Private health insurance can offer you fast access to the healthcare you need, whether that’s tests, consultations with a specialist or surgery.
However, with different plans offering different levels of cover, it’s not always straightforward to find the best health insurance provider for you – let alone if you’re also looking to cover your partner or family, too.
Here Telegraph Money takes a closer look at what private health insurance providers offer, and how you can get the best value for money.
What is private health insurance?
Private health insurance is a type of insurance policy that covers your medical costs if you choose to use private healthcare.
Although there is a huge variation between policies, they can be arranged to cover the cost of consulting a specialist, tests and any treatment you require, such as surgery or physiotherapy.
But, it’s important to be aware that cover will only be for acute conditions that can be treated or cured, rather than for the management of long-term chronic conditions.
You also won’t usually be covered for emergency treatment, cosmetic surgery or pregnancy.
You might also hear private health insurance described as private medical insurance, or PMI.
Policies can be set up to cover individuals, couples or families.
Why consider private health insurance?
NHS waiting lists are currently at a record high, with 7.5 million people awaiting treatment.
It’s hardly surprising, then, that almost three-quarters of people would use private healthcare if they could afford it, according to a recent poll by YouGov.
Going private might mean you don’t wait as long, but it can also land you with a hefty medical bill – a hip replacement could cost you £10,000 or more – if you don’t have insurance.
Although private health insurance itself isn’t cheap, it can spare you a huge bill and give you the peace of mind that if you need tests or treatment, your costs will be covered.
In addition to covering your medical bills, private health insurance can also give you more control over your treatment, often giving you a choice over which specialist you see and which hospital you use.
It will likely be easier to get appointments at a time that suits you, too.
Another big draw for private health insurance is that it may include cover for treatments that aren’t available on the NHS, such as certain cancer drugs.
Your hospital experience is likely to be more comfortable as well – for example, staying in a private room with an ensuite bathroom, rather than an open ward.
The best private health insurers 2024
The “best” health insurance provider will vary depending on your circumstances and what kind of cover you’re looking for.
It can be difficult to choose, but one place to start is seeing how providers fair when it comes to customer reviews and policy analysis.
The consumer group Which? has compiled a ratings system of private healthcare providers based on a customer survey and its own analysis of the policies.
The not-for-profit insurer Western Provident Association (WPA) came out on top of the pile and is the Which? recommended provider.
Its Complete Health policy comes with three levels of cover – core, mid-range and comprehensive.
The two higher tiers have more out-patient cover and there are also options to add in cover for cancer, mental health and treatment if you’re overseas.
Aviva came second. Its service offers 24/7 access to GP appointments and up to £2,000 towards mental health treatment.
You can also choose to enhance or reduce your cover by adding or removing certain elements as you see fit.
AXA is in third place, which offers everything you’d expect plus specialist menopause support. It has monthly and annual payment options.
How much does private health insurance cost?
Private medical insurance is, unfortunately, expensive – it’s telling that in the Which? survey mentioned above, no provider scored more than three stars (out of a possible five) for value for money.
However, just how much you will pay depends on the level of cover you choose, your age and medical history, the number of people you want covered by the policy as well as where you live.
Which? looked into how much a typical 35-year-old couple might pay compared to a 55-year-old couple.
Based on illustrative quotes from the providers’ websites, Aviva’s full cover policy came out cheapest at £878 for the younger couple, and £1,410 for the older couple.
Other policy prices were well over £1,000 for the 35-year-olds, and breached £2,000 for older couples.
These prices can vary quite widely depending on your circumstances and the level of cover you choose.
Are different types of private health insurance available?
Different levels of cover are available from insurance companies – for example, a provider might offer basic (or core), intermediate and comprehensive levels of cover.
Exactly what’s included will vary, but typically core policies will provide treatment-only cover, while higher tiers will include more out-patient cover, such as consultations and diagnostics as well as treatment.
Comprehensive policies will provide the highest level of cover and may also include additional therapies and mental health cover.
You might also find that there are specialist policies available, for example over-55s plans or policies that only cover specific conditions like cancer.
When you apply for private health insurance you may also get to choose how your policy is underwritten. There are typically two methods insurers will use:
Full medical underwriting
This is where you will be asked to provide details of your medical history and, if necessary, your insurer may need to get further information from your GP.
It will use this information to calculate the cost of your private medical insurance – however, if you have suffered a condition that is likely to return, it may be excluded from your policy.
Moratorium underwriting
Some providers might give you the option to not supply any medical information when you apply for your cover.
Instead, if you claim, the insurer may need to request information from you, and if you have suffered any symptoms of that condition, received treatment or medication for it, or even sought advice from your GP in recent years (typically five), then your insurance may not cover the cost.
Which option should I go for?
This comes down to personal preference.
Full underwriting might seem like a bit of a hassle when you are applying, but the real upside is that you will know exactly what you are covered for and, if you come to claim, the process should be faster.
However, moratorium underwriting may have more appeal if you have a clean bill of health and haven’t suffered any medical conditions over the last few years.
It’s worth noting though, that if you have private medical insurance from your employer you will likely be on a group plan.
This means that you won’t typically be asked for information on your medical history, with underwriting based on factors such as the average age of the workforce and where your employer is based.
How to choose the best private medical insurance provider for you
The Which? survey provides an excellent start to your research, but to get the best value for money it’s important to think about what you need and the elements that are most important to you.
Do you, for example, want the “full private experience” or are you simply looking to limit your exposure to a big bill if you need to have an operation?
Before you choose your policy, here are a few points to check:
- How much out-patient cover is included (for example consultations and tests)?
- Do you have free choice of hospital and specialist, or will there be restrictions?
- What additional benefits are available – for example, access to private GPs or mental health support?
- How much cover is available for each element of the policy?
- What are your underwriting options and what will be excluded by the policy?
You’ll need to weigh up whether or not a policy is going to suit you based on what details are most important to you, and what is or isn’t included.
It’s particularly important to check the details if you are choosing a cheaper or lower tier policy, as it’s these that will typically cap payouts at lower levels, offer fewer benefits and place more restrictions on the doctors or hospitals offered.
How to cut the cost of private medical insurance
Private health insurance isn’t cheap, but there are a number of ways to keep costs under control:
- Focus on core benefits, like in-patient cover: increasing protection for out-patient cover, mental health cover and additional therapies will all increase your costs.
- Pay annually rather than monthly: paying annually could knock 5pc off your premium, if you can afford to do so.
- Shop around for your policy: comparison sites can be helpful, but a specialist insurance broker should also be able to help you strike the right balance between cost and cover.
- Consider hospital or specialist limits: you may be able to cut your costs by choosing a policy that limits the hospitals or specialists you use – the inclusion of some London hospitals, for example, can put costs up substantially.
- Increase your excess: by agreeing to pay more towards the cost of your claim, you can reduce the cost of your cover. Bupa, for example offers excess levels from £0 right up to £500.
Making the most of your private health insurance
Once you have bought your private health insurance it’s important to read through your policy documents to ensure you know what is covered and what is not.
To get maximum value for money, you should also ensure you know about any additional features of your cover that you might have overlooked.
Some providers, for example, offer free video consultations with private GPs or let you refer yourself for treatments like physiotherapy or mental health support, without seeing a doctor first.
Some also offer hefty discounts on things like gym memberships, which can help you make savings if you were thinking of signing up anyway.
Making a claim on private health insurance
How you claim will depend on your provider, but typically you will need to get a referral from a GP first.
Once you have this you will then need to contact your provider’s claims team and it will tell you whether you will be covered.
The only exceptions are likely to be for treatments such as physiotherapy or osteopathy, which don’t always need a referral from your GP.
You can usually submit a claim over the phone or online.
If you have a fully underwritten policy this should be reasonably straightforward but, if you have a moratorium plan, you may need to provide some medical information or agree to let your insurer contact your GP.
Once your claim has been approved, your provider will let you know what you need to do to proceed and access the advice or treatment that you need.
FAQs
Is it worth paying for private health insurance?
Free healthcare is available at the point of the use in the UK through the NHS.
However, private health insurance remains an option for those who are concerned by strains on the NHS and would prefer to manage the costs of getting consultations, tests and treatment in the private sector.
It ultimately comes down to personal preference.
What are the disadvantages of private health insurance in the UK?
Although private health insurance can offer you fast access to specialist consultations, diagnostics and treatment for certain medical problems, it is expensive.
If you don’t need to claim, or if timely treatment is available on the NHS, you might conclude you’ve not had value for money.
Is it worth having Bupa cover?
The name Bupa might be synonymous with private healthcare, but there are numerous insurers operating in the market, so it’s always worth comparing policies before you choose a provider.
You also don’t necessarily need Bupa health insurance to access Bupa’s network of private hospitals.
Are there any alternatives to private health insurance?
Private health insurance is the only policy that can cover the cost of treatment in the private sector.
However, there are other policies that can either help you with healthcare costs or provide a pay out if you are seriously ill.
Healthcare cash plans, for example, will pay a cash benefit to help with the costs of everyday healthcare, such as a trip to the dentist or optician, physiotherapy, podiatry or osteopathy, even a stay in hospital.
Alternatively, critical illness insurance, which is often combined with life insurance, pays out a lump sum if you are diagnosed with one of the life-threatening conditions covered by the policy such as heart-disease, stroke, multiple sclerosis and certain cancers.
It’s up to you how you spend the pay-out.
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