How is Comprehensive Health Insurance Different from Basic Health Insurance?

What Is Private Health Insurance, and How Does It Work?

Private health insurance keeps individuals and their family members covered against financial burdens from unexpected medical cases. It provides easy access to private healthcare services if you have any illness or injury that needs immediate treatment. Additionally, you get the benefit of choosing your own hospital or consultants, no more waiting periods for the NHS, and many more. 

Insurers like Bupa, Axa, Aviva, and The Exeter provide various private health insurance plans for different needs. So, always choose an insurance which provides the coverage required for your health. Basically, there are two options available: Basic and Comprehensive health insurance policies. While the basic plan provides standard coverage, a comprehensive plan is all-inclusive. But, if you want to add extra options to your basic plan, you can even tailor-make your policy. The insurance policy covers you when you start paying premiums, and you can make a claim when needed by contacting the insurer.

What Does a Basic Private Health Insurance Plan Cover?

A basic health insurance plan is designed to provide coverage for standard treatments in the UK. Suppose you do not want to have a comprehensive health insurance plan by adding optional extras like dental care, optical treatment and more. Then, you can still access the healthcare and membership benefits, including discounts, with a basic plan.

Let’s have a look at some of the treatments and services covered under a basic health insurance plan.

Inpatient and Day-Patient Treatment

Inpatient care refers to any treatments or services that need you to stay overnight in the hospital. For example, you may need inpatient care for a major surgery or a serious illness which needs monitoring and rehabilitative treatment.

All types of private health insurance plans cover inpatient treatment, including surgery. This means you can skip NHS waiting lists if a hospital stay is required. A private room is also provided to you, which includes benefits like chef-prepared meals and an en-suite bathroom.

Basic plans also provide coverage for day-care unit treatments. Day-patient care includes low-risk procedures that require you to stay in the hospital for some time but also allow you to return home on the same day. So, buy private medical insurance in the UK that suits your needs.

Mental Health Support

All health insurance plans provide coverage for some form of mental health support. Coverage for mental health varies on health insurance plans offered by different private medical insurance providers. But, most plans typically include Counselling and Cognitive Behavioural Therapy(CBT). Some insurance companies let you refer yourself for limited sessions without seeing the GP. Additionally, you can also contact mental health helplines to get advice about your own or your children’s mental health.

The number of mental health conditions varies as per insurers. Always check what is included when you look for mental health insurance plans.

Cancer Care

Cancer treatment is an important part of every health insurance plan in the UK. A basic health insurance plan covers the costs of chemotherapy, surgery, and radiotherapy. In addition, some private medical insurance providers in the UK also cover expenses for therapies and services like prosthetics, wigs, nutritionist appointments, and reconstructive surgeries.

Virtual GP Services

Basic health insurance policies include virtual or digital GP services. This means you can easily book a GP consultation online anytime. This inclusion benefits individuals who are unable to book an appointment with an NHS GP at their preferred time. Please note that you can book video appointments only with some virtual services. With other virtual GP services, you have to input your symptoms into an app, and then a doctor will call you.

If you have a complex medical need, virtual or telephone appointments are not suitable. They are better for a consultant referral or a private prescription for acute problems.

Consultant and Hospital Choice

Like the NHS, private health insurance lets you choose where to be treated and by whom. Each insurance provider has various hospital lists. They add their standard list on all the insurance policies as well. You can choose a hospital and a consultant after considering the facilities and distance from home. Additionally, you can select an expert consultant based on the treatment you need.

Please note that if you opt for a guided consultant choice, the options for consultants will be limited. Here, your private health insurance provider will provide you with a shortlist of consultants.

Perks and Discounts

You can get discounts and perks, such as discounted gym memberships, movie tickets, free coffee, and more when taking out a health insurance plan. While some insurance policies have discounts for all members, others let you earn better awards. 

For example, Bupa’s reward program includes discounts on multi-gym memberships and Fitbit products.

What are Comprehensive Health Insurance Plans, and What Do they cover?

A comprehensive health insurance plan is an all-inclusive one that provides financial protection during health or medical emergencies. What sets it apart from a basic health insurance plan is that it allows you to cover more treatments and illnesses. In addition, you can get your treatment quicker and in a better atmosphere than in an NHS hospital.

With a comprehensive plan, you can cover various expenses, including consultations, inpatient treatment, medical testing, outpatient treatment, and more. This type of insurance plan can also aid with aftercare treatments like mental care, physiotherapy, and alternative therapies.

Let’s have a look at the features of a comprehensive health insurance plan.

Outpatient Treatment

All comprehensive health insurance plans offered by insurers cover outpatient treatment costs. By outpatient, we mean any treatment that does not require a stay in the hospital. It includes consultant appointments, diagnostic tests and scans, and physiotherapy treatment. It is a good idea to consider outpatient coverage on your health insurance plan as it means you don’t have to wait longer for diagnosis and can begin treatment faster. If you need physiotherapy, a comprehensive plan will probably include coverage for it. You might even have the option to refer yourself for a set number of sessions.

Comprehensive Coverage for Mental Health

All types of health insurance policies cover mental health support. This can include counselling, access to online resources and telephone helplines.

But, if you want extensive coverage for serious mental health conditions, a comprehensive insurance plan is the best option.

Alternative Treatment Options and Therapies

Private health insurance provides access to advanced treatments and new medications that may not be available in NHS hospitals. A comprehensive health insurance plan can also offer different treatment options and therapies like homoeopathy, acupuncture and osteopathy, which basic plans don’t include.

Coverage for Extra Treatment Sessions

A basic insurance plan has financial limits or a limited number of treatment sessions. Opting for a comprehensive health insurance plan helps cover higher treatment costs or more sessions. If you want to increase the financial limit on specific treatments, you can pay more to do so.

A comprehensive private health insurance plan also covers various types of treatments. For example, buying the most comprehensive plans can also get you coverage for stem cell therapy or genetic testing.

Extended Choice of Hospitals

We discussed that a basic plan would only include a standard hospital list given by an insurer. But you can also get an extended list by paying an extra cost. Extended hospital lists show that private healthcare costs are higher in some locations because of facility costs or higher wages. So, you will have to pay more for treatment in big cities. For example, if you want to include HCA hospitals in your plan, this may increase your monthly premium to 25%.

Dental and Optical Cover

The NHS provides free eye tests and dental treatments in some cases. But, many people now pay for routine optical and dental care. Comprehensive health insurance can save money on optical and dental treatments as it already covers the cost of your private treatment.

As per the policy chosen, the insurance can cover costs for routine check-ups, glasses, treatments, and contact lenses. Typically, insurance covers glasses and contact lenses only when you need them for the first time or if your prescription changes.

What Is Not Included in a Comprehensive Health Insurance Plan?

Each insurer has its own comprehensive policies and coverage regulations. While one insurer may cover non-standard therapies, another insurer won’t. So, even the most comprehensive policy can have exclusions. You can only use health insurance for acute conditions that may arise after buying the policy. Acute conditions include any illness or injury which can be cured with treatment.

A health insurance plan will not cover chronic conditions like asthma or diabetes. This is because these conditions can only be monitored and controlled but not cured.

For better clarity, here’s a list of standard inclusions for all medical insurance plans:

• Pre-existing conditions
• Long-lasting and incurable conditions
• Birth and fertility
• Organ transplants
• Drug abuse
• Cosmetic and non-essential procedures

Note that if you saw a doctor for treatment or advice for any illness in five years before taking a policy, this condition will not be covered in the policy for the first two years. If the illness does not reoccur, it can be added to the policy.

What is the Cost of Comprehensive Health Insurance?

The cost of an insurance policy differs by the providers. But, there are a few elements which impact the cost of comprehensive health insurance in the UK:

• Age: The younger you are, the lower the price will be. So, the price of insurance increases with age.
• Medical history: Medical history, along with overall health, can influence the premium costs
• The way of life you live: If you smoke, exercise, or drink alcohol, it can affect the cost.
• Location: Your location also plays a role in health insurance. In places like London, health insurance is more expensive.
• Coverage: No matter which insurance you choose, an increase in coverage will lead to an increase in cost.

As the prices of an insurance policy are based on various factors, it is important to do a private health insurance comparison in the UK before buying one. Also, if you already have a health insurance plan, check the market every year to ensure you have the best plan.

Reach Out to Us!

In the UK, individuals choose health insurance plans based on their needs. At Premier PMI, we help you understand different types of health insurance plans and how to get the right coverage for your health. With us, you can get a comparison quote, and we’ll connect you with a specialist soon. Get in touch with us to get a policy tailored to your needs.

Disclaimer: The information provided in the blog is general. The best type of coverage and policy will depend on your circumstances. Please do your own research or connect with an advisor before making any decision.

Stuart Hendy, Senior PMI Advisor &Editor

Stuart Hendy is a highly experienced health insurance broker with extensive knowledge of private medical insurance and private treatment. His expertise is frequently sought by industry professionals and his insights have been featured in leading financial publications. Stuart is committed to providing his clients with the best possible healthcare solutions and empowering them to make informed decisions.

• LinkedIn

FAQ