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Private Medical Insurance

Healthcare when you need it

Nothing is more important to you than your health and the health of your family. If you or your loved ones were to experience worrying symptoms, private medical insurance can offer reassurance and control at a difficult time. Private medical insurance (often also referred to as ‘health insurance’) is an insurance policy that covers the costs of private healthcare, from diagnosis to treatment.

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Private medical insurance gives you fast access to eligible health treatment when you need it, from seeing a specialist for prompt diagnosis to having a comfortable private hospital stay. You’ll be covered for conditions that begin after joining which can be cured – these are known as ‘acute conditions’.

The environment you’ll be treated in will vary depending on where you’re located and the type of treatment you need. You could be treated in a private hospital, health centre or private section of an NHS hospital.

Concentrate on getting better sooner

Diagnosis and treatment can be dealt with almost immediately, reducing the anxiety of the unknown and allowing you to concentrate on getting better sooner. With many health experts predicting that patients are set to experience poorer care and even longer waiting times, many people are turning to private health care for that extra peace of mind.

If you don’t already have it as part of your employee benefits package, and you can afford to pay the premiums, you might decide it’s worth paying extra to have more choice over your care.

Choice in the level of care

Most UK residents are entitled to free healthcare from the NHS. One of the main reasons people take out private health insurance is to avoid long NHS waiting times. Health insurance pays all – or some – of your medical bills if you’re treated privately. It gives you a choice in the level of care you get and how and when it is provided.

You don’t have to take out private medical insurance – but if you don’t want to use the NHS, you might find it hard to pay for private treatment without insurance, especially for serious conditions.

It may also be possible, under private medical insurance, to access the latest drugs and treatments licensed by the National Institute of Health and Clinical Excellence (NICE), which aren’t routinely available on the NHS (outpatient drugs are not covered).

What does it cover?

Like all insurance, the cover you receive from private medical insurance depends on the policy you buy. Basic private medical insurance usually covers the costs of most in-patient treatments (tests and surgery) and daycare surgery.

Some policies extend to out-patient treatments (such as specialists and consultants) and might pay you a small fixed amount for each night you spend in an NHS hospital.

You also might be able to choose a policy which covers mental health, depression and sports injuries, but these aren’t always covered.

There are two main types of private medical insurance policy:

  • Indemnity policies that meet the costs of having private medical treatment for an acute illness or injury on a short-term basis. This could include a private room in a hospital, surgeons’ and other specialists’ fees, outpatient treatment like physiotherapy, and daycare treatment including surgical and diagnostic procedures
  • Cash plan policies, which provide a lump sum benefit payment in certain situations. Generally, the consumer will pay a monthly premium in return for cover, for up to 100% of costs for treatment like an inpatient stay in an NHS hospital, or dental or optical treatment. These may not be included under an indemnity policy
What else do I need to know?

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