Many people needing treatment for a variety of different healthcare concerns or more serious illnesses may decide to seek private health care coverage in order to help them get their treatment, rather than relying on the NHS for provision if they become unwell. More people these days are opting to take this route, to reduce their waiting time or to see a consultant when they want to.
It can make sense to look into purchasing affordable private health insurance in the UK. If you’ve never considered it before or need some help understanding all the jargon and terms associated with it, we’ve put together a helpful guide to explaining how private healthcare in the UK works and how it might benefit you.
What is Private Health Coverage in the UK?
Private health coverage is a type of insurance policy that you can either get via the company you work for, or on a self-pay basis. These options, and the types of policy you can have will be explained in more detail below.
- Just yourself
- Your and your spouse/partner as a joint policy
- Your entire family
- Your child
- Medical care in pregnancy
- Optical cover
- Dentist or orthodontic cover
You can also choose a policy based on your age, especially if you are over 50. Some companies have special policies for anyone who is in this age range and above.
How private healthcare coverage works in the UK
If you are employed by a company you may already have a work based private health insurance package. If you’re unsure, check any documents you may have received when you joined the organisation you work for. Some people who don’t have this luxury decide to pay for their own private treatment. This is called self-pay.
There are three main types of policy for either option mentioned above:
Private health insurance policies
Here you pay a monthly premium and the company will cover you if you are ill. This works out cheaper if you do it via the company you work for rather than self-pay.
Hospital Cash Plans
These types of policy tend to have cheaper premiums but will only ever pay out a set amount towards a stay in hospital, meaning you’ll still have to foot some of the bill yourself.
Critical Illness Cover
This type of policy will pay out a one-off lump sum of cash, if you’ve been diagnosed with a serious condition such as a stroke, heart attack or cancer.
Costs of private health insurance policies in the UK
How much your private health insurance policy costs depends on a few different factors:
- How old you are
- What your medical history is
- Any congenital conditions or illnesses that run in the family
- If you smoke
- If you are obese
- The conditions you choose to cover, the more you add, the more it will cost
Some insurers won’t cover pre-existing conditions, whilst others will but only if a set amount of time has elapsed from one period of treatment to another.
Can I lower the cost of private health insurance?
You can lower the cost of private health insurance in the UK by adding on a no claims discount. If you’ve had health insurance for a long time and not claimed at all, your premiums could become much cheaper if you do not make any claims.
Choosing a higher excess can lower the overall cost. It will make your premiums lower but can adversely affect your policy if you need to make a claim at any stage. Consider adding a waiting period to give cheaper cover. If the NHS waiting list in your area is less than your wait period, you get your treatment via the NHS. If the waiting list is much longer than your policy will pay for private treatment.
You can lower the cost of your premium if you choose to use nominated hospitals. Check the locations of private treatment centres near you that offer the services you require and if they are local to you, you can opt to be treated there. Offer to prove your health. Some insurers will offer to lower your premiums if you prove you do not smoke or that you have a regular gym membership.
Why opt for private health insurance?
- Deciding to seek a second opinion on their case
- Previous dissatisfaction with NHS care
- Wanting to avoid long NHS waiting lists
- Concerns about the rise of hospital infections in NHS premises
- Choice of when/where you can be treated
- Faster treatment times
- Option to choose your own consultant
There are also occasionally options to undergo medical treatments and procedures that aren’t routinely available on the NHS. Patients are always advised to check out waiting times via the NHS for routine procedures, as sometimes they can be quick.
Is there anything private health insurance won’t cover?
There are always exceptions to the rule and you’ll need to check the fine print on your policy, but many health insurance policies don’t cover patients for:
- Long term illnesses that have no cure
- Anything pre-existing for which you have already received medication or treatment for.
- A&E treatment
- Antenatal care
If you’ve been diagnosed with a condition or illness that requires hospital treatment and you decide to use your private health insurance, you’ll need to visit your GP for a referral letter. Your GP will then find and recommend a consultant who is experienced in treating your particular health concern and will write a private patient referral letter on your behalf. NHS GPs cannot charge for this.
Always make sure to check your medical insurance to be certain that the condition you wish to be treated for is covered by your insurance policy. You must then contact them directly to get an authorisation reference from them. Once this is done, an appointment time will be arranged with a consultant, then they will write to your GP to let them know what they have found.
The consultant you have seen will then raise an invoice and your private health care insurance company will settle. However, if there is any excess to be paid on the policy that has to be paid separately, by you. If you require a period of inpatient treatment, an admission to a private healthcare facility will be arranged. Treatment will be carried out and then a follow up appointment with the consultant will occur.
Your insurance company will again pay any charges for care, apart from any excess on your policy which must be paid by you. It’s worth pointing out that if your private health cover is via self-pay (ie not provided by a company or organisation you work for) then it’s likely that any treatment needed will have to be paid for upfront, usually before an admission to hospital.
I have a legitimate health concern but no insurance, what can I do?
If you’ve been diagnosed with a health care concern and are worried about your condition with a long waiting time to see a consultant, then you might want to go ahead and book an initial appointment to see a consultant privately.
An initial appointment will cost anything up to £200. This has to be paid on the day, or to be settled ASAP if it is found no treatment is necessary. If you receive a diagnosis or need further treatment the consultant will follow up with your GP to update them on treatment and any other measures that need to be taken.
If surgery is needed them you can request that the hospital issue you with a price for this. It should always include the doctor’s fee and hospital costs to carry out any procedures. It’s worth noting that you can decide not to go ahead and transfer back to the care of the NHS at any time. Often with the same consultant.
Are there any cover limits with private health insurance?
Just as with other types of insurance policy, even the best private health insurance policies UK come with a limit on how much the consumer can claim. There will be annual limits on:
- The overall amount you can claim
- The amount you can claim per condition
- What you can claim for out/inpatient treatment
- The amount you can claim for a certain type of treatment (for instance physiotherapy)
There are some private health insurance policies that will only pay for private treatment if you have had to wait six months or more on the NHS.