Private health and protection insurance expert and editor
Private health insurance can offer people reduced waiting times and greater flexibility concerning where, when and who provides their medical treatment, alongside many other significant benefits. But is private health insurance worth the money when you can get free healthcare via the NHS? This article looks at the pros and cons of private health insurance plans, and by the end, we hope you will be able to decide for yourself.
In short, yes. It is worth having health insurance in the UK. With NHS waiting lists at near-record lengths and millions awaiting treatment, private health insurance has never been more valuable.
That said, there are limitations: it can be costly, doesn't cover pre-existing or chronic conditions, and can't replace NHS emergency services.
In the UK, we're fortunate to have the National Health Service (NHS), which is free at the point of use for British taxpayers. In times gone by, private health insurance was seen as a luxury that only those with the means to pay for a policy would opt for. However, in recent times, especially since the Covid-19 Pandemic, the NHS has been overwhelmed. With waiting times and surgical backlogs at record-breaking levels, people increasingly turn to the private sector for their healthcare.
Whether you have private medical insurance or not, you can access private treatment as long as you have the money to pay for it. All private hospitals and private healthcare providers in the UK allow people to "self-pay" for surgery and procedures and offer medical loans to spread the cost.
This year, we got quotes from leading private hospitals for a range of common private healthcare procedures. Here's what you can typically expect to pay if you don't have private medical insurance:
The cost of private surgery varies based on where you live, typically costing more in cities like London and Manchester. As private healthcare treatment costs are higher in those locations, most insurance providers will charge higher premiums for those living there.
Firstly, we need to point out that private health insurance covers acute medical conditions after taking out a policy. Pre-existing medical conditions will be excluded, typically any you've suffered from or required treatment for five years before taking out the policy.
You'll note that we used the word "acute", as private medical insurance doesn't cover chronic conditions, meaning those that can't be cured. Private health insurance plans also don't cover emergency treatment, so your NHS hospital is the best place to go if you need urgent care.
While what is and isn't covered will depend on your provider, policy and personal requirements and medical history, here is what you can typically expect from a basic and comprehensive policy.
With a basic policy, you need to be diagnosed via the NHS before being referred to a private hospital for treatment. While still beneficial, it can delay your ultimate recovery if you are on a waiting list for tests or scans.
Comprehensive policies will cover all of the above, plus:
As you're more likely to need tests than treatment, there's a higher probability you'll claim outpatient cover; therefore, comprehensive policies cost quite a lot more than basic ones.
Whether you opt for a basic or comprehensive policy, you'll have several options to enhance your cover further. Here are some of the options you can choose from, each of which will add to your monthly premium:
Before purchasing a health insurance policy, it's important to make sure you're aware of all the associated benefits and disadvantages. It's common not to see value in all the benefits a health insurance policy offers. Hence, it's worthwhile speaking to an expert to configure your plan before you buy.
Don't need to use central London hospitals? OK. Want access to a virtual GP? No problem. Let your adviser know what is and isn't essential to you, and they will do the rest.
The benefits of private health insurance are numerous, and while there are a number of them that will apply to everyone, there may be some more nuanced benefits that you only see from a specific policy or provider.
1. Faster medical treatment
Waiting times for treatment via the NHS are the longest they've ever been, leaving millions of people suffering for extended periods. Private health insurance enables you to be seen and treated far quicker.
If you have comprehensive health insurance, your diagnosis will also take place privately, speeding things up even more.
2. Have a dedicated consultant
Typically on the NHS, you will see a variety of consultants, so who you see may not always be the same as your last appointment. If you have private health insurance, you will receive an appointed consultant who will take overall responsibility for your care.
Not only that, you'll have more say in who's treating you. If you know there is a particular consultant who has had brilliant results treating your condition, you can ask for them.
Axa, Aviva, Vitality and Bupa all offer something called "guided consultants", which restricts you to a smaller pool of specialists in return for an approximate discount of 20% on your policy. While an excellent way to minimise the cost of a policy, it somewhat undermines this benefit. You can pay those health insurance providers to un-restrict your consultant list or opt for one of the smaller providers, i.e. WPA, The Exeter, Freedom or National Friendly, who all offer unrestricted access as standard.
3. Appointments at a time and place that suits you
Appointments via the NHS will usually be at a time and location that you have no control over. Privately, you can choose where and when your appointment will be and have much flexibility over how you are treated.
This is especially useful for working adults and those with families, as fitting appointments around life commitments can be difficult.
4. High-quality facilities
Private hospitals compete against each other, so you tend to see significant investment in hospital facilities. Private health insurance is the way to go if you want access to the highest quality facilities.
5. Access to cutting-edge treatments and drugs
The NHS only has limited resources, and you'll often find that the latest and most expensive treatments and drugs won't be available.
One of the significant benefits of private health insurance is that it gives you access to cutting-edge drugs and treatments which may not be available yet on the NHS.
6. Private, ensuite rooms
Rather than being on a shared ward with strict visiting hours and rules, you'll have a private room with an ensuite bathroom. Visiting hours will be far more flexible; generally, your hospital stay should be much more comfortable.
7. Virtual GP services
NHS GPs are struggling to deal with the demand placed on them, and the number of full-time GPs employed by the NHS is also reducing year on year. All the best health insurance providers now include virtual GP services, which give you round-the-clock access to fully qualified GPs on the phone or via video call.
Some insurers also extend their outpatient cover to include face-to-face private GP appointments in places such as London.
8. Additional policy benefits
In addition to those listed above, you may find that your health insurance policy gives you some of these additional benefits:
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As with anything, there are some disadvantages to private health insurance and private healthcare.
Private health insurance only covers the cost of private treatment for conditions classed as acute, meaning those that will respond to treatment. Chronic, incurable diseases aren't included. Private healthcare works alongside NHS services and won't fully replace everything. The NHS is still the best place to go if you suffer from a chronic condition, such as diabetes or asthma.
Private health insurance excludes emergency services and routine pregnancy. For either of these, you would still be seen via the NHS. Some insurers, such as Freedom, cover specific pregnancy complications; however, it's still somewhat limited.
Unlike the NHS, where they will treat you regardless of whether you have suffered from the issue in the past, private health insurance doesn't usually cover pre-existing medical conditions unless you haven't had symptoms for five or more years.
However, there is an exception to this rule if you opt for moratorium underwriting. If you don't suffer symptoms or require treatment for a pre-existing medical condition for a period of two-years after taking out your private health insurance policy, most insurers will then include that condition in your cover.
Private health insurance isn't free, which is a disadvantage compared to the NHS, and you'll need to pay regular insurance premiums. You'll also find that the cost of your insurance will usually increase every year as you age.
Navigating the increasingly complex world of health insurance is a full-time job. Our FCA-approved health insurance brokers are here to answer any questions you may have and provide you with free policy advice.
Our experienced health insurance brokers compare different providers and their cover options for you
We recently researched the average cost of private health insurance and obtained over 700 quotes from the eight leading private health insurance providers. While the price of your policy will differ based on your requirements, age, location, medical history and more, we can share those numbers with you to give you an idea of what you might expect to pay.
Average based on quotes from eight leading health insurers in 10 UK cities. Prices are accurate as of 16th February 2022. We opted for a comprehensive policy, with a £250 excess (or as close as possible), outpatient cover limited to a maximum of £1,500 in claims per year, and we included therapies cover. We defaulted to each provider's standard hospital list and used moratorium underwriting.
Overall, we believe private healthcare insurance's benefits outweigh the disadvantages. It should always be remembered that it works alongside the NHS, not instead. When you look at it like that, you soon start to see that you will have all the benefits of the NHS and private healthcare.
Medical insurance is increasingly becoming more valuable with the challenges the NHS faces in the UK. While it'll never replace the NHS, having the ability to access private healthcare services is hugely beneficial to many.
Disclaimer: This information is general and what is best for you will depend on your personal circumstances. Please speak with a financial adviser or do your own research before making a decision.
Chris Steele is myTribe’s resident expert in private health insurance and healthcare, with over a decade of experience in the field. As a Chartered Insurance Institute (CII) qualified professional, he has helped countless consumers navigate private medical insurance. Regularly quoted by national media, Chris is a trusted voice in the UK insurance industry, with his insights featured in leading consumer finance publications.
Private medical insurance is becoming increasingly valuable in the UK due to the NHS's record-breaking backlogs. With people being stuck on waiting lists for many months, private healthcare insurance policies give you the assurance that you will be treated as soon as possible if you become unwell or suffer an injury.
The NHS is brilliant and provides many services that the private sector can't, however it is overburdened. Private healthcare has many advantages, but it would be wrong to say it is categorically "better".
Private medical insurance doesn't typically cover routine pregnancy, so it's not worth taking out a policy if that's why you are thinking of it.
Private medical insurance has never been more valuable given the NHS's challenges. While it can be expensive, the benefits it provides are extensive. If you're considering cancelling your policy due to the cost, please request a comparison quote from us, as our brokers can typically find ways to reduce your premiums without sacrificing too much cover.
Medical insurance gives you access to private healthcare providers in the UK. What is and isn't covered by your private medical insurance depends on your policy, with basic ones covering inpatient treatments and surgeries and more comprehensive policies covering outpatient treatments. Private medical insurance doesn't cover pre-existing medical conditions, so if you're currently suffering symptoms or waiting for treatment, you'll need to stay with the NHS or pay for the private treatment yourself. In most cases, you'll still need to see your NHS GP before being referred for tests or treatments privately.
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