What is private medical insurance?
Private medical insurance is designed to help you access medical treatment quickly, bypassing standard NHS waiting times and giving you a wider range of options when it comes to booking appointment times or choosing specialists. The biggest difference between private healthcare and the NHS is the speed at which you'll be seen and treated.
Private medical insurance is generally aimed at covering specific, acute health conditions that might affect you in the future. An acute condition can be described as a health problem that’s likely to respond quickly to treatment so that you can return to your previous level of health – for example, an illness requiring a brief hospital stay, or a broken leg.
Before you consider taking out private medical insurance, it’s important to remember that you the vast majority of insurers won’t cover you for the following things:
- Emergency treatment - if you have an illness or injury that requires you to visit A&E, this will be handled by the NHS. Planned follow-ups, however, may be covered by your policy. So, if you break your leg, your initial emergency treatment will be carried out by the NHS, but if you’re asked to come back for a scheduled operation on it, this may be covered by your policy.
- Chronic conditions - illnesses, diseases or injuries that either continue indefinitely, have no known cure, come back (or are likely to come back), need long term monitoring or need ongoing control or relief of symptoms.
- Existing conditions - having an existing health condition won’t generally prevent you from being covered for other conditions, but you won’t be covered for that condition either at the time of taking out the policy or in the future. Many private health insurance providers will ask you to complete a medical declaration when you sign up, confirming your current state of health.
- Non-essential medical procedures - private medical insurance policies tend to exclude things like IVF, pregnancy-related healthcare, and cosmetic surgery.
What types of medical insurance are available?
Comprehensive private medical insurance
This is probably what most people think of when it comes to private medical insurance. Comprehensive cover pays for private diagnosis and care at a time that suits you. There are many different variations depending on the insurance company, so research your options carefully before committing to a provider.
Comprehensive policies will often include:
- A choice of hospitals, both NHS and private
- A faster diagnosis
- A choice of specialists
- Flexible appointments
Comprehensive policies may offer the option of:
- Treatment for mental health conditions
- At-home nursing care
- Complementary or alternative therapies (such as acupuncture or osteopathy)
- Dental cover
- Optical cover
- Enhanced cancer cover (this may include extra assistance such as a free helpline or a payout on diagnosis to help with essential expenses)
Basic private medical insurance
If you find that comprehensive medical cover is beyond your budget, or that it doesn’t fit your needs, many medical insurance providers offer a range of options when it comes to reducing your costs. These basic policies will usually cover only some stages in the healthcare process – for example, you might be covered for private treatment following an NHS diagnosis, or vice versa. Some policies give you the option of going private if NHS waiting lists exceed six weeks.
On-demand private medical treatment
If you’re happy to rely on NHS treatment for most of your healthcare needs, but would like to access private treatment for a specific non-emergency procedure – for example, a hip replacement – many private healthcare providers offer this option. Opting to have this kind of procedure done privately means that not only will you be seen faster than on the NHS, you’ll also benefit from things like a choice of hospitals, a private room (where possible) and appointments to suit your schedule.
Many providers also offer cashback plans, which provide cash payments to help with everyday healthcare costs. These plans allow you to pay for your treatment and then claim back some (or all) of the costs in the form of cash refunds.