Health insurance can ensure that you won’t need to worry about NHS waiting lists if you ever need medical treatment in the future. It also pays towards the cost of treatment, tests or surgery that you would otherwise have to foot yourself.
It is typically aimed at acute, short-term and curable conditions, rather than existing, long-term ailments, disabilities, or incurables diseases – more on that later.
Health insurance is designed to offer treatment alongside the services provided by the NHS. For example, doctors appointments would still be through the NHS, but with private medical insurance you could also receive:
- Faster treatment.
- The option to choose a time and place that is convenient for you.
- Better facilities.
- A wider range of treatment types and drugs.
How does health insurance work in the UK?
Finding private health insurance works much in the same way as you’d carry out a search for car, mobile or home insurance! First off, you carry out a search over the phone or online to find the most suitable policy to suit your needs.
Some policies let you choose exactly what your plan covers, and the price will be based on what you select and how many options you add. Others offer broader plans at a set price, encompassing the most common options.
Some policies make you fill out health declaration. If you have existing conditions, you may be charged more for your policy, or you may be required to cover the cost of associated treatments yourself. If you are disabled, some providers do not cover any treatment related to your condition.
Once you’ve taken out your selected health insurance policy, you will pay a monthly “premium” for the service, and your insurance can pay out if treatment is required (provided it’s covered) during the time the policy is active.
What does health insurance cover?
Health insurance covers a variety of things, including exclusive drugs, hospital stays, scans and surgical procedures – to name a few. But as with all types of insurance, it will completely depend on which policy you opt for.
It can include cover for treatment you get as either:
- An inpatient—when a hospital bed is required for tests or surgery.
- An outpatient—for consultations, diagnoses and treatments where overnight stays aren’t required.
- A day patient—for regular appointments.
Basic plans usually cover inpatient care only, whereas comprehensive health insurance tends to cover a wider range of treatments – but expect the premium to be higher.
There are limitations to every policy however, and the majority of plans do not cover treatments for any of the following:
- Emergency treatment. Ambulances and A&E are usually run by the NHS.
- Chronic illnesses or long term incurable conditions such as HIV.
- Treatment for drug or alcohol abuse, such as rehabilitation costs.
- Elective treatment, including cosmetic surgery and fertility treatment.
- Care and treatment during pregnancy, although emergencies and health complications may be covered in specialist plans.
There are a wide range of possible private medical insurance products available. At a basic level, you can choose a policy specifically designed for:
- You and your partner.
- Your whole family.
- Your child(ren).
We’ve discussed that comprehensive health insurance covers the widest range of treatments, but there are there are also more specialist plans available, such as those aimed at older people. For example, you can select from:
- Over 50s health insurance.
- Over 65s health insurance.
- Over 70s health insurance.
These plans will vary by lender, but may cover things like hospital treatment, surgery, consultancies, tests and scans, dental work, optical appointments and home-nursing care.
There are also policies available which have been designed with particular treatments, diseases or conditions in mind, such as:
- Medical care during pregnancy.
- Disease-specific treatment (e.g. cancer treatment).
- Dental treatment.
- Optical appointments.
- Psychiatric treatment.
There are also affordable plans which allow the policy holder to go private if the NHS waiting list is longer than, usually, six weeks.
Depending on the type of plan you opt for, there are numerous advantages of taking out a health insurance policy. These include (but are not limited to):
- Access to specialist drugs and treatments – some drugs and treatments aren’t available on the NHS either because they’re too expensive or haven’t been approved by the National Institute for Health and Clinical Excellence (England and Wales) or the Scottish Medicines Consortium.
- Specialist referrals – you are able to ask your GP to refer you to a private expert if you want a second opinion, or access to specialist treatment options.
- Reduced wait time. Health insurance can reduce the time spent waiting on NHS treatment, potentially leading to faster diagnoses.
- More flexibility. You are (to an extent) able to choose a specific surgeon and hospital location for added convenience to suit your needs.
- Better facilities. Private medical insurance can be used to get a private room rather than sharing a mixed-sex ward.
- Access to more scans. If the NHS refuses to let you have a scan, or there’s a delay in your referral, you can use your insurance to pay for one sooner.
Some disadvantages you could come across are:
- Most treatment is already available on the NHS. NHS hospitals can be as just as good or even better than private ones. What’s more, serious illnesses are always given priority NHS treatment.
- Expense. Health insurance can be very expensive, and premiums will rise every year, and with age. So if you take out a plan when you’re 30, by the time you’re older and more likely to require hospital treatment you may have more difficulty in affording it.
- Payable excess. As with every type of insurance, UK private health insurance policies use an excess to help control claims. Health insurance excesses are usually either charged per year, or per claim. The amount of excess you choose to pay will usually have a direct impact on the cost of your plan.
- Not everything is covered. As established, some incurable chronic illnesses, disabilities and other conditions are not covered by many policies – but ensure to speak to an expert to see if any specialist plans are available.
- Not always convenient.While some policies offer you a choice of approved hospitals and consultant, it doesn’t necessarily mean that you will be able to see the consultant you want at a location that is convenient to you.
Cost is usually the most significant factors which makes or breaks customers’ decisions to take out private medical insurance – after all, it can be expensive in some cases.
However, it’s important to note that, alongside the type of plan and how many products are included in your cover, there are a number of other factors that impact how much it will set you back:
- Age. The older you are, the more you can expect to pay.
- Lifestyle. If you smoke, drink excessively or are overweight, you may have to pay higher premiums.
- Medical history. If you have suffered from certain conditions in the past it puts you at higher risk and costs may be higher.
- Family medical history. Again, if there is a family history of conditions that may be genetic, you may have to pay higher premiums.
What’s more, some of these factors may actually inhibit you from taking out health insurance policies – it all depends on the insurer’s criteria.
If you’re considering taking out private medical insurance, it’s important to first speak with a specialist to ensure you find the most suitable type of cover for your individual circumstances.
If you have any questions surrounding health insurance or want to compare policies to find the best option for you and your loved ones, contact Online Money Advisor today on 0800 304 7880 or make an enquiry here.