Private Health Insurance

Taking out a private health insurance policy in the UK may seem like a redundant investment if you’re already paying national insurance, but this isn’t necessarily true. Private medical insurance can be greatly beneficial for many people, provided you choose the right policy for you. Here, we’ll help clarify what a private health insurance policy entails and what its benefits can be, as well as lending a better idea of what to look for so you can find cover that suits your situation and needs.

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What is private health insurance in the UK?

Private health insurance cover in the UK essentially works as a booster to the services you can receive through the NHS. It doesn’t mean that you cannot have NHS treatment too, but it provides you with access to private medical facilities and resources that might otherwise be costly.

You can choose from several types of private cover in the UK, usually depending on who the policy is for. The most commonly identified types of cover are for the following groups:

  • Individuals
  • Families
  • Joint (i.e., for couples or partners)
  • Child
  • Company (a policy taken out by a business and made available to employees)
  • Over 50s

How private health insurance works

For a monthly fee, you can use your private medical insurance to make claims for any eligible private healthcare you receive. Your insurance will cover some or all of the costs of private treatments and may even give you cashback for NHS hospital stays, depending on the nature of your treatment.

Generally, insurers will have a specific list of private healthcare facilities that are eligible for full-cost compensation. Should you choose or need to go to a private medical centre that isn’t on that list, you may be able to claim a percentage of the cost under your policy. This is on a case-by-case basis, so it’s worth always checking with your policy provider before going elsewhere for treatment.

However, this only counts for any illness or injury that is covered by your policy. As the policy is created, you’ll be able to go through an itemised list of what is and isn’t covered to ensure you’re receiving the level of coverage you feel you need.

The benefits of having private health insurance

The main advantage of private medical insurance is that you’ll get access to private healthcare, which usually provides treatment faster than the NHS. Private healthcare insurers will partner with a variety of centres, allowing you to also choose where and by whom you receive treatment. Not only does this mean that you can get appointments and tests booked sooner, but you’re also helping those who need treatment through the NHS by not increasing the demand on public hospitals.

Private healthcare facilities

Private healthcare facilities are not affiliated with the NHS, which means the cost of any treatment you receive there isn’t subsidised by government healthcare funding. Most are run by a commercial company, charity or other non-profit organisation, which is why the cost of treatment is charged to the patient. With private health insurance, this cost is covered by your policy — providing the treatment is included in your coverage. Due to their exclusivity, you usually experience shorter waiting times and more convenient, comfortable surroundings.

Since private treatment centres are completely independent, you can choose to be treated wherever you like, though your insurer will have a list of the facilities that are fully covered by your policy. Amenities and treatments will vary from one hospital to another, so it’s always worth looking at what local options your policy will cover to see if they are suitable for your needs. Some NHS hospitals have a private wing or clinic too, which may be included in your policy. Assess all the options available under your policy for a good idea of whether it’s the right choice for you. Not only does this allow you to make a decision based on the offered services, but also to determine what facilities are most conveniently located for ease of access.

GP accessibility

Many private health insurance providers offer access to GP appointments through an app. This gives you fast access to medical support, a quicker referral process and the ability to keep track of appointments, should you require any further private treatment.

Additional coverage options

Many private health cover policies allow you to add further coverage for specific types of treatment at an additional cost. This is factored into your coverage premium and reflected in your monthly payments. These can include things like direct access to physiotherapists or mental health specialists. Usually these types of treatment require a GP referral, which can be a lengthy process, since demand may well outstrip availability for these healthcare providers. With a private insurer, you can get the treatment and support you need quicker, with more flexibility for scheduling appointments or sessions.

Important things to consider

You have a pre-existing condition that you last received professional medical assistance for three years ago. If, after two years you’ve not required any further health care for that condition, an insurer may deem it no longer at risk of recurrence and therefore include it under your policy.

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The cost of private health insurance in the UK

It’s very difficult to determine the cost of private medical insurance, since each individual case is calculated based on a broad combination of factors.

As a rough estimate, the average annual premium will be around £1,500. This means that monthly premiums equate to about £125. Lots of people can pay much less than this, but it’s all dependent on your particular requirements. Remember – this is an average based on the whole industry, so it takes the highest and lowest premiums into account. Other factors for calculation include age, lifestyle, medical history and the cover you’re requesting.

Core policy coverage

This average is based on the bottom line policy premium value and doesn’t take into account whether policies have optional extras. Medical insurance consists of a base premium, which usually covers the “core” elements of the policy:

  • Private hospital and day-patient unit fees
  • NHS in-patient treatment costs
  • Specialist fees, including consultations
  • External prosthesis
  • Surgery
  • Oral surgery
  • Ambulance transport

Note that each of these areas are covered at the discretion of the policy provider and some may be excluded, depending on your personal circumstances. If you would like to have specific additions or changes made to your policy, you should always consult with your broker or policy provider to see how this may affect your premium.

Optional extras

There are various additional areas of your healthcare that you can choose to add to your insurance policy. Each will incur an additional cost to your premium, so they’re available purely at the discretion of yourself and the policy provider — insurers can decide whether to cover you for an optional extra or not based on your medical history and circumstances, just as they do with the core policy areas.

Examples of optional extras

  • Specialist consultations
  • Diagnostic tests
  • Dentist fees
  • Acupuncture
  • Chiropractics
  • Travel cover for international treatment and care
  • Private hospital and day-patient psychiatric treatment
  • Special psychiatric consultation and treatment, including psychologists and cognitive behaviour therapists
  • CT, MRI and PET scans
  • Physiotherapy
  • Optician fees, including eye tests

The extra options each insurer offers will vary, both in availability and how they are grouped or priced.

These lists are not extensive or exclusive. Each private medical insurer is different and will consider every policy individually, but this gives you a good idea of what might be included in your core policy and the additions that could be available to you.

Should I get a private health insurance policy?

Choosing to take out a private health insurance policy is a very personal decision to make. Your particular circumstances and expectations are paramount to determining whether it is right for you.

Medical treatment for private patients offers many excellent benefits, especially if you have specialist needs that require immediate attention. The flexibility and customisable nature of private medical cover allows you to adapt your coverage to suit the situation of yourself and your loved ones, but there are several key factors to consider when choosing private health insurance.


Perhaps the most important thing to bear in mind when weighing up the advantages and disadvantages of private health cover is the expense. It’s important to understand the details of your premium and how this will affect your financial situation. Take out a policy that you feel comfortable affording without much impact on your day-to-day standard of living. By consulting with your broker or insurance provider, you can make adjustments to your level of cover to balance your monthly outgoings.


Depending on your circumstances and requirements, you may want very specific coverage for certain occurrences. Ensuring your policy covers you for what you want and need is paramount to getting beneficial private insurance. This is particularly important for any preexisting conditions, familial genetic conditions or any other forms of treatment that aren’t included under an insurance’s core cover. Health insurance for mental health treatment, for example, can pay dividends if prolonged therapy or medication is required, but many policies only support this for a finite length of time.

What are the alternatives to private health insurance?

There are several alternative options available to UK citizens if you’re unsure that private medical cover is right for you.

Firstly, the NHS will always offer treatment for all conditions, but with demand high and resources low, this is often a significant motivator for considering private health insurance in the first place. If you do choose to take out a private health insurance policy, this doesn’t impact your eligibility to access NHS care in any way.

Setting up a private, dedicated savings account for private medical expenses can be a good option for some, though this will limit the amount of treatment to whatever those savings can afford. Critical illness cover can be used to obtain a lump sum after diagnosis of a set list of critical illnesses. These policies increase with age and can become very costly over a long period of time, especially since eligible illnesses are limited.

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