Health insurance

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What is health insurance?

Health insurance helps cover the cost of private treatment for pre-agreed conditions.

You'll sometimes hear it called private medical insurance (PMI), but in most cases the product is the same – although exactly what's covered will vary from policy to policy.

You’ll pay a monthly or annual premium and when you need to access private medical care, your insurance policy will cover some or all of these costs.

Double check you don’t already have health insurance through your employer before taking out your own cover. Some companies offer private healthcare as part of a benefits package. It tends to be for the employee only, but sometimes it extends to your family too.

health insurance

In August 2021, there were 5.45m people on NHS waiting lists, according to The BBC.

The average waiting list time was 11.6 weeks according to The NHS.

Health insurance could help you get treatment sooner.

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What’s covered by health insurance?

It depends on the level of cover you have. 

Basic health insurance policies will cover:

  • In-patient treatments, like routine health checks, tests and surgery
  • Overnight stays

Mid-level policies usually include the above, plus:

  • Out-patient treatment (medical care that can be done without an overnight stay in hospital)

Comprehensive policies include all of the above, as well as:

  • Mental health care
  • Physiotherapy
  • At-home care

What’s not covered by health insurance

Health insurance policies don’t generally cover:

  • Chronic conditions
  • GP services
  • Accident and emergency admissions
  • Pre-existing conditions
  • Drug abuse
  • Self-inflicted injuries
  • Infertility
  • Cosmetic surgery
  • Preventative treatment
  • Mobility aids

How does private health insurance work?

You might think you don't need private health insurance if you’re entitled to treatment on the NHS. But PMI works alongside your NHS treatment, giving you faster access to a greater range of treatments.

You’ll pay monthly or yearly premiums and choose your excess at the outset. The excess is the amount you agree to pay towards your treatment cost.

For example, if your excess is £100 and you have a treatment costing £500, your insurance will cover £400 and you’ll pay the £100 excess yourself.

How to access private treatment

If you get ill, you’ll need to make an appointment with your GP first.

Tell your GP that you have private medical insurance. They’ll be able to refer you for any private treatment that’s available under your policy.

How much will a private medical insurance policy cost?

This depends on your personal circumstances and the level of cover you need.

Your personal circumstances include things like your age, whether you smoke or vape, where you live and your medical history.

Whether you choose a basic, medium or comprehensive policy, your voluntary excess and how many nominated hospitals you choose will all affect the price too. 

You might be able to bring your premium down by choosing a six-week wait option on your policy. This means that if the NHS waiting list is less than six weeks for the treatment you need, you’ll have it done on the NHS instead.

Cost of private treatments 

Treatment Cost
Wisdom tooth removal £2,350
Hip replacement £12,198
Knee replacement £13,205
Gall bladder removal £6,199
Cataract surgery £2,518
Slipped disc removal £7,988
Laparoscopic hernia repair £3,352
Colonoscopy £2,063
Gastroscopy £1,670
Carpal tunnel release £1,993
Tonsillectomy £2,772
Knee arthroscopy £3,673
Abdominal hysterectomy £7,089
Shoulder replacement £11,020

According to MyTribe Insurance in October 2021

How to get a health insurance quote and how to claim

Getting a health insurance quote online couldn’t be simpler – fill in some details, compare your policy options and pick which one is right for you.

Claiming can be pretty straightforward too. It starts with a GP appointment to get a diagnosis and referral. Then your insurer can check it covers that condition and help you book a consultation where you’ll come up with your treatment plan.

Your insurer will be in touch if there’s any excess to pay.

Watch our video guide now >

According to the Office for National Statistics, the amount spent on healthcare was equal to £3,227 per person in 2018.

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Benefits of private health insurance

Private health insurance has its advantages:

  • You can access treatment and diagnostic scans quickly
  • Extra support with your recovery – things like extended physiotherapy, which you might not be offered through the NHS
  • Access to a wider range of treatments and drugs
  • The freedom to choose – your hospital, consultant and facilities
  • Simple referrals to specialists if you need a second opinion

Potential disadvantages of private health

But it isn’t a cure-all:

  • It can be expensive and the cost increases as you get older
  • Chronic or incurable conditions are rarely covered, and neither are injuries from some high-risk activities
  • Pre-existing medical conditions are rarely covered. If you want cover for one, it’ll cost a lot more
  • There’s no guarantee you’ll get access to a particular treatment or drug, or that unconventional treatments will be covered by your policy

How can I cut the cost of health insurance

There are a few steps you can take to bring costs down:

  1. Give up smoking

    Non-smokers usually get a cheaper deal. There are NHS support services that can help you quit

  2. See what your job package offers

    Your company may offer free healthcare – check before you buy a policy

  3. Increase the excess

    But only if you’d be able to afford to pay that amount upfront

  4. Pay annually

    A lump sum generally works out cheaper than monthly premiums

  5. Live a healthy lifestyle

    Certain insurers will give you a cheaper deal if you stay fit

  6. Exclude anything you don’t need

    Are there any treatments you feel you could cut from your policy?

  7. Shop around

    Compare your options to make sure you’re getting a great deal

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