MoneyMagpie Editor and financial expert Vicky Parry explores the pros and cons of private health insurance
With NHS waiting lists months long for simple things, and seeing a GP a challenge due to patient numbers and limited time, more people are turning to private healthcare. But what does it cost, and how does private health insurance work?
What is private health insurance?
Paying a monthly amount to a health insurance company means that when you need healthcare, you can access GP and specialist treatment much faster than on the NHS.
As with any insurance, this could mean you pay for years and years without needing to claim anything – but it could also save you thousands on life-saving care. Insurance is always a risk: you might pay out more than you get back, but could you afford to not have the access to the care if you needed it?
How does it work?
You pay a monthly premium to a health provider. In return, you can access private healthcare within days instead of weeks or months on the NHS. Your insurance gives you access to booking services with private GPs and consultants, who will be able to see your NHS medical record if you choose to share it with them (which is recommended).
For smaller treatments and some initial consultations, you might need to pay first and then reclaim the costs from your insurance. If you need treatment, always check with your health insurance provider before booking it, to make sure it is covered by them.
Any treatment or healthcare specialist you speak to via private healthcare can keep your NHS GP and medical record up-to-date, with your permission. This helps you receive seamless care between NHS and private settings.
Employee private health insurance
Many employers will offer private health insurance as an employee benefit. This might be as a standard benefit offered to all employees, or as a salary sacrifice. These schemes will also often include discounted gym memberships.
If your employer offers private health insurance, it can be worthwhile considering the package on offer. This is because they will often get corporate discounts on premiums, meaning you can access a higher level of cover for less.
However, people with pre-existing conditions may not be covered, and other forms of insurance could be better suited to your personal circumstances. Make sure you read all the fine print before signing up to a policy, otherwise you could be paying for something you can’t use.
What isn’t covered by private health insurance?
Every policy differs, so it’s really important to assess the level of cover you want, the excess you’re able to pay on any treatments, and your current health situation. Most standard private health insurance policies are designed to help you receive timely care for acute, short-term conditions. Comprehensive policies are more expensive, but offer broader care for chronic or long-term conditions.
If you have an existing illness or previous injury causing long-term difficulties, this is called a “pre-existing condition”. Some policies might not cover for any healthcare related to that pre-existing condition, so it’s really important to read all the fine print of any policy before agreeing to it.
A standard policy is likely to include an excess – the amount you have to pay before you can claim costs on the insurance – as well as an upper limit per condition. This means once you’ve claimed the maximum amount for a condition, you won’t be covered by the insurance any more.
Emergency care is not covered by private health insurance, but with a comprehensive policy you could receive follow-up care such as physiotherapy or ongoing surgical needs. Similarly, many standard policies won’t cover ongoing cancer care – but they might be able to get you a faster diagnosis and initial treatment.
Pay as you go private health
Private healthcare can be accessed by anybody: you don’t need to have insurance to get it. However, it is very expensive for most people and this means it’s often a last resort.
An increasingly common private healthcare option people do choose to take is a private GP service. This makes it easier to speak to a GP on the same day, often by a video call, to get reassurance or start the ball rolling on a referral pathway.
There are online services like Dr. Online, or healthcare groups like Bupa and Nuffield Health, which let you book a GP appointment and pay for it.
Expect to pay around £60 to £90 for the first appointment, depending on whether it is in person or remote, and less for follow ups. Your first appointment is a longer consultation. If the private GP prescribes medication, there will be an extra cost for that medication (which is much higher than the NHS standard prescription cost of £9.90).
Some private GP services offer a subscription service, such as Bupa’s Well+ Bronze from £15 a month, which can be a way to have consistent GP care for complex conditions without huge charges.
You can also self-refer to private specialists, like rheumatologists, endocrinologists, or gynaecological consultants. These appointments are much more expensive, around £200-£300, about half an hour long, and could result in additional payment for follow-ups.
They can be useful if you need to see someone fast for reassurance, but unless you also have funds for follow-up tests and appointments, it’s still best to wait for your NHS treatment. A specialist can, for example, provide a diagnosis and refer you back to your NHS GP – but it won’t push you up the NHS waiting list for treatment. However, it may help you access interim care, such as medication prescribed by a GP, sooner.
How to keep health insurance low
There are some things you can do to keep your health insurance premiums lower. The first is to be proactive on preventative care (aka looking after yourself).
Many insurance providers reward customers who have a healthy lifestyle and may even offer discounts on gym memberships and fitness kit to incentivise getting active.
For example, Vitality health insurance runs a rewards programme. Connect your fitness tracker to their app, and you earn points to convert either to partner rewards for discounts and freebies on your shopping, or to reduce your health insurance premiums.
This might seem impossible if you think you’re not particularly mobile due to poor health. However, all movement can count. So, a gentle walk around the block or a chair dance at home can build up your rewards points.
If you want to cycle everywhere but your mobility prevents you, consider an electric tricycle like those by Jorvik Tricycles. A tricycle provides more stability than a bicycle, lets you carry your groceries in a basket rather than unbalanced in a bag on your back, and the power-assisted cycling means you can cycle up hills and for longer than without.
Participating in a healthy lifestyle also reduces your premiums. Quitting smoking and alcohol, for example, are ideal for improving your overall health anyway – and over time can help bring your premiums down.
Finally – of course – it’s important to shop around and compare your private health insurance cover before you buy. Using cashback websites can give you a big chunk of change back on your policy, while shopping around before the policy renews can help you negotiate a better price, too.
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