We in the UK are extremely fortunate to have the National Health Service. Since it was first established in 1948, all Britons have had a medical safety net. In many other countries wealth, or a lack of it, determines what medical treatment you can receive and when you can receive it. In the UK we are all covered in a medical emergency.

But with nearly 70 million people living here, the NHS is under intense pressure, with personnel and finances stretched to breaking point. The COVID-19 situation has underlined these difficulties, and they are not going away any time soon.

Waiting lists for non-urgent procedures and treatments are growing but there is an alternative. There is nothing to prevent an individual from buying medical care except the sheer cost. Happily, for most of us, the need for medical interventions are few and far between, but with many procedures costing thousands of pounds, any procedure might drain your savings pretty quickly.

But what about private medical insurance? Where can it step in to provide better—or at least faster—care? Read on to find out exactly what private medical insurance provides, and if it’s right for you.

What is private medical insurance?

Private medical insurance, or private health insurance as it is also known, provides you with a plan that will pay all or part of the medical bills if you decide to be treated privately. Each company offers a choice of level of cover to suit you and offers anyone who takes out a policy the chance to receive private medical treatments they might otherwise be unable to afford.

Medical insurance works in the same way as other forms of insurance. You pay a premium, usually monthly, and claim on your policy when you need to. Depending on your cover, you will have to pay a certain amount yourself (an excess) but the insurance will provide the majority of the cash to cover the costs.

What does private medical insurance cover?

Private medical insurance is principally designed to help you pay for tests and treatment for acute conditions that occur after you take out the policy. Generally it doesn’t cover long-term problems such as diabetes, arthritis, and hypertension, for example, or pre-existing conditions.

Exactly what is covered varies with the plan you opt for, but even basic policies cover things like in-patient procedures, such as tests and surgery (including day surgery). More comprehensive plans also include outpatient consultations, tests and therapies (such as physiotherapy), nursing care and accommodation, plus access to drugs and therapies not available through the NHS.

In addition to chronic and pre-existing conditions, it is rare for any private medical insurance to cover:

  • Appearance-related cosmetic surgery (unprovoked by injury)
  • Conventional pregnancy and childbirth
  • Organ transplants

While not covered as standard, policies are available that include sports injuries, mental health, and other conditions.

How much does private medical insurance cost?

Private health insurance is no different to other products offered by insurance companies as how much you pay is dictated by what cover you choose, your circumstances, and where you live.

Some of the factors affecting the premiums are:

  • Age – as you get older you are more likely to need medical attention so the premiums are likely to rise.
  • Medical history – if your previous health records indicate that you are more inclined to need medical treatments it may mean the cost of insurance will rise. This includes your family medical history which may show that you are more likely to develop certain conditions.
  • Lifestyle – being fit and healthy may not lower premiums but smoking, drinking and a high BMI will certainly push them up.
  • Postcode – though it relies on a generalisation, where you live is seen by insurance companies as an indicator of you developing certain medical problems and has an effect on what you pay.
  • How comprehensive the cover – basic medical insurance is considerably less expensive than one that has all the bells and whistles.

A ballpark figure? Currently around £100 per month is an average figure for medical insurance for a couple in their mid-thirties but obviously what you will pay is affected hugely by all the factors above.

How do I choose which plan is best for me?

First of all make sure that health insurance is not part of your employment package as many employers offer this to their workers. If not you have to ask:

  • How much am I willing to spend?
  • What cover do I want?
  • How much of the medical costs am I prepared to contribute?
  • How wide a choice of hospital do you want?

Once you have answered these questions honestly, you should be able to look at what is available in the marketplace. If in doubt, seek guidance from a qualified insurance expert to help you narrow down the possibilities.

Do you need private medical insurance?

Whether or not you need private health insurance depends entirely on you and your situation. For those that can afford it, medical insurance gives peace of mind that should the need arise, action can be taken quickly and at a facility they have chosen.

The NHS is wonderful and the care they provide is exemplary but they are stretched. You often have to be prepared to wait for appointments, and the wait can be long. Though it is extremely good at responding to life-threatening conditions, for more mundane problems or those that require further investigation, can take a long time to get the care you want and need.

Private medical insurance used to be criticised as a form of “queue jumping” and certainly private healthcare does promise speed – it’s one of the primary reasons to pay for it. But nowadays, it’s also worth noting that those who pay for their healthcare also reduce the burden on the NHS.

What other options are there?

Healthcare cashplans are inevitably much cheaper than private medical insurance but are much more limited. They are intended for the everyday expenses of opticians, dentists and so on, not serious medical problems.

Life insurance often includes critical illness cover that pays a lump sum in the event you are diagnosed with any of a number of serious illnesses but is nothing like as comprehensive as full private health insurance. However, it may also help to pay for any necessary changes to your home or even pay off your mortgage.

The alternative is always there to pay for medical treatment from your own pocket. That way you are totally in control of your healthcare, but even for the wealthy that can be frighteningly expensive.

Takeaways

Private medical insurance is yet another monthly outgoing from your income and can be seen as an unnecessary expense, but when a health problem arises and you start feeling anxious, it will feel like money well-spent. If you deal with health anxiety or simply find it difficult to continue on with your life when you know you could have the problem dealt with quickly, private medical insurance is a great investment in your future health, mentally and physically.