditions, this could indicate that you are likely to as well, which can make insurance more expensive for you.
     
  • Your lifestyle – Factors like smoking, drinking and your weight can all affect the price you pay.
     
  • Where you live – It seems unfair, but some areas of the country are linked to certain medical conditions and others carry a higher price tag for private treatment. Something as apparently trivial as your postcode might mean private medical insurance is more expensive.

How can I reduce the cost of private health insurance?

There are ways to bring the cost of private medical insurance down, no matter your circumstances. These include:

  • Adding a waiting period – Opting for the waiting period means that if you can be treated through the NHS within six weeks, you won’t be covered for private treatment. As soon as the NHS waiting list goes over the six-week period, you can go private and claim on your insurance.
     
  • Limit the hospitals – You may be able to bring down the cost of your insurance by limiting the number of hospitals and surgeries available to you.
     
  • Choose a higher excess – You have to pay an excess when you need to claim, unless you’ve selected the £0 option. Agreeing to pay a higher excess can bring down the cost of your premiums. However, facing a higher excess may put you off claiming on your insurance, which can make your policy unsuitable for your needs.
     
  • Having a no-claims discount – If you haven’t had to claim on your insurance for a certain length of time, you could get a discount – much like you do for car insurance.
     
  • Living in a ‘healthy’ postcode – As mentioned above, health insurance can be cheaper in some places than others, so you could bear this in mind when buying a home.

Does the cost of private medical insurance go up?

Generally the cost of your healthcare premiums will go up as you age, and will also increase with inflation. They may also rise if you’ve had to claim recently. But if you’ve made lifestyle changes, such as you’re now in a healthy weight and stopped smoking, you may be able to get a cheaper quote. Some people find simply switching provider brings down their premium.

What does UK private medical insurance cover?

Insurers will offer different plans, which can fall into basic, mid-range and comprehensive categories, though they may have different names for them. The table shows what’s generally covered on each type of policy.

Type of cover

What’s usually covered

There may be limits on:

Basic

  • In-patient treatment (when you stay in hospital)

 

 

  • Ambulance transport
  • Home nursing
  • Types of treatment and the hospitals you can choose
  • The number of treatments you can have in one year
  • Diagnostic tests – you will normally be diagnosed by the NHS

Mid-range

  • Inpatient treatment
  • Outpatient treatment (where you don’t need to stay overnight)
  • Consultation appointments, diagnostic tests, and services like physiotherapy and sometimes psychiatry
  • The number of treatments you can have in a year, though usually more than basic policies
  • Ambulance transport
  • Home nursing
  • Hospitals you can use

Comprehensive

  • Inpatient and outpatient treatment
  • Home nursing
  • Private ambulance
  • A parent staying in hospital with a child (depending on the policy)
  • Dental treatment
  • Alternative medicine
  • May cover whole family, rather than an individual

 

As you would with other insurance policies, you can often choose various add-ons, though each addition will usually add a few pounds to your monthly premium. Here are the common add-ons people opt for:

  • Dental
  • Optical
  • Psychiatric
  • Physiotherapy
  • Medical treatment and care at home
  • A private room when you stay in hospital
  • Specific illnesses – but do check with your insurer. Cancer treatment, for example, is now covered by most standard policies, but some may still exclude it (or some types of it).  

What is not covered by private medical insurance in the UK?

Some conditions and treatments are rarely covered by private health insurance, including most pre-existing medical conditions. These include:

  • Chronic conditions – Ongoing treatment for incurable illnesses like HIV, diabetes and some cancers aren’t included.
  • Emergency treatment – These services are mostly provided by the NHS.
  • Elective treatment – These are treatments you don’t necessarily need but want, such as cosmetic surgery.
  • Treatments required by some lifestyle factors – Such as drug and alcohol rehabilitation services.
  • Treatment abroad – If it’s an emergency, this should be covered by your travel insurance. You may be able to get specialist insurance if you want to have treatment overseas.
  • Pregnancy care – You will normally need to pay extra for care during pregnancy, though some unexpected complications may be covered.

What is the typical cost of the most popular private medical procedures?

Private medical care is certainly not cheap – hence the need for insurance if you’re not using the NHS. To give you an idea on costs, here are some ballpark figures for common treatments carried out privately.

Type of treatment

Approx cost

Knee or hip replacement surgery

£10,000 to £15,000

Hernia repair

£2,500

Having a pacemaker fitted

£5,000

Wisdom tooth removal

£2,000

Cataract surgery (one eye)

£2,500

Gall bladder removal

£6,000

Cancer treatment – chemotherapy

£30,000

Do I need private medical insurance?

Having private treatment is considered a luxury by many. Because the NHS offers fantastic levels of care and treatment, you don’t need private medical insurance to lead a healthy life with access to medical support.

However, some people prefer to go through private healthcare services to jump ahead of NHS waiting lists, and perhaps to have more flexibiliy over their treatment, such as receiving care at home. When you consider the costs of paying for each private treatment, you might prefer to have insurance in place to help pay your bills.

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About the author
Nick Green is a financial journalist writing for Unbiased.co.uk, the site that has helped over 10 million people find financial, business and legal advice. Nick has been writing professionally on money and business topics for over 15 years, and has previously written for leading accountancy firms PKF and BDO.