Is Private Health Insurance Worth It?

Do I Need Health Insurance?

The NHS offers free healthcare to UK residents and provides good facilities. However, after the Covid-19 pandemic, waiting times have significantly increased. Private health insurance can complement the NHS by allowing quicker access to consultants and faster treatment for acute conditions that begin after your policy starts. According to NHS statistics, over 5 million are on waiting lists, making private insurance increasingly valuable. For example, the average cost of comprehensive private medical insurance for a 40-year-old is £60.55 per month. So, is private health insurance worth it UK? The short answer is YES.

What is covered by private health insurance?

Remember, health insurance doesn’t cover chronic conditions that don’t have a cure, like diabetes, hypertension, or asthma. The level of coverage you receive depends on the plan you choose. Some plans might only offer basic care, while others provide more, including referrals to specialists for more detailed treatment.

Basic Plan

A basic plan covers inpatient treatment, including hospital stays and surgeries that require overnight care. However, it does not include outpatient care so you won’t be covered for diagnostic tests or consultations outside the hospital.

Mid-Range Plan

A mid-range plan includes both inpatient and limited outpatient care. Outpatient cover usually has a set limit, such as £500, £750, or £1,000 per year, covering diagnostic tests and consultations up to those amounts. You can add full diagnostics with health insurance providers like Vitality Health and The Exeter. 

Comprehensive Plan

Comprehensive policies will cover all the benefits of basic and mid-range plans, plus:

• Includes outpatient treatments, cover outside the hospital
• Covers diagnostic tests, scans, and consultations to help you get diagnosed faster.
• Provides comprehensive cancer cover for cancer treatments.

All private health insurance plans include comprehensive cancer cover and access to a virtual GP service.

Additional Benefits

You can further enhance your policy by adding extra benefits for an additional cost.

Excess Options

Excess options vary from £0, 200, £250, £500, £1,000, £3,000, £5,000. This is the amount you’ll need to pay out of pocket before your insurance covers the remaining costs.

What isn’t covered by private health insurance?

While private medical insurance covers many things, like physiotherapy, diagnostic tests, and hospitalisation, some exclusions are unlikely to be covered, including:

• Chronic conditions
• Pre-existing conditions
• Cosmetic surgeries
• Prescriptions
• Pregnancy and childbirth
• Professional sports injuries

Chronic Conditions

• Asthma
• Arthritis 
• Chronic obstructive pulmonary diseases
• Diabetes
• Heart, liver and kidney disease
• Crohn’s disease
• Some types of Cancer
• Other diseases which cannot be cured.

Advantages and disadvantages of private health insurance

Before you decide to get private health insurance, it’s important to understand the benefits of private medical insurance. This will help you figure out if it’s the right choice for you.

Benefits of Private Health Insurance

Health insurance offers many advantages that often outweigh the disadvantages. Here’s a summary of the advantages of private health care:

Quick Access

You can access medical treatments much faster than the NHS. For instance, if you need cataract surgery or knee replacement, you could have it done within a few weeks rather than waiting several months. This is especially beneficial for non-emergency procedures.

Private Consultant

It often provides you with a private consultant. This means you have one specialist who manages your care throughout your treatment. Unlike the NHS, where you might see different doctors, a dedicated consultant ensures more personalised care. For example, if you have a complex issue, having one expert who knows your case inside out can make a big difference.

Flexible Appointments

One of the big benefits is the flexibility in scheduling appointments. You can choose appointment times that fit your schedule, which can be particularly helpful if you have a busy lifestyle or family commitments. If you need to see a specialist, you can often pick a time that works best for you rather than waiting for a slot in a crowded NHS clinic.

High-Quality Facilities

Private hospitals typically offer newer and more comfortable facilities compared to public ones. You might enjoy a private room with a personal bathroom, a la carte menu and more pleasant surroundings. This can significantly enhance your overall experience and comfort during your stay.

Access to New Treatments

It may give you access to the latest cancer treatments and medications that might not be available through public healthcare. For example, you might be able to receive cutting-edge therapies that are still in the early stages of public rollout.

Additional Benefits

Many health insurance providers, like Vitality, offer lifestyle benefits to promote healthy living. For example, Vitality provides an Apple Watch to track your activities. Members also enjoy discounts on healthy groceries from Waitrose, Amazon Prime memberships, cinema tickets, and free coffee from Caffè Nero. These perks are designed to encourage wellness and make a healthier lifestyle more enjoyable and accessible.

Disadvantages of Private Health Insurance

Plan Limits

Private insurance often covers only sudden, treatable conditions. Long-term or chronic conditions like diabetes may not be covered. For these issues, you would still rely on the NHS for ongoing care.

Pre-existing Conditions

Insurance typically does not cover pre-existing conditions, meaning if you had a condition before taking out the policy, it might not be covered. Some plans may provide coverage after a certain period without symptoms, but this varies.

Accedent and Emergency

In the event of an accident or medical emergency, you will need to rely on the NHS for immediate treatment. You should call 999 right away to get emergency assistance. Once you are stabilised and no longer in an emergency, your private health insurance may cover a transfer to a private hospital if needed.

Pregnancy, infertility or childbirth

Health insurance often excludes coverage for pregnancy, infertility treatments, and childbirth. This means that routine prenatal care, labour and delivery, and fertility treatments are generally not covered under private health insurance plans.

Cost

You will pay monthly premiums for private health insurance, which can increase as you age. This ongoing cost can add up and is a consideration compared to the generally free care provided by the NHS.

How Much Does Private Health Insurance Cost on Average?

Private health insurance in the UK generally costs around £1,350 per year, which is about £125 per month. However, premiums can vary significantly based on your insurer, the level of cover, the hospital list and excess.

What can affect your insurance premium?

Several factors impact the cost of private health insurance. These include:

• Number of people covered
• Age
• Medical history
• Lifestyle
• Location

How much is private healthcare uk?

Here are some typical costs for private healthcare procedures without health insurance:

• Pacemaker Fitting -£5,500
• Hernia Repair – £2,250
• Hip Replacement costs approximately £13,180
• Knee Replacement £13,326
• Chemotherapy- £35,000
• Gallbladder Removal £6,324
• Slipped Disc Removal £8,356
• Cataract Surgery (one eye) costs about £2,098
• Wisdom Tooth Removal is approximately £1,560

*These prices reflect the average cost in London and are accurate for 2024.

Private health insurance premiums comparison

The following table compares the average annual cost for mid-range health insurance policies with £750 outpatient cover, £100 excess, a selected hospital list, and a London postcode for a 40-year-old healthy non-smoker:

Is private health insurance worth the money?

With the increasing pressure on the NHS, private health insurance is becoming more valuable. Although it can’t replace the NHS, it offers significant benefits. Having private health insurance allows you to access faster medical care, avoid long waiting times, and choose your preferred consultants and hospitals.

For example, if you need urgent treatment or see a specialist, private insurance can often provide quicker access than the NHS. It also offers more comfort with private rooms and potentially access to cutting-edge treatments not yet available on the NHS.

Are There Alternatives to Traditional Health Insurance?

Yes, there are other options besides traditional health insurance, each with its own pros and cons.

Cash Plan

These are cheaper than private health insurance and cover everyday health costs. They can help with dental and optical care and some therapies. However, they don’t cover serious medical conditions or major treatments.

Self-Insurance

This means saving money in a separate account for medical expenses. You pay for treatments directly from your savings. It’s flexible but requires careful planning and might not be suitable for everyone.

Self Pay

You can pay for private medical care on your own. This method can be expensive but allows you to choose your treatments and providers. It’s often used for consultations or second opinions rather than long-term care.

Best Health Insurance Providers in the UK

Bupa

Bupa is a leading health insurance provider in the UK, known for its extensive network and quality care. Their plans offer options for both outpatient and inpatient care. Outpatient care includes specialist consultations, diagnostic tests, and therapies. Inpatient care covers hospital stays, surgeries, and specialist treatments. Premiums start at around £1,200 annually. Additional benefits include access to a network of private hospitals, a 24/7 nurse helpline, and health assessments.

AXA Health

AXA Health provides comprehensive and flexible health insurance plans tailored to various needs. Outpatient care includes consultations with specialists, diagnostic tests and some therapies. Inpatient care covers hospital stays, surgery and advanced treatments. Premiums typically begin around £1,400 per year. Additional benefits feature access to a wide network of hospitals, mental health support and optional extras such as gym memberships.

Aviva

Aviva offers versatile health insurance plans with a focus on high-quality care and support. Their outpatient care covers specialist consultations, diagnostic tests and certain treatments. Inpatient care includes hospital stays, surgical procedures and treatment by specialists. Premiums generally start at about £1,300 annually. Additional benefits include access to private hospitals, virtual GP services and wellness programs.

Vitality

Vitality is known for its emphasis on promoting healthy living and providing wellness benefits. Outpatient care includes specialist consultations and diagnostic tests. Inpatient care covers hospital stays and surgical procedures. Premiums start at around £1,500 per year. Additional benefits include an Apple Watch for tracking health, discounts on healthy groceries, cinema tickets and gym memberships.

Simplyhealth

Simplyhealth offers affordable cash plan options with clear and straightforward cover. Outpatient care includes specialist consultations, diagnostic tests and some therapies. Inpatient care covers hospital stays and surgeries. Premiums typically begin at around £1,100 annually. Additional benefits feature access to private hospitals, a 24/7 health advice line and discounts on dental and optical care.

How can I buy private medical health insurance?

There are a few ways to purchase health insurance, each with its own advantages. Here’s a breakdown of the main options:

• Employer-Provided Health Insurance – Offered as a benefit, potentially subsidised or discounted.
• Directly from Insurance Providers – Visit provider websites (e.g., Bupa, AXA PPP Healthcare) or contact them by phone.
• Insurance Brokers: Brokers offer expert advice and access to multiple products, though they may charge a fee or earn commissions.
• PremierPMI: Contact us directly, and one of our insurance experts will assist you in finding the best health insurance plan for your needs.