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Private health insurance: a beginner’s guide

Joanna Faith
Written By:
Joanna Faith

Our expert answers some of the most common questions about private health cover.

With NHS satisfaction levels at their lowest for a decade, it comes as no surprise that the number of Brits looking to invest in private health insurance, or private medical insurance (PMI) as it is known in the industry, continues to rise.

Waiting times for hospital and GP appointments are reportedly the biggest factors to blame. Meanwhile, numbers looking to cover their healthcare needs privately are on the up, with health insurance comparison site, ActiveQuote, seeing a 34% rise in enquiries in the first three months of 2019 alone.

So, what exactly does private health insurance cover you for, and how much does it cost? Provided you are aware of the restrictions involved, the good news is securing health insurance has never been a more viable option.

An ageing population, budget cuts and staff shortages are just some of the factors cited in the media as placing increased pressure on public health services, driving increasing amounts of prospective policy holders to look at the possibility of private health cover instead.

Getting your head around exactly what health insurance means is still an unknown for many, however, and putting a policy in place which covers all of your healthcare needs can feel daunting at times. Despite the wide range of cover available, and an extensive glossary of terms to match, securing the right deal doesn’t have to be a minefield, however – provided you have a clear idea of what your needs are before you start looking.

Here are some of the questions which, as a first-time health insurance policy holder, you might find yourself asking – along with the answers you need.

What does private health insurance cover me for?

Fully comprehensive day and inpatient cover is covered as standard by most providers – that is, the cost of care when a policy holder is hospitalised.

Outpatient cover is also usually provided to cover consultant appointments, scans, physiotherapy, blood tests and more. Dental, optical and other specialist services are widely considered to be ‘add ons’ so check with your policy provider which additional benefits are included in your premium, and which you’ll need to pay extra for.

What isn’t covered?

Illness and injury arising from a pre-existing condition at the time a policy is taken out isn’t generally covered. Failing to declare such a condition could also void your policy when it comes to making a claim, so keeping your provider informed is essential.

Chronic illnesses such as cancer, diabetes, epilepsy and organ transplants are also generally not covered.  It is also possible to end up with unwanted exclusions should you pick the wrong type of policy to begin with, so staying upfront about your medical circumstances at all time is essential.

The best time to insure yourself is when you are completely healthy – getting covered when you are fit is an effective way to ‘lock in’ your good health.

How much does it cost?

In most cases, a policy premium will be quoted based on the health of the prospective holder, and their age. The average premium for UK private health insurance is £1,435 per year, but you could pay much less than that depending on these two factors. Different medical groups also offer various discount deals so comparing similar but cheaper cover between providers is fairly common practice.

Are there any additional costs involved, apart from my monthly premium?

Excesses also apply in most cases, usually per person, so it’s worth bearing in mind that a family of four has the potential to rack up a hefty bill over the course of a year should more than one member require treatment within that time. Making sure specified excesses are affordable in all cases is also a must, therefore.

Where would I go for treatment?

By doing your own Insurance Discovery you’ll be able to get a better choice when it comes to where you receive your treatment, and who provides it. Private healthcare gives you access to more than 400 private hospitals, the most up to date drug and treatment options, as well as leading specialists in varying fields.

In some cases, you may also be able to access treatment provided in a public healthcare setting on a private basis, outside of standard NHS hours, for example.  It is also possible to reduce the cost of a premium by as much as 25% simply by restricting the list of hospitals you are willing to use, such as those closest to you geographically, for example.

Can I still use public health services?

There isn’t a choice to be made between the NHS and private health services when you take out a policy with a private medical insurer. As a UK taxpayer, you’ll still have the same access to public health services you’ve always had.

Being a private healthcare policy holder does mean you won’t have to endure long waiting list times to receive non-emergency treatment, however. Private treatment is effectively available to anyone who has the ability to pay for it but it is likely to cost you more without insurance in place, especially if long-term treatment or repeat appointments are required.

Mark Todd is private medical insurance team leader at ActiveQuote