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Private healthcare

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Should I consider private healthcare?

Private healthcare is paid-for medical treatment. It's an alternative to being treated for free by the NHS.

It can be costly, but you can take out private medical insurance (PMI) to pay for it – also known as health insurance.

Health insurance helps you to avoid the waiting lists and it also gives you access to consultants and procedures that may not be available on the NHS.

If you have health insurance and you need private medical treatment, some or most of your costs can be covered – making expensive treatments more affordable.

You’ll pay a monthly premium for medical insurance which can cover the cost of private treatment, but you’ll usually still have to pay an excess for each claim.

Choosing a higher excess can bring the cost of your premiums down, but you have to be sure you’ll be able to pay it should you need to make a claim.

You can take out an individual healthcare policy, joint cover for you and a partner, or you may decide to insure your whole family.

Benefits of private healthcare

Choosing private healthcare  has lots of benefits – although they come at a cost:

  • Avoiding long waiting lists for medical procedures
  • Receiving a faster diagnosis from specialist doctors
  • Being able to choose the hospital, consultant and a convenient appointment time
  • Having your own room with ensuite bathroom facilities and a menu of food to choose from when you need to stay in hospital
  • Access to treatments and procedures that may not be available on the NHS

Disadvantages of private healthcare

There are some disadvantages to opting for private treatment:

  • It’s very expensive
  • It’s hard to know the cost for sure when you start treatment – you could end up staying in hospital for longer than you thought, for example, leading to extra bills
  • The private hospital you use may not have emergency care facilities, which may mean you end up being transferred back with the NHS until your condition is stable
  • It’s not necessarily better. Some conditions could be treated in NHS facilities anyway, so you won’t get much extra for your money

How do I get private healthcare?

You usually need to visit your GP first and be referred to private healthcare.

If you’re interested in going private, just ask your GP if it’s an option and they should be able to give you more details.

Ask your GP for a referral to a private specialist. There are two main types of referral – you can ask your GP to refer you to a specific consultant or specialist, or provide you with an open referral letter.

An open referral letter is addressed to any consultant that specialises in this condition – your insurance provider can then provide you with a choice of consultants with the clinical skills and expertise you need.

Make sure you’re clear on the costs involved and when payment will be due, especially if you don’t have private medical insurance.

How to claim for private healthcare on your insurance

If you have PMI, you can claim for the cost on your policy instead:

  1. Read your health insurance policy document – check what conditions and treatments are included in your cover and what their specific claims process is.

  2. Speak with your GP about your condition and let him or her know that you have private health insurance.

  3. Ask your GP for a referral letter.

  4. Once you’ve seen your specialist, let your insurance provider know what the next steps in your treatment will be. And make sure you understand how any fees should be paid. Sometimes you’ll need to pay first and claim the costs back, but some insurers will pay the private specialist directly.

How much does private healthcare cost?

It varies a lot depending on the treatment you’re having and where you’re having it.

For example, two of the biggest providers, Nuffield Health and Benenden listed these prices in August 2021:

 
Treatment Nuffield Health, Brentwood Benenden
Cataract surgery (one eye) £2,820 £2,250
Gallbladder surgery £6,415 £5,335
Back pain treatment £2,535 £1,225-£2,300

 

Don’t forget to factor in that there might be extra costs added for initial consultations and follow-up appointments.

Health insurance can help with the costs.

Which? found that people in the UK aged under 65 reported paying £1,200 a year on average in 2020, while those 65 and over were paying an average of £2,000 a year. 

If you need one or more treatment, your health insurance could end up being good value.

It’s worth getting some quotes – your own cover could cost a lot less than the average.

The price you pay for private health cover can be affected by:

  • Your age – the older you are the more your premiums are likely to be
  • Where you live – private healthcare tends to cost more if you live in London or in other major cities
  • Your lifestyle – factors like smoking, drinking and being overweight can all affect how much you’ll pay 
  • The benefits you choose – if you’re given options to help personalise your policy, only choosing the benefits you need can reduce your costs
  • Any pre-existing medical conditions – these are unlikely to be covered, but they may suggest you’re at risk of further problems which might increase your premiums

Frequently asked questions

Treatments available privately include:

  • Inpatient and outpatient treatments
  • Physiotherapy
  • Treatment for cancer
  • Dentistry
  • Psychiatry
  • Eye care
  • Maternity care
  • Cosmetic surgery
  • Alternative therapies, such as acupuncture

Not all of these will be covered by private medical insurance, so check with your provider before agreeing to treatment.

Fees can vary between hospitals, so it’s a good idea to understand exactly what you’ll be paying for before you book your treatment.

If you stay in a private hospital you can expect to be charged for things like:

  • Your accommodation
  • Staff fees - these will differ depending on the members of hospital staff involved in your care
  • Your consultant’s fee
  • The fee for your surgeon and anaesthetist
  • Bandages and dressings
  • Meals
  • X-rays and blood tests
  • Medication you’re given during your hospital stay

If you have a health insurance policy that requires you to pay for healthcare costs and then claim them back from your insurer, you need to make sure you’ll have the funds in place to enable you to do this.

Yes, sometimes you can receive private treatment in an NHS hospital. 

There’s no standard charge for having private treatment in an NHS facility, instead the charges will be set by the local authority. 

You’ll still have a private room, but it will be in an NHS hospital so it may not be the same type of room that you’d expect in a private hospital. 

This depends on the cover you have - you’ll still need to pay your excess and your health insurance will then cover some or all of the rest of the cost.

Sometimes there are benefit limits on private healthcare plans. This means you’re only covered up to a certain amount of money - for example, you may have an outpatient limit. 

If the cost of your treatment is more than your limit, you’ll need to pay for the difference as well as the excess agreed on your premium.

Agreeing a higher excess when you take out your private healthcare can be a good way to reduce your premiums. You’ll usually only have to pay your excess once in a year, not if you have further treatment during the year.

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