If the COVID-19 pandemic taught us anything, it is to be hugely grateful for the free medical care the NHS provides us here in the UK. We know that we can go to see a doctor or be rushed to A&E and not worry about how we will pay for the care. Those in countries like the US are not so lucky, where even a ride in an ambulance can cost hundreds or thousands of dollars.

However, that doesn’t mean that the NHS is perfect. They do their best, and serious issues are often fast-tracked and dealt with in a matter of days or weeks, but an issue that’s not life-threatening can take months to resolve. If you’ve tried to get a doctor’s appointment with your local GP, you may have found that you either have to be fast out the starting gate—calling reception as soon as the practice opens—or wait weeks for an appointment. It’s not uncommon to hear people recommend that you go straight to see a pharmacist to see if you can bypass a doctor’s appointment.

If you dislike the idea of working on someone else’s schedule or feeling like you can’t look a gift horse in the mouth because it’s free, even though you’re dissatisfied with the level of care, you may be considering private medical insurance. But, is it really worth it when we have the NHS? Below, we’ll examine the pros and cons so you can make an educated decision.

What does private medical insurance in the UK cover?

Private medical insurance covers a wide range of general care and specialist treatment. Like any policy, what it covers will depend on the policy you buy, as some will cover very specific conditions, while others will be more general or include benefits such as a free annual check-up or an annual allowance for other treatments.

It usually covers any treatments where you’re an inpatient, where you need to be in hospital overnight for observation, tests, or surgery, as well as many outpatient treatments such as tests, consultations, and treatment. Some also cover regular appointments.

Private insurance typically offers additional benefits, especially if it’s a comprehensive policy, which may include (or allow you to choose from):

  • Physiotherapy, chiropody, and similar treatments
  • Treatment for diseases like cancer
  • Dental treatment
  • Optical treatment
  • Psychiatric treatment
  • Other medical treatment, such as nursing at home

What doesn’t private medical insurance cover?

Private medical insurance doesn’t usually cover private routine appointments. So, if you want to see a doctor for a matter a GP would typically deal with, you’ll usually have to pay for it out of pocket.

It also rarely covers ongoing issues and will limit how much treatment you can get through them before you need to pay or return to NHS care. Illnesses and problems that are rarely covered (or only covered for a limited time) are:

  • Ongoing, life-long diseases (such as HIV)
  • Cosmetic treatment
  • Fertility treatment
  • Other self-elected treatment
  • Emergency treatment
  • Treatment for self-inflicted issues (such as drug abuse)
  • Treatment while abroad (this will/should be covered by your travel insurance)
  • Care and treatment during pregnancy
  • Preexisting conditions

There are always exceptions, so do your thorough research to find out if there is a policy that covers you in a specific circumstance you may be worried about. Also be aware that for many of the issues covered above, if you have the money to pay out-of-pocket for private care, you can still go private. For example, you may want to have your baby in a private care facility, in which case you could foot the bill.

What are the pros of buying private medical insurance?

There are many advantages to buying private medical insurance, some of which are:

  • You’ll be seen and treated much more quickly
  • You’re a customer, so you feel like you can make requests and speak up when you want something or feel like something is dissatisfactory
  • You can choose your doctor(s) and hospital
  • You get a private or semi-private room should you be admitted to hospital
  • You can get a wider range of treatments that the NHS won’t pay for, such as physiotherapy

What are the cons of buying private medical insurance?

As with any form of insurance (and anything in life!), there are some downsides:

  • It can be expensive, and it’s an expense you don’t have to pay for
  • You may have some conditions excluded
  • There are limits on how much you can claim for a condition or other treatment
  • You’ll need to pay an excess, as with other forms of insurance
  • Most treatments are available through the NHS if you’re willing to wait or take a gamble on how long it will take
  • In an emergency, you still have to go to the NHS (though it may be possible to move to private care once the danger has passed)
  • You usually have to go further for care

What types of private medical insurance policies are there?

You can find policies that cover just you, you and your partner, your family, or just for your children. Most people will choose to buy comprehensive medical insurance because it offers the widest range of care, but there are more specific policies you can buy if you are most concerned about one area of your health (or your family’s health). These are:

  • Dental insurance
  • Optical insurance
  • Pregnancy and newborn care
  • Cancer

There are also policies specifically designed for older age groups, such as over 50s, over 65s, and over 70s, but make sure you consult with an impartial expert if you aren’t sure if these policies will work for you. Sometimes, specific or age-related policies are more expensive or as expensive as a comprehensive policy that would also cover your concerns, so speak to an insurance expert if you’re unsure.

Is private medical insurance expensive?

It can be, it totally depends on who is being insured. Some of the factors insurers take into account are:

  • Age
  • Medical history
  • Family history
  • Lifestyle factors (such as smoking, drinking, and whether you’re overweight)
  • What conditions you need/want to have covered

Does your employer provide it?

Before you buy a policy, it may be worth speaking to HR to see if there are any company private healthcare policies you may already have access to or be able to access at a reduced rate.

Should I buy private medical insurance?

Thankfully, private medical insurance is not a necessity here in the UK. You will receive treatment when you need it, and the majority of the time the level of care you receive will be outstanding. Whether or not you should or shouldn’t buy private medical insurance really comes down to your personality type, personal views of the NHS, and financial circumstances.

If you are someone with a lot of health anxiety, then it may be beneficial for you to have private medical insurance for peace of mind so you know you can get care when you need it, and not be stuck on a waitlist. You may also find it calming to know you will be in a private room, and not stuck in a stressful situation that may worsen your condition.

If you have had a negative experience with the NHS in the past, you may also want private insurance so you’ll be able to get private care in most circumstances.

However, if you trust the NHS, you’re not a worrier, and you either would struggle to pay insurance premiums or have plenty of money you could pay for private treatment if you desired it, then maybe insurance isn’t for you. If you need help choosing your life insurance, home insurance, or private medical insurance, we’re here to help. Our experienced and impartial experts will guide you through your options and ensure you have the very best policy for you and your circumstances. To find out more, click here.