A Guide to Health Insurance for Retirees in the UK

As you transition into this new phase of life, prioritising your health with private insurance can allow you to fully enjoy retirement, free from the worry of delayed treatments or unexpected medical costs.

NHS Backlog Hits Critical Levels with Growing Treatment Delays

The question of how long NHS waiting times are has been a major concern for many of us lately. According to the British Medical Association (BMA), the NHS backlog has reached critical levels, with waiting lists and delays in care worsening significantly due to COVID-19. 

As of July 2024, there were 7.62 million cases on the waiting list for consultant-led treatment, compared to 4.57 million before the pandemic in February 2020. Out of these, 3.14 million patients have been waiting over 18 weeks, and almost 290,300 patients have been waiting over a year for care.

The BMA also highlights the severe impact on cancer treatment. Only 67.7% of patients started cancer treatment within 62 days of an urgent referral, far below the 85% target, putting patients at serious risk.

The backlog is likely to take years to clear, exacerbated by workforce shortages and ongoing demand. As a result, more people are considering private health insurance to ensure faster access to care, as NHS waiting times remain a significant challenge for many patients.

How does Health insurance work for retirees?

Health insurance can be a great option for you as a retiree in the UK, helping to cover the cost of private medical treatment. As you get older, you might need more healthcare, and private insurance lets you access doctors, tests and surgeries faster than through the NHS. You’ll pay a monthly fee, called a premium, and in return, your insurance will cover most of the costs if you need treatment.

For example, if you need hip surgery, your health insurance allows you to book it at a private hospital without having to wait months on the NHS. Your insurance company will pay the hospital directly. You can also choose to add extra benefits, like physiotherapy or dental care, depending on your needs.

The cost of your health insurance premium depends on factors like your age, health history, postcode and the level of cover you want. If you already have a condition, like diabetes, the insurance won’t cover treatments for it. However, if you haven’t been diagnosed with anything yet, your insurance can help with future issues like cancer or joint problems.

You can choose a smaller plan that covers just major hospital stays or opt for full cover, including specialist appointments and tests.

Health insurance Plan options

When choosing health insurance as a retiree, you’ll come across different types of plans. Two of the most common options are Comprehensive plans and Treatment-Only plans. Understanding the difference will help you choose what suits your needs best.

Comprehensive Plans

A comprehensive health insurance plan covers a wide range of medical treatments. This includes inpatient care (where you stay in the hospital), outpatient services like diagnostic tests and scans, specialist consultations, and therapies such as physiotherapy. Comprehensive plans provide peace of mind, as they cover most healthcare situations.

For example, if you need both surgery and follow-up scans or physiotherapy, a comprehensive plan will cover these without extra out-of-pocket costs. This type of plan is ideal if you want full coverage and quicker access to treatments without relying on the NHS for any aspect of your care.

Treatment-Only Plans

A treatment-only plan, sometimes called a “Core” or “Hospital-Only” plan, is more basic. It covers inpatient care, like hospital stays and surgeries, but does not include outpatient care like diagnostic tests, specialist consultations, or scans.

For example, if you require surgery, the plan will pay for the procedure and hospital stay, but if you need a scan or diagnostic tests beforehand, you will have to pay for those separately. Treatment-only plans are usually cheaper than comprehensive plans, making them a good choice if you only want coverage for major medical events and don’t mind paying for outpatient care yourself.

However, you can often add some outpatient treatment to your core plan if you want coverage for certain diagnostics or specialist consultations without fully upgrading to a comprehensive plan.

Coming out of a company health insurance scheme.

If your former employer provided you with a private health insurance policy, it’s worth checking if you can continue the medical insurance plan after retirement. In many cases, you may be able to take over the policy, keep the same benefits and simply start paying the premiums yourself. This can be a cost-effective option, as group policies often come with lower premiums than those you’d find if you were to get a new individual plan on your own. 

Continuing with your employer’s plan can help you avoid the hassle of switching insurance providers and undergoing new medical assessments, which might lead to exclusions or higher premiums due to age or pre-existing conditions. 

Our advisers can help you smoothly transition from your company scheme to an individual plan, ensuring your health coverage is uninterrupted. We will take care of all the details, making sure that your health is not affected during the process. This way, you can maintain the same level of care without any gaps in coverage or unnecessary complications.

What does a health policy cover?

A health insurance plan for retirees works just like any other health insurance plan. It provides coverage for unexpected medical treatment and quick access to private medical care. Health insurance covers any acute conditions that occur after the policy start date, as long as you had no symptoms, sought treatments or received medications in the past five years. The typical health insurance plan includes the following features with most insurance providers in the UK:

Core Cover

• Inpatient and Day Patient care
• Comprehensive Cancer Cover
• Surgeries for essential procedures
• Inpatient full diagnostics
• Private hospital stay
• Private room during your stay
• Private ambulance service
• A la carte menu for meals
• Special treatment access
• Fast access to treatments
• Virtual/Online GP 24/7

Optional Extras for Additional Premium

• Dental and optical cover
• Physiotherapy services
• Mental Health Cover
• Worldwide Travel Cover
• No Claims Discount Protection
• Private Face-to-Face GP consultations
• Upgrade to London Hospitals
• Add some outpatient limit (£250, £500, £1,000, £1,500 and unlimited)

What is not covered by health insurance?

Health insurance is essential for covering unexpected medical expenses, but it’s important to know what it does not cover. While it helps with acute conditions that can be treated and resolved, chronic conditions that require ongoing management are usually excluded from coverage. For example, if you have a condition like diabetes or asthma, any related treatments might not be included in your policy. Most health insurance plans also have specific exclusions that can lead to unexpected costs. Understanding these exclusions will help you make better decisions about your healthcare needs.

Common exclusions include:

• treatments for addiction
• cosmetic surgery
• chronic conditions like asthma or diabetes
• experimental treatments
• non-essential procedures

Always read your policy carefully to know what is covered and what isn’t. It’s also wise to consider your family history and any potential health risks when choosing your plan. Being informed will help you select the right coverage for your needs.

Which health insurance is best for retirees?

When it comes to health insurance for retirees, most providers offer similar plans, but each has its unique features that can influence your choice. Here’s an overview of some of the best health insurance providers available for retirees, including AXA, Aviva, The Exeter, Bupa, Freedom Health, and Vitality Health.

AXA Health

AXA Health offers a few health insurance plans with no upper age limits. This means you can get coverage at any stage of your retirement. They provide access to over 250 private hospitals across the UK, making it easier to find care close to home. AXA’s standard coverage includes inpatient and day-patient care, ensuring you have support during hospital stays.

Additionally, their outpatient cover is optional and is a great add-on for those who want extra peace of mind. AXA Health stands out with its unlimited physiotherapy and chiropractic sessions, which can be particularly beneficial if you wish to maintain an active lifestyle during retirement.

Aviva

Aviva Health provides comprehensive health insurance that includes cancer treatments and drugs that are usually not available through the NHS. They have a unique feature called the 6-Week Option. If the NHS offers treatment after six weeks, you can choose to receive that treatment privately. This option allows you to save on premiums while still having access to quality care.

Aviva also covers a wide range of medical treatments and services, including inpatient and outpatient care, making it a strong choice for retirees.

The Exeter

The Exeter is a friendly society that offers a community-rated scheme specifically designed for people aged 70 to 80. This means that your claims do not directly affect your renewal premiums. Instead, the claims of all members of the community influence the annual increases, which helps spread the risk and can be particularly beneficial for older individuals.

Their core plan includes outpatient surgery, cancer treatment, and mental health care, ensuring you have access to essential services. The Exeter also features the HealthWise App, allowing you to request a second opinion if you’re unhappy with a diagnosis. They are highly rated for customer satisfaction, making it easier for you to get the help you need without lengthy phone calls.

Bupa

Bupa is one of the UK’s largest health insurance providers. They offer a comprehensive health insurance plan that covers a wide range of treatments and therapies across an extensive network of private hospitals and treatment centres. Bupa has no upper age limits, making it accessible for retirees.

In addition to the standard plan, Bupa provides discounts and rewards exclusive to their members. They also offer a Treatment and Care Only plan for lower premiums, ensuring you can access necessary services without breaking the bank. Their website also offers helpful links to information on specific conditions, mental health support, and healthy eating, helping you maintain your overall well-being.

Freedom Health

Freedom Health is a family-run health insurance company known for its excellent service and value. It has won multiple awards, been recognised as a leading health insurance provider for the past four years. They offer an Essential Plan that provides basic cover at a lower price, making it a great option for budget-conscious retirees.

One of the key benefits of Freedom Health is that your premiums are not affected by your postcode. This means you can access affordable health insurance plans regardless of where you live in the UK.

Vitality Health

Vitality Health takes a unique approach to health insurance by encouraging clients to lead healthier lifestyles. They offer discounts on gym memberships, healthy food from retailers like Waitrose, Amazon Prime discounts and even cinema tickets.

Vitality also promotes daily activity by rewarding clients with an Apple Watch when they meet their walking goals. Their Switch and Save scheme allows you to save up to 10% on your renewal price when switching from another provider for a like-for-like policy. This focus on wellness not only benefits your health but can also lower your insurance costs over time.

Choosing the right health insurance provider as a retiree is crucial for ensuring you receive the best possible care. Each of these insurers—AXA, Aviva, The Exeter, Bupa, Freedom Health and Vitality Health—offers unique features and benefits. By carefully considering your options, you can find a health insurance plan that provides peace of mind and access to quality healthcare throughout your retirement.

What affects the cost of health insurance for retirees?

When it comes to health insurance for retirees over 65, the costs can be higher compared to those under 60. As you age, the chances of needing medical care increase, leading to higher premiums. Let’s explore what drives these insurance costs.

Age

One of the main factors that affects your health insurance cost is your age. As you get older, your premiums typically rise because older adults usually require more medical care. If you’re nearing retirement, be prepared for higher insurance costs simply due to your age.

Medical History

Your past health conditions also impact your premiums. If you have had serious issues, like heart problems or ongoing treatments, insurers may charge you more. They view you as a higher risk for future claims, so it’s important to understand how your medical history can affect what you pay.

Underwriting Choices

Underwriting is how insurance companies determine how healthy you are. There are three types of underwriting: Moratorium, Full Medical Underwriting, and Continued Personal Medical Exclusions. A broker will assess your health situation and recommend the best underwriting option for you, which can influence your premium rates.

Policy Excess

Policy excess refers to the amount of money you agree to pay out of your own pocket when you make a claim. If you select a higher excess, your monthly premiums will be lower. This is because you’re taking on more risk yourself, making it easier for the insurer. You can choose an excess from various options, like £0, £100, £200, and even up to £5,000.

Hospital List

Where you live can also affect your health insurance costs. Some regions have more private hospitals, which can change pricing. For example, if you want to be treated at top hospitals in London or see a specialist in areas like Harley Street, your premium will be higher. On the other hand, if you’re okay with your insurer choosing a consultant from three nearby hospitals, your premium may be lower.

Smoking Status

If you smoke tobacco, including vaping, expect your premiums to be higher. Insurers see smoking as a significant health risk since it can lead to serious health issues like lung and mouth cancer. Therefore, being a smoker usually results in higher insurance costs.

Optional Add-Ons

Many health insurance plans offer extra services, like therapy or mental health coverage. While these options can be useful, they can also increase your premiums. If you don’t use these services often, consider removing them to help lower your monthly costs.

How to Reduce Health Insurance Premiums

If you believe your premiums are too high or if you’re being offered expensive policies, there are ways to lower your costs. Working with a broker can help you find more affordable options or suggest the best policies for your situation.

One effective method to lower your premium is to increase your policy excess. By agreeing to pay more out of pocket when making a claim, you can reduce your monthly premiums. Just make sure you’re comfortable with the amount you may need to pay when you need care.

Another approach is to shop around every year. Compare your current insurer’s renewal quote with offers from other companies. You might discover a better deal that suits your needs more effectively.

If you plan to stay with your current insurance company, don’t hesitate to negotiate your premiums. Reach out to them and ask if they can provide you with a better rate. They may be willing to adjust your plan to keep you as a customer.

It’s also smart to review the optional extras in your policy. If you find that you don’t frequently use certain services, removing them can help reduce your premium costs.

Choosing a consult-select option for your hospital list can also save you money. Plans with limited hospital choices often have lower costs because insurers can negotiate better rates with specific providers.

Finally, consider downgrading to NHS cancer treatment options or opting for a 6-week wait option. Think about limiting your outpatient coverage, as this can add significantly to your costs. If you’re comfortable paying for outpatient services as needed, reducing this cover can lead to savings on your premiums.

By understanding these factors and applying some of these strategies you can reduce your health insurance premium.

How Brokers Can Lower Your Health Insurance Costs

If you’re asking how a broker can help you save on health insurance, you’re in the right place. Brokers have the expertise and access to a range of options that can lead to real savings on your premiums.

Brokers understand the UK health insurance market and keep up with the latest policies to find you the best value. They assess your specific healthcare needs and budget, ensuring you get the right coverage without overspending.

With connections to multiple insurers, brokers can compare plans and negotiate better rates that you might not secure on your own. They can spot hidden discounts and benefits that aren’t always clear, helping you maximise your investment.

By doing the legwork, brokers save you time and hassle, allowing you to focus on your health. Plus, they provide ongoing support, regularly reviewing your policy to make sure you always have the best health insurance policy!