Is private health insurance worth it?
In the UK, we know how lucky we are to have the NHS providing free healthcare for everyone who needs it. However, it’s no secret just how strained its services have become, which is why more and more people are turning their attention to private health insurance plans.
Regardless of the cost, many simply want the peace of mind that they can access effective treatment as quickly as possible.
We help a lot of people who are very interested in the benefits of a private healthcare insurance policy, but ultimately don’t know whether private health insurance is worth it. You probably have a lot of questions yourself, which is why we’ve put together this guide explaining everything you need to know about private medical insurance and how it works in the UK.
What is covered by private health insurance?
Put simply, private health insurance covers medical treatment for acute conditions. Unlike chronic conditions like diabetes, epilepsy and heart disease, long-term illnesses that tend to be incurable, an acute condition occurs quickly and suddenly, with resolvable symptoms. Examples include broken bones, burns, flu, heart attacks and pneumonia.
However, the level of private health insurance cover you receive will depend on the private health insurance you choose. Some will offer limited medical care, while others may give you access to specialists. Every policy falls into one of three categories:
- Basic: Covers inpatient treatment, which is any medical care requiring a hospital bed or an overnight stay.
- Mid-range: Covers both inpatient and outpatient treatment. Mid-range cover will often include what we call ‘limited outpatient cover’, which restricts the number of consultations you can claim per year. Some providers will then cover all diagnostic tests and scans in full, while others only offer limited cover.
- Comprehensive: The highest level of cover. Details depend on the provider, but the main difference between mid-range and comprehensive cover is that comprehensive usually doesn’t put limits on outpatient care.
Many providers will also let you include additional health insurance cover options, such as mental health, cancer, and private GP cover, if these aren’t already included in your policy.
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What private medical insurance doesn’t cover
When choosing a private health insurance policy, it’s important to understand that certain treatments and conditions are typically excluded from coverage. While policies vary between providers, most do not cover the following:
- Pre-existing medical conditions – Any health issues you had before your policy started may not be covered.
- Chronic illnesses – Conditions with no known cure, such as diabetes, arthritis, epilepsy, and HIV/AIDs-related illnesses, are usually excluded.
- Elective and cosmetic procedures – Treatments like cosmetic surgery, fertility treatments, and weight loss surgery are generally not included.
- Routine pregnancy and childbirth – Standard maternity care is not covered, although complications and emergencies may be.
- Emergency treatment – Private health insurance does not replace the NHS for urgent care, including A&E visits and ambulance services.
- Injuries from dangerous activities – High-risk sports injuries and injuries arising from war or conflict are typically not covered.
- Rehabilitation for substance abuse – Treatment for drug or alcohol addiction is usually excluded.
- Medical treatment abroad – Most policies do not include overseas treatment, which is typically covered by travel insurance.
Some policies may offer optional add-ons for mental health support, sports injury treatment, and long-term cancer care, but coverage varies. Always check policy details carefully to ensure you have the protection you need.
How much does private health insurance cost?
The cost of private health insurance varies based on several key factors, including:
- Level of coverage – Policies that cover more conditions and treatments will typically cost more.
- Your age – Premiums tend to increase as you get older.
- Medical history – Conditions such as cancer, diabetes, or high blood pressure can affect the cost.
- Family medical history – A history of heart disease, cancer, or strokes in your family may impact your premiums.
- Lifestyle choices – Smoking, a high BMI, or other lifestyle factors can lead to higher costs.
Ways to reduce the cost of health insurance
Private health insurance doesn’t have to be expensive—there are several ways to lower your premiums:
- No claims discount – If you go a certain period without making a claim, your premiums may decrease.
- Adjusting your excess – Choosing a higher excess (the amount you pay toward treatment before insurance covers the rest) can lower your monthly costs.
- Adding a six-week option – Some policies offer lower premiums if you agree to use NHS treatment if the waiting time is below a set period (e.g., six weeks).
- Choosing specific hospitals – Limiting your treatment to a select group of hospitals or clinics can reduce costs, but ensure they meet your needs.
- Improving your health – Some insurers offer discounts for non-smokers or those who regularly exercise.
By tailoring your policy to your specific needs and budget, you can find affordable private health insurance without compromising on essential coverage.