Your health insurance will cover the cost of private care if you become ill. In other words, if you require medical care, it will be covered by your private health insurance. What is and is not covered varies widely by provider, coverage, and medical history.
As we’ll see, the best health insurance policies will cover the expense of inpatient and day-patient care (when you’re admitted to the hospital). However, it is only more comprehensive insurance, sometimes with add-ons, that covers you for outpatient treatments and even testing.
The Basics of Private Health Insurance
Here’s a quick rundown of how private medical insurance works in the United Kingdom. You may select between two types of health insurance policies: a basic plan that only covers inpatient treatment; and a more comprehensive health insurance policy that includes coverage for outpatient therapy and diagnostic testing.
To get a medical diagnosis, you would be required to go through the NHS with basic coverage, and then, if eligible, you would be treated privately. In contrast, with a comprehensive plan, everything will take place in a private healthcare environment once you’ve seen your GP.
All of your tests and consultations leading up to a medical diagnosis will take place in the privacy of your own home. Also, outpatient coverage lets you get specialised care for mild illnesses that might not require you to stay in the hospital overnight.
Options for Financing
We won’t go into great detail on underwriting here, but it is important to note that it will influence your policy and pricing. The majority of private medical insurance operates on a moratorium underwriting basis. If you have a more complicated medical history, comprehensive medical underwriting may be a better option. When you chat with a health insurance broker, they will be able to advise you on the best sort of underwriting for your specific situation.
Advantages of Health Insurance
In general, a health insurance policy will provide you with the following benefits:
- Private therapy is frequently speedier because it avoids NHS waiting lines.
- Private consultants and specialists are available.
- Drugs and specialized treatment options that are not always accessible through the NHS
- If you are admitted to the hospital, you will be given a private room.
- More options for treatment providers
- Various awards, discounts, and member incentives are available.
What is covered by private health insurance?
Private insurance covers the cost of treating acute medical illnesses, which are ones from which you can normally recover. Even the most basic coverage will cover the expense of treatment at a private hospital when you need a bed for the day or overnight. But you must first get a diagnosis from the NHS before you can use this insurance to pay for private hospital care.
Outpatient coverage is sometimes restricted to a monetary value each year in comprehensive insurance. With these rules, all you need is a recommendation from your doctor, and everything after that is handled secretly. Each provider and its policies will be unique, so take your time while selecting the best one for you. We urge that you consult with a certified broker before making any decisions.
They are familiar with all of the policies and may provide you with personalized counsel. Pre-existing medical issues are not covered by health insurance. Most diseases are automatically ruled out if you have had symptoms or treatment for them in the last five years. If you don’t have any symptoms for two years and your coverage is moratorium-based, you’ll be covered after that. As a result, your medical history determines what is and isn’t covered by private medical insurance providers.
Additional Policy Alternatives
While comprehensive insurance provides a lot of coverage, all health insurers provide a variety of extra options to allow you to customize your coverage level; they often include:
Outpatient treatment—is generally restricted to a single year. Coverage for therapies like physiotherapy (though many plans may already include physiotherapy sessions after surgery as part of their main plan). Many policies allow access to helplines for mental health treatment. Even still, access to more extensive private treatment alternatives will likely cost you more.
Dental and optical coverage—you can get help paying for routine visits and check-ups. If you want your private health insurance to cover you outside of the UK, you must purchase travel insurance.
Unrestricted consultant selection—certain providers, such as WPA, The Exeter, National Friendly, and Freedom, do not restrict your options. Still, larger corporations do, but you may pay to have this removed.
Access to more hospitals—all providers manage their own hospital lists, which can be extended for a fee. As you can see, there are several alternatives to consider, so we recommend speaking with a broker when comparing private health insurance firms. They will help you work through the problems and make sure that, based on your medical history, you get coverage for the things you want.
What is not included?
While you may pay to have a wide range of services covered, all insurance has exclusions.
In general, these are as follows:
- Pre-existing medical issues: Your medical history will have an impact on your coverage.
- Long-term (chronic) conditions are monitored and treated.
- Treatment in an emergency
- Cosmetic surgery
- Alcoholism, drug addiction, and self-harm
- Infertility, childbirth, and birth control
- Treatment received outside of the United Kingdom
Is it worthwhile to purchase private health insurance?
If you get sick, health insurance gives you access to private healthcare options, but is it worth it and necessary? In a strict sense, none of us require private insurance. In the United Kingdom, we have the NHS, and they do an excellent job with the resources they have. However, at the time of writing, the NHS was still dealing with record-breaking waiting lists, not just for non-urgent surgeries but also for cancer care.
Is private healthcare better than the NHS?
The NHS is a really vital service, and there are many things that private healthcare does not provide, such as accident and emergency services. In certain ways, private healthcare is superior to public healthcare, such as shorter wait times and higher-quality hospital facilities. Many NHS consultants and surgeons also work privately, so you’ll likely see the same specialists either way; it’s just that you’ll see them sooner privately.
Do pre-existing diseases get covered by insurance?
No, pre-existing conditions are not covered by insurance. The only time you don’t have to pay is if you don’t get any symptoms or need treatment for the medical condition in the two years after you buy a policy (this is called your “moratorium period”). If this is the case, insurers will frequently cover the disease.
What health insurance company has the best ratings?
WPA and The Exeter have the top client ratings among UK health insurers. They have, however, both acquired significantly less than the rest. Axa, for example, has a Feefo rating of 4.6 out of 5 based on over 7000 evaluations.
Which health insurance provider has the best level of client satisfaction?
Exeter is without a doubt the health insurance provider with the highest levels of client satisfaction.