Health Insurance

antoine fruchard Antoine Fruchard  updated on September 28, 2020

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Of all the factors which affect your lifestyle, your health is probably the most important. If you’re ill – even if it’s nothing serious, just a cold that seems to drag on for ever – it’s impossible to enjoy your life.

You want to get things sorted out as quickly as possible.Of course, the NHS will do the job – at least for most of the costs. But sometimes, it’s under-resourced, and there’s a long waiting list.

How long are you prepared to wait?

If the answer is “not long at all”, then maybe you should think about UK private health insurance. This article tells you everything you need to know about what private medical insurance is, what it costs, and what benefits it can deliver, so you can make an informed choice. Let’s dive in!

What is health insurance?

Health insurance is similar to any other kind of insurance – it provides you with cover against certain risks. If you incur medical costs due to accident or illness, it will cover the cost of private healthcare.

What are the key benefits of health insurance?

In summary, what are the main benefits of getting health insurance?

  • the choice of hospitals you’d like to visit or consultants and practitioners you like to consult
  • access to some cancer drugs that are not covered through the standard NHS scheme
  • fast-tracking healthcare services bypassing NHS waiting lists for consultations and appointments.

Those benefits are particularly relevant if you often need healthcare appointments of if you have existing medical record.

A good health insurance policy will greatly increase your choices of treatment and timing.

For instance, some NHS procedures have long waiting lists and appointments are scheduled without your being given any choice in the date chosen. Private health insurance puts you in charge. You’ll get more choice over which hospital you go to, as well.

You’ll probably get treated more quickly. Even diagnostic tests can take months to access on the NHS – you’ll find out what’s wrong more speedily with private insurance, and that can improve your chances of successful treatment. And the range of treatments available may be wider than you’ll be offered on the NHS.

Private insurance may also provide better aftercare. That’s not just a luxury but can guarantee better outcomes. On the other hand having a private room rather than being on an open ward probably won’t make you better, but it might make you feel better.

Remember that you can still get NHS care even if you have a private health insurance. This isn’t an either/or choice – it’s a supplementary option.

Why do I need private health insurance?

You do not need private health insurance in the UK, in the same way you need car or home insurance. It’s not a legal requirement, and the National Health Service will provide you with necessary medical care. However, private insurance can expand your options and give you a better experience.

For instance, while it can sometimes be difficult to get NHS diagnostic tests, and you may have to wait a long time for an operation, private health insurance can get you quicker tests and treatment. You may be able to get a specialist referral, for instance for sports medicine. You may have more control over the timing of your appointments and surgery, which can be useful if you’re self-employed, for instance. You may also have access to an expanded range of treatments. Depending on your policy, you may find you have access to better aftercare, such as outpatient appointments to check on your progress or physiotherapy to get you back up and running.

Is private health insurance worth it?

That’s for you to decide. You need to set your private health insurance cost against the benefit of quicker, better treatment.

However, you must know that over 4 million people think it’s worth their while, so you’ll be in good company if you choose to insure privately.

How does health insurance work?

Private medical insurance works like any other insurance – you pay a premium every year or month, and in the event that you incur a cost, you can claim against the insurance.

There may be limits on how many times a year you can claim, what type of treatments you can receive, or what conditions are covered, but the basic idea is very simple.

What are the main types of health insurance?

Several different types of health insurance are available depending on who needs to be covered – you, you and your family, or your children.

  • Individual health insurance is just what it says – it covers you as an individual.
  • Family health insurance can include you, your partner and children. You can even include children who are away at university on such a policy.
  • Joint or couples health insurance just covers you and your partner. (You don’t need to be married, just living at the same address.)
  • Children’s health insurance is also available, separately, if you don’t want to or can’t add them to your own policy.

What are the other types of private health insurance?

Business health insurance

Health insurance is often provided as a ‘perk’ to employees as part of their remuneration. Employers aren’t being wholly disinterested when they provide it, since they’ll benefit if staff can get appointments more quickly and at a more convenient time.

International health insurance

International health insurance is available for those who are moving to live or work abroad. It’s not the same kind of insurance you’ll want if you are travelling, whether for work or for pleasure – it will cover you if, for instance, you’re going to work in Dubai for a few years, teach English in Korea, or retire to Panama.

In some countries you’ll find that the local state system is very limited, so private health insurance is a must. Unlike UK based medical insurance, international health insurance will also offer cover for long term conditions and maternity care.

Dental health insurance

Whether you’re on the NHS or go private, dental bills can be high if you’re unlucky enough to need extensive treatment. For instance if you need a couple of crowns you’re going to pay over £250 even on the NHS. Dental insurance will cover you for these costs, and many policies will also cover you for emergency dental care abroad.

Before you get dental insurance, though, check you’re not already covered, for instance by a healthcare cash plan.

Healthcare cash plans

Healthcare cash plans cover you for the cost of routine healthcare such as appointments with your optician, dentist or physio. They may include complementary treatments such as massage, tooth whitening, or osteopathy. You pay for your treatment, and then claim it back under the plan – but remember there will be an annual limit on how much you can claim.

These plans won’t cover you for surgery or hospital stays.

What are the main private healthcare companies in the UK?

The biggest healthcare insurers in the UK are AXA PPP, BUPA, Aviva, Vitality and WPA. They don’t all have the same business model; AXA and Aviva, for instance, are insurance companies that also provide other types of insurance (such as car and home insurance), while BUPA focuses only on healthcare and runs its own hospitals as well as providing health insurance.

Other insurers include Saga, Freedom, General & Medical, CS Healthcare, and Exeter, among others.

What does private health insurance cover?

Private health insurance will cover the cost of both inpatient and outpatient care, private prescriptions and diagnostic tests. Your consultations, hospitalisation, and outpatient appointments are all covered.

For instance, if you need surgery for a hernia, or a hip or knee replacement, your insurer will pay. Day surgery to restore a damaged tendon in one of your fingers would be covered. So would blood tests, CAT scans, X-rays, and similar diagnostic procedures.

However, you may not be covered if you have a flare-up from an existing condition that is under control.

What are the healthcare costs in the UK?

Private medical costs
Hip replacement£12-14,000
Knee surgery£13,000
Cataract surgery£2,500
MRI scan£500
Gall bladder removal£6,000
Skin lesion removal£960
CT scan£900
Dental implant£2,500
Private medical healthcare costs

What does private health insurance not cover?

Private health insurance won’t cover:

  • emergency care – you’ll get this on the NHS;
  • long-term, chronic conditions such as diabetes; kidney dialysis;
  • routine medical treatment such as antibiotics, flu jabs, colds, and so on;
  • drug or alcohol abuse or self-inflicted injuries ;
  • maternity care;
  • mobility aids;
  • professional sports injuries;
  • dementia;
  • sexual dysfunction;
  • cosmetic surgery that’s purely aesthetic (compared to, for instance, hiding disfiguring scars after surgery or an accident);
  • treatment abroad (this should be covered by your travel insurance policy).

Regular healthcare policies may not cover dentistry, opticians, physiotherapy or mental health. However, cover for these areas is usually available as a paid-for optional extra, or for dentistry and optical care you could consider a healthcare cash plan.

Remember that each insurer will set its own rules for cover. Many insurers offer different levels of cover so you can choose a plan that suits your budget. So you’ll need to check your policy to ensure that you are getting exactly the cover you want.

What optional extras can I get with health insurance?

Many health insurers will allow you to choose from a number of optional extra types of cover. These might include

  • Optical cover
  • Dentistry cover
  • Psychiatric cover (which can be useful, as the NHS has very long waiting lists for mental health services)
  • Complementary therapy cover (physiotherapy, chiropractic, osteopathy)

It’s up to you to decide whether these extras are worth the expense. For instance if your employer covers your optical test and eyewear – which they’re legally obliged to do if you work with a computer screen – then optical cover isn’t needed.

An eye test is only £25, but a pair of specs can cost £300 if you have specific requirements, so cover might be well worthwhile.

On the other hand dentistry cover might be useful, even if you’re with an NHS dentist. While the charge for an examination and polish is only £22.70, if you need a crown, dentures or a bridge, you’ll be paying £269.30 for the work – which might stretch your budget. Private dentistry fees are higher.

How much will private health insurance cost?

The cost of your health insurance will depend on the level of cover you want as well as on your own age and state of health (yes, as you’d expect, health insurance gets more expensive as you get older and your bones get creakier). Generally you’ll be considering one of three tiers of care:

  • basic – pays for inpatient treatment only,
  • medium – will also cover outpatient treatment / aftercare,
  • comprehensive – covers all your healthcare costs.

Some policies offer you a pick’n’mix option, and there are a number of ways you can reduce the cost of your premiums – we talk about those below.

You’re wondering how much is health insurance going to cost? As a rough guide, a 30-year old non-smoker could pay from £10 a month for basic healthcare cover, and £35 a month for a fully comprehensive cover with unlimited payouts.

How much is private health insurance for older people? If you’re at the other end of the age spectrum you will need to pay considerably more – from £80-122 a month at age 55, up to £100-187 a month for over-65s.

InsurerMonthly premiumCover features
logo freedom 1£23.87£250 excess, national hospitals list, includes physiotherapy
logo general and medical£32.39First choice hospitals, £250 excess
logo axa ppp£37.27£250 excess, national hospitals
logo bupa£39.57£250 excess, limited hospital list
Private health insurance comparison

*We only looked for policies that cover chemotherapy/radiotherapy and outpatient treatment. Excluding this cover could get you a cheaper price. 30-year-old female non-smoker

What will affect the price of my private health insurance?

Various factors will affect the price of your insurance. The amount of cover and the details of cover have a huge impact; a policy with a £50,000 annual limit will cost less than one with a £2m limit, for instance. The excess amount (how much you have to pay out of your own pocket before making a claim) will also affect the price. And of course, the more individuals covered by a policy, the more it will cost – individual cover will be cheaper than joint or family health insurance.

But the price of your insurance will also reflect how risky the insurer thinks you’ll be to insure. So the insurer will want to know:

  • your age,
  • your state of health and lifestyle,
  • whether you smoke,
  • whether and how much you drink, and
  • whether you take regular exercise.

You may also be asked about your family medical history, as some conditions can be inherited. Where you live can also affect your premium – just as with car insurance, London is the most expensive place to live.

How can you keep your private medical insurance premium low?

There are various ways that you can reduce your premium.

  • Pick a higher excess amount. That means you’ll have to pay more out of your own pocket before you can claim. If your main concern is to have private cover for really major healthcare issues, and you’re happy to pay for small injuries or incidental treatment yourself, this can be worth considering.
  • Consider a co-payment policy. That means you’ll commit to paying a given percentage of any claim (usually 10 or 15%) up to a maximum amount.
  • Choose a reduced level of cover, such as a policy which only covers in-patient stays.
  • Take out a policy with a reduced hospital list. This gives you less choice in terms of where you receive your healthcare but will cut your premiums.
  • The ‘six week option’ will reduce your costs, too. You agree to use the NHS as long as the wait for an appointment is less than six weeks – but if it’s longer, your insurer will pay for private treatment.
  • Pay annually. As with other insurance, if you can afford to pay annually rather than monthly, you’ll usually get a better price.
  • Live an healthier lifestyle. If you smoke, give it up. Start using the gym. Some insurers offer a discount on gym membership with their policies. Aviva offers an app called MyHealthCounts to check your health and lifestyle – it could reduce your premiums by 15%.

Even if you haven’t bought a ‘six week option’ policy, you can build a no-claims bonus by using the NHS for smaller and non-urgent health issues, if the waiting times are not too long.

How can I find the best private health insurance in the UK?

The best way to find a private health policy that suits you is to compare policies online.

UK health insurance is a well developed and reasonably competitive market. You’ll find, though, that some of the big names in home or car insurance don’t have a health product, while specialist health insurance companies like BUPA, General & Medical, and Freedom Healthcare make a strong showing.

We’ve already curated the insurers for you, and show clearly what they do and don’t cover. Remember, though, you need to check the cover, not just the price, if you want the best health insurance for your needs.

What should I pay attention to whilst comparing private health insurance quotes?

To compare health insurance quotes properly, you need to check whether the price quoted gives you everything you need, or whether there are extras that you need to add. We’ve done a lot of the work for you, but you do need to take a little time to think about the results. To compare health insurance properly, consider the following issues:

  • What extras might you want or need and how much will they cost?
  • Is the amount insured right for you?
  • Are there any exclusions? One budget insurer manages to reduce its prices by not including any cover for cancer. That’s a pretty big exclusion and you might not be happy with it.

What do I need to sign up for health insurance?

You really don’t need a lot of paperwork to sign up for health insurance. You probably won’t need to do a medical. You just need to be able to give the insurer basic facts about yourself and your health and lifestyle.

Do I need a medical screening before getting health insurance?

You don’t necessarily need a medical screening. Many insurers will only ask for you to fill in a declaration.

Does health insurance cover me abroad?

Regular health insurance won’t cover you abroad. If you are moving to live or work abroad, you’ll need international health insurance. If you’re only going on a business or holiday trip, you’ll need travel health insurance – this medical cover will be part of your overall travel insurance.

How can I get holiday health insurance?

If you’re taking a holiday abroad or going on a business trip, you’ll need to ensure that you have medical cover. Private health insurance won’t cover this – you’ll need it to be provided as part of your travel insurance.

You can take out either single-trip travel cover, or an annual, multi-trip policy; ‘backpacker’ policies that cover extended trips (such as overlanding Africa or round the world sabbaticals) are also available. You’ll get cover for flight cancellations, luggage, and so on, as well as holiday health insurance, all in one package.

Policies generally divide the world up into various regions; the USA is more expensive to insure, owing to the high cost of healthcare there; Europe is generally the least expensive. Ensure you are covered for all the countries you want to visit and that any sports you want to participate in (eg hiking, motorbiking, climbing, scuba diving) are covered.

Some (not all) employers will cover their employees for business travel. But make sure you know if there are any exclusions, particularly if you have a health condition that might not be covered, or if you are pregnant.

What’s the difference between travel insurance and international health insurance?

Travel insurance is intended for UK residents who are making trips overseas that will last from a few days to three months. It’s sometimes referred to as expat health insurance.

If you are moving abroad for an extended period, you’ll need to get international health insurance. This will cover your healthcare costs in the country where you’re living.

European Health Insurance Card and health insurance

If you’re a UK resident, at the moment the European Health Insurance Card (EHIC) allows you to access EEA member states’ and Swiss healthcare systems on the same terms as nationals. That doesn’t always mean free; for instance, in France you’ll only be covered for 80% of treatment costs and you’ll have to pay the rest yourself. A two-week hospital stay could see you forking out about £1,000 even after using your EHIC, so it could be worth ensuring you have separate travel medical cover.

However, at the moment it seems like Brits will lose their entitlement to a European Health Insurance Card after Brexit. You’ll lose your EHIC once the UK exits the Transitional Period on 31st December 2020. After that, you’ll need to rely on the medical cover provided in your travel insurance. And if you wanted to renew your European Health Insurance Card – sorry, but it’s really too late.

Can I get health insurance with pre-existing medical conditions?

Yes, you can get health insurance with a pre-existing medical condition. However, there will be limitations.

  • Your existing condition won’t be covered. Nor will any other conditions that it causes.
  • Your insurance could cost you more if that condition makes you a worse risk (for instance, some chronic conditions affect the immune system and make you more vulnerable to infections).

Most insurers apply a five year cut-off, so if you had a disease as a child, and completely recovered, it won’t count.

Some insurers may cover pre-existing conditions – particularly minor conditions. If you have health conditions, you may find that using a broker is a good idea, as they will know specialists and be able to talk to underwriters.

How does health insurance for pre-existing medical condition work?

Insurers treat pre-existing conditions in one of two ways:

  • full medical cover underwriting – you’ll need to give full details of your pre-existing conditions and access to your medical records, but you’ll get certainty on exactly what is covered.
  • moratorium underwriting – you don’t have to give full details when you apply, but if you claim, your insurer will then examine your medical records to decide whether they will pay the claim.

The ‘moratorium’ is generally two years – after which pre-existing conditions that have not shown recurring symptoms or required any treatment will be covered once more.

Will my health condition affect my premium?

You may end up paying more if you have a health condition, even if the insurer is not willing to cover you for healthcare costs in relation to that condition. This is for two reasons;

  • You’ll probably have a smaller pool of insurers to choose from, so the market is less competitive;
  • your condition might make you vulnerable to infections or other health issues, or there might be the risk of side effects from your medication.

Can I get health insurance if I am disabled?

Yes, disabled people can get health insurance. However, health conditions that relate to your disability might not be covered.

Can I get health insurance if I have a mental problem?

Yes, you should be able to get health insurance. However, you do need to disclose the mental health issues to your insurer. Since some mental health conditions canincrease the risk of, for instance, alcoholism or abuse of medication, you may find your premiums are higher than would otherwise be the case.

Are there any age limits to get health insurance?

Most insurers do have an age limit on their health insurance. For some, it’s 65; for others, it can be up to 80.

If you’re over 50 you may find that a special over-50s policy is more suitable and cheaper for you. Many insurers offer policies specially targeted at older consumers.

What is self employed health insurance?

If you’re self-employed, you won’t get sick pay, and you can’t afford time off. Self-employed health insurance will cut your waiting times and lets you fit your treatment into your busy working life so neither you nor your clients suffer.

You might also consider income protection to cover your earnings during any time that you need to take off. Sometimes people do refer to this as ‘self employed health insurance’ but it’s not the same as a medical policy and you will need to take it out separately.

Can I add other people on my health insurance?

You can add a partner living at the same address, or dependent children including students at university, to your health policy.

Can I have two health insurance policies in the UK?

You could purchase two health policies, with different exclusions and cover, but you’d then have problems making a claim – each insurer would want to ensure it didn’t pay for something covered by the other.

However, there is one case in which it may make sense for you to have two policies – a private medical policy and a healthcare cash plan. That’s because these two types of policy provide quite different cover. The medical policy will cover hospital treatment and other specialized care, while the cash plan will cover smaller costs such as opticians’ and dentists’ bills.

What is permanent health insurance in the UK?

Permanent Health Insurance (PHI) is not to be confused with private health insurance – it is the way the industry refers to policies which cover you for loss of earnings if you are unable to work because of ill health.

You can cover up to 70% of your annual income. That means even if you’re so ill that you’re unable to work for an extended period, your bills will be paid.

Are health insurance payouts taxable in the UK?

Neither payouts for medical costs nor payouts for PHI claims are taxable.

If your employer provides you with a private health scheme, you’ll pay tax on the premiums as part of your PAYE. So your tax is already paid – you won’t pay again if you make a claim.  

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