The National Health Service (NHS) is an amazing institution that we can be proud of. It offers some of the best treatments in the world from the best medical professionals and is free at the point of delivery. While we all rely on it at some point in our lives, however, it does have its limitations.

A survey commissioned by Engage Britain found that more than a fifth of people who had either taken out a private healthcare policy or paid for treatment privately did so because of concerns over how long it would take to access treatment on the NHS.

Given that waiting lists are longer than ever, exacerbated by the challenges created by the pandemic, it may be worth considering taking out a medical insurance policy. Or, if you already have one, review it to make sure it still offers you the cover you may need.

Given that waiting lists are longer than ever, exacerbated by the challenges created by the pandemic, it may be worth considering taking out a medical insurance policy

Do you need private health insurance?

All UK citizens are entitled to receive free treatment on the NHS. So unlike many other countries, if you hold a UK passport, it’s not absolutely necessary to pay for additional private cover. 

But you may wish to take out a policy if: you are concerned about waiting lists, would prefer to recuperate in the comparative luxury of a private hospital, have a specialist requirement such as a sports injury that’s not treatable on the NHS, or don’t have medical insurance through your employer. 

What is covered?

As with all insurance, the higher the cost of the policy, the more cover it’s likely to provide. Think about what you need and what is a ‘nice to have’, alongside how much you can afford to spend on monthly premiums without impacting your other expenses.

The more basic policies usually pay for in-patient treatments such as tests and surgery.

Other policies include out-patient treatments such as specialists and consultants and may pay you a small, fixed amount for each night you spend in an NHS hospital.

You can also choose from a range of add-ons such as dental cover, mental health treatment and sports injuries, which may not be covered already.

What isn't covered?

Your healthcare insurance won’t usually cover private treatment for:

  • organ transplants
  • pre-existing medical conditions
  • normal pregnancy and childbirth costs
  • cosmetic surgery to improve your appearance
  • injuries relating to dangerous sports or arising from war 
  • chronic illnesses such as HIV/AIDs-related illnesses, diabetes, epilepsy, hypertension (high blood pressure) and related illnesses.

As with all insurance, the higher the cost of the policy, the more cover it’s likely to provide

Comparison of NHS v private insurance

You’re still entitled to free health care from the NHS, even if you have a private health insurance policy or you choose to pay for additional private care.

However, you can only have one healthcare team supervising treatment for a specific condition. So, if you need a knee operation, for instance, you would need to opt to have both the operation and post-care with either the NHS or a private provider; you can’t mix and match services.

The case for private health care:

  • You can ask your GP to refer you privately to a specialist, which will normally mean you’ll be seen a lot quicker than on the NHS. 
  • There may be a longer wait for scans on the NHS, or they may not let you have one if they don’t think it’s critical – remember every NHS Trust is working to a budget. You can use your insurance cover to pay for any scan your NHS or private doctor thinks you need.
  • If an NHS operation wait time is longer than six weeks, you will be treated privately.
  • You have far more control over your surgeon, your hospital and the date and time of your treatment. The extent of choice will depend on your policy.
  • NHS hospitals generally have open wards, which lack privacy and can be noisy. With a private policy, you usually get a private room.
  • Some specialist drugs are not available on the NHS because they are either too expensive or not approved by the National Institute for Health and Clinical Excellence in England and Wales (NICE) or the Scottish Medicines Consortium (SMC). These drugs may be available on your private cover.

The case against private health care:

  • If you have a serious illness such as cancer, heart disease or stroke, you’ll get priority NHS treatment. 
  • A private healthcare policy doesn’t generally cover chronic or incurable illnesses like diabetes, epilepsy and arthritis.
  • Any pre-existing conditions aren’t generally covered, although you may be able to add them to your policy at a cost.
  • If you choose a policy with an approved list of consultants and hospitals, it may not give you access to your most convenient hospital or include the specialist consultant you want. You need to check this when choosing a policy.
  • Private medical insurance can be expensive and more so as you get older. The NHS is free for life.

Private medical insurance can be expensive and more so as you get older. The NHS is free for life

How to choose a policy

1. Do you have private mediate insurance through work?

If so, you’re already covered, so there is no point paying out twice! You can normally adjust the policy at your own expense, such as adding more cover options or reducing your excess.

2. Cost considerations

Most private healthcare policies will take into account your current health and age when pricing up a policy. There are ways to cut, for instance:

  • You could limit the level of hospitals you have access to or the specialists you’re able to see.  
  • You may choose to allow the NHS to diagnose your condition before private treatment.
  • You may choose to limit treatment to just in-patient rather than out-patient cover.
  • Or you can increase your voluntary excess up to £5,000, which may give you significant savings on the monthly premiums.

Some policies also take into account your overall wellbeing, fitness and lifestyle choices. For instance, new digitally-led insurance providers like Yu Life promote healthy living and offer rewards that encourage people to live a healthier life, rather than just the cover itself.

3. Be honest

It might be tempting to underplay your alcohol intake or overplay how many times you go to the gym, but if you’re not truthful about your health and lifestyle, you may find that your insurance company won’t cover your claim. And then any money you’ve spent on premiums is completely wasted.

4. Get professional advice

When it comes to financial planning, healthcare needs and any existing cover should be considered when reviewing your circumstances. It’s all part of your Life Landscape. Your requirements may be complex or straightforward. If you have any pre-existing medical conditions or are unsure what you need, an independent adviser will help you find the best policy and tailor it to your requirements.

They will also help scrutinise every aspect of your policy to understand what’s covered and what’s not. Look out for fixed-sum excess charges and add-ons, such as dental or maternity care, and check whether you’ll be covered for the cost of hospital stays.

Get in touch

To speak to one of our team, arrange an appointment or find out more, call 0800 915 0000, or use our contact form here.