Is private health insurance worth it?
Increased people are choosing to pay for private healthcare because they are frustrated with long waiting lists and difficulties in getting the care they need through the NHS.
Last year, a record number of 272,000 people in the UK paid for their own surgery or tests at private hospitals. This is a 33% increase compared to the year before the pandemic, according to the Private Healthcare Information Network (PHIN).
Even more people, more than double that number, had their treatment covered by private medical insurance.
Private health insurance can help you get seen by a doctor faster, but it is important to consider the costs. Like any insurance, there are limits, restrictions, and things that may not be covered.
In this article, we will explain:
- What is private health insurance and what does it cover?
- Does health insurance covers pre-existing conditions?
- How much does private healthcare cost?
- Can I get cheaper health insurance?
- Do I need private health insurance?
- How do I choose a private healthcare plan?
What is private health insurance?
If you have concerns about cancer, persistent knee pain, or any other troubling symptoms, private healthcare insurance can offer you a range of advantages, although it does come with a price.
By paying your premium, you can expect prompt access to private healthcare services, including assessments, diagnosis, treatment, and post-care support.
Additionally, you may have the freedom to select the specialist you prefer and the convenience of attending a private hospital near your location.
It is worth noting that private health insurance not only focuses on physical health but is also expanding its coverage to provide more support for mental health, as recognised by the leading private health insurance companies.
What does private health insurance cover?
The coverage provided by private health insurance can vary depending on the insurance provider and the level of coverage you select.
However, comprehensive private health insurance typically includes the following:
- Private consultations with specialist doctors (private GP consultations may not be covered).
- In-patient treatment, including surgical procedures.
- Out-patient services, such as scans, tests, and x-rays.
- Physiotherapy for issues like back pain or sports injuries, usually limited to a maximum of 12 sessions.
- Access to medical helplines and virtual GP appointments available 24/7.
Nevertheless, it is important to understand that private healthcare insurance does not cover all your medical needs. There are certain exclusions to be aware of, including:
- Emergency treatment: In case of urgent medical assistance, you should always consult your GP, call emergency services (999), or visit the Accident & Emergency department.
- Maternity care: While you have the option to pay for giving birth in a private hospital, it will not be covered by your insurance policy, nor will routine pregnancy appointments.
- Chronic conditions: You cannot make claims for the treatment of chronic conditions like arthritis or diabetes, for example.
Does private healthcare cover pre-existing medical conditions?
Pre-existing medical conditions refer to health issues that you already have at the time of purchasing a private health insurance policy.
Typically, these conditions are not covered by your insurance policy. However, if you have a “moratorium” policy, coverage may be reinstated if you go two years from the policy’s start date without experiencing any symptoms or requiring treatment.
There is an exception if you have private health insurance through your employer. Certain high-level schemes may offer coverage for pre-existing conditions.
How much does private healthcare cost?
Research from myTribe, an independent insurance information service, suggests that the average cost of a hip replacement is around £12,198. Additionally, cataract removal can cost up to £3,200, while slipped disc removal may amount to £8,000.
In comparison, the average cost of private health insurance is approximately £1,500 per year or £125 per month, according to data from the financial comparison website Unbiased*. However, it is important to note that costs can vary significantly based on factors such as age and location.
Your health and lifestyle choices also impact the cost, with smokers paying more than non-smokers.
The level of coverage you choose is another key factor affecting the cost of private health insurance. It is essential to consider this aspect when comparing different insurance plans.
Furthermore, it is worth considering that opting for family private health insurance, which includes coverage for your partner and children, will result in higher costs. You can find more information in our guide to family life insurance.
How to get cheap private health insurance
Private healthcare costs can be high, but there are ways to lower them:
- Match your cover to your budget and needs: Consider if you really need extras like dental or optical cover, and prioritise what matters most to you, such as psychiatric care.
- Increase your excess: Agreeing to pay a portion of your claims can reduce costs without compromising overall coverage.
- Choose a six–week option: Some insurers offer lower costs if you use the NHS for non-urgent treatments within a specified period.
- Limit your hospital options: Opting for a plan with a smaller network of hospitals can save you money compared to more expensive policies.
- Stay healthy: Leading a healthy lifestyle and not smoking can result in cheaper premiums, as insurers see healthier individuals as less likely to make claims.
By implementing these strategies, you can manage private healthcare costs while still receiving the coverage you need.
Do I need private health insurance?
The decision to purchase private medical insurance is entirely up to you, based on your individual needs.
If you have concerns about long NHS waiting lists, private health insurance can provide invaluable peace of mind.
On the other hand, if you have confidence in the NHS and believe it will be there when you need it, you may not view private insurance as a priority or worthwhile expense.
For some individuals, the decision is practical. For example, if you are self-employed, private healthcare insurance can ensure that poor health or an accident does not hinder your ability to earn money for longer than necessary.
Alternatively, if you prefer the idea of accessing private healthcare when needed but do not want to pay for insurance, you can consider self-funding. This involves setting aside savings specifically for medical expenses or creating a dedicated savings account where you regularly deposit money. However, it is important to be aware that medical expenses can be substantial, and there is a risk that your savings may be depleted before completing the necessary medical treatment.
How do I choose a private healthcare plan?
You have options when it comes to purchasing private health insurance. You can buy it directly from insurance providers or utilise online comparison websites or brokers who will search the market on your behalf.
Given the complexity of the product and the wide range of options available, using a broker or comparison website is often a wise choice. They can help you find the best private health insurance that suits your needs.
Private healthcare companies:
- AXA Health
- The Exeter
- Freedom Health Insurance
- General and Medical
So is private health insurance worth it?
Ultimately, the decision of whether private health insurance is worth it depends on the following factors:
- Concerns about the state of the NHS: If you are worried about the condition of the National Health Service and its ability to provide timely care, private health insurance can offer reassurance.
- Waiting times for diagnosis and treatment: If you anticipate lengthy waiting times for medical services, private health insurance may be a valuable investment.
For some individuals who make multiple claims, private health insurance can provide excellent value for money. Others may be paying solely for peace of mind.
Unfortunately, without a crystal ball, it is impossible to predict which category you would fall into.
Considering the high cost of private health insurance, it is important to assess whether you can afford it. It should not cause financial strain, as it would defeat the purpose of providing peace of mind.
Other types of insurance to consider
Private health insurance is the only policy that directly reimburses you for the expenses incurred from private healthcare. However, there are other financial support options available in case of serious illness or death.
Critical illness insurance, for instance, provides a lump sum payment if you are diagnosed with an illness or condition covered by the plan. On the other hand, life insurance pays out a lump sum if you pass away during the policy’s term. Often, these two types of coverage are bundled together in a single plan with a monthly premium.
Alternatively, you can opt for income protection. Instead of a lump sum, this type of insurance provides a monthly benefit to replace your salary if you are unable to work due to illness or injury.