With concerns about NHS backlogs and the rationing of more expensive drugs, private health insurance might seem like the answer, but before you buy, it pays to check exactly what it will and won’t cover.
For some people, health insurance, often known as private medical insurance, isn’t a priority (and they’re happy to do without it), but others consider it essential.
Whatever your views, there’s one thing that most people can agree on and that’s that it doesn’t come cheap, especially once you reach your 50s, 60s, and beyond. Most people take out health insurance that’s either free or subsidised by their employer, but many employers don’t offer it and, if you’re self-employed or retired, you’ll have to buy it yourself.
Here, we explain what private health insurance does and doesn’t cover, and look at ways you might be able to reduce the cost of your premiums.
What does private health insurance cover?
Different policies cover different illnesses, so there’s no hard-and-fast rule about what private health insurance covers. However, in general terms, private health insurance is likely to pay for…
- The cost of treating short-term illnesses, sometimes known as acute conditions, if they start after you take the policy out
- Diagnostic inpatient tests
- Medicines not yet approved on the NHS for treating certain conditions (for example, expensive cancer drugs)
- Treatment at a private hospital or a private facility in an NHS hospital. You will usually be offered a choice of hospitals and your own private room, often with its own en suite bathroom.
What extras might private health insurance cover?
There are all kinds of extras that may be included in your private health insurance. They include:
- Outpatient tests and treatment
- Physiotherapy
- Complementary therapies
- Counselling services
- Dental treatment
- Optical appointments
When buying cover, make sure you read the small print carefully so that you know exactly what is and isn’t covered by your policy, as this will help avoid any nasty surprises if you need to make a claim.
What doesn't private medical insurance cover?
Private medical insurance usually won’t cover any pre-existing medical conditions. These are conditions which you may have been diagnosed with, treated for, or have experienced symptoms of prior to taking out cover.
It’s also important to note that policies typically include a qualifying period. This is the set period of time that must pass after you’ve bought your medical insurance cover, during which you can’t make a claim.
All medical insurance policies will carry some exclusions, so make sure you check the policy small print so that you know what these are. Exclusions often will include cosmetic treatment, treatment of chronic, incurable conditions and dental work.
Where to buy private medical insurance
There are two main ways to buy private medical insurance.
You can either go directly to a health insurance provider or you can ask a health insurance broker or advisor to help you find the right cover to suit your needs.
It might seem that buying private health insurance online is the cheapest and quickest option, but there are so many terms and conditions in private health insurance policies that it’s usually a good idea to seek professional advice on the best option to suit your needs.
How can I save money on private health insurance premiums?
If you like the idea of private health insurance, but are worried about the cost of premiums, there are ways you might be able to save money…
- Use the NHS for treatment at outpatients’ clinics (or pay for treatment yourself)
- Increase the excess on your policy. The excess is the part of any insurance claim that you must pay yourself. If you have savings that you can put towards your treatment, you could increase your excess substantially, but make sure it remains affordable
- Limit the range of hospitals you can be treated at (or stick to less expensive ones)
Some insurers offer policies on a ‘six-week wait’ basis, which means that if the NHS waiting list for a particular procedure is less than six weeks, you use the NHS for treatment. If it is longer, your health insurance pays. These policies can be 30-35% cheaper than standard private health insurance. Find out more about saving on private medical insurance in our guide Where can I find affordable private health; insurance?
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