Do you need private medical insurance?insurance – do you need it?

Private medical insurance, also known as health insurance, is an additional type of insurance that can provide you with access to healthcare services beyond what is available through the National Health Service (NHS). If you do not already have private medical insurance as part of your employee benefits package and you can afford the premiums, you may decide that it is worth paying extra for this type of coverage in order to have more choice and control over your healthcare.

Private medical insurance – What is it?

Most people who live in the UK are entitled to free healthcare through the National Health Service (NHS). Health insurance is an additional type of insurance that can help you pay for medical treatment that is not covered by the NHS. With health insurance, you have more choice in the level of care you receive and how and when it is provided. It is not required to have health insurance, but if you prefer not to use the NHS, it may be difficult to pay for private medical treatment without insurance, especially for serious conditions.

What does it cover?

Private medical insurance, like other types of insurance, offers different levels of coverage depending on the policy you choose. Basic private medical insurance usually covers the costs of most inpatient treatments, such as tests and surgery, and day-care surgery. Some policies also provide coverage for outpatient treatments, including visits to specialists and consultants. Some private medical insurance policies may also pay a fixed amount for each night you spend in an NHS hospital. The specific coverage you receive with your policy will depend on the policy you choose.

What isn’t covered?

Your healthcare insurance usually won’t cover private treatment for:

  • organ transplants
  • pre-existing medical conditions
  • normal pregnancy and childbirth costs
  • cosmetic surgery to improve your appearance
  • injuries relating to dangerous sports or arising from war or war-like hostilities
  • chronic illnesses such as HIV/AIDs-related illnesses, diabetes, epilepsy, hypertension and related illnesses.

You might be able to choose a policy which covers mental health, depression and sports injuries but these aren’t always covered.

Do you need it?

It’s very much a personal choice.

You get free treatment on the NHS, so you only really need private medical insurance if:

There are a few reasons why you might consider purchasing private medical insurance:

  • If you prefer not to wait for treatment through the NHS, private medical insurance can provide you with faster access to healthcare services.
  • If you prefer to use private hospitals rather than NHS hospitals, private medical insurance can help you to pay for these services.
  • If you want coverage for drugs and treatments that are not available through the NHS, such as specialist surgery for sports-related injuries, private medical insurance may be able to provide this coverage. It’s important to check that the treatment you are interested in is included in your policy before you buy it.

Who doesn’t need private medical insurance cover?

You don’t need private medical insurance if:

-I am happy to use the National Health Service (NHS) for my healthcare needs.

-I already have medical insurance through my job.

-I am concerned about my child getting sick and know that children have priority on the NHS.

-I only have enough money for basic insurance like car and home insurance (and life insurance if I have dependents).

-I have debts to pay off and no savings, so I should use my money for that instead of buying private medical insurance.

-I have enough money saved to pay for individual medical treatments if needed, and it may be more cost-effective to pay for treatments privately instead of paying regular insurance premiums.

Pros and cons

Note: all of this depends on the type of policy you buy.

Pros

Your GP can refer you to a private specialist or expert for a second opinion or specialized treatment.

-If the NHS delays or denies a scan, you can use your insurance to pay for it.

-If you have a long wait time for NHS treatment, you can use your insurance to reduce the waiting time.

-With insurance, you can choose a surgeon and hospital that fits your schedule and location, which may not be possible with the NHS.

-You can use insurance to get a private hospital room instead of staying in a shared ward.

-Insurance may provide access to specialist drugs and treatments that are not available through the NHS due to cost or lack of approval from regulatory bodies.

-Insurance can provide quicker access to physiotherapy sessions than what is available through the NHS.

Cons

-The NHS may provide better care for serious illnesses like cancer, heart disease, or stroke, and NHS hospitals can be just as good as or better than private hospitals.

-Private medical insurance can be expensive, with a typical family premium ranging from £700 to £1,800 per year. Premiums will increase every year and with age, so by the time you are older and more likely to need hospital treatment, you may not be able to afford it.

-Most insurance policies do not cover chronic, incurable illnesses like diabetes and some cancers.

-If you choose a policy with an approved list of consultants and hospitals, it may not include the specialist you want to see or a convenient location for treatment.

Is private medical insurance good value for money?

-Private medical insurance can be a good value if you may need expensive, specialized treatment.

-If you are an athlete, for example, you might want access to private specialists and experts not available through the NHS.

-You should get a policy that covers the type of treatment you may need.

-If you need to make multiple claims, private medical insurance could save you money.

-Even with private medical insurance, you can still use the NHS as a backup for any treatments not covered by your insurance policy.

Alternative options if you want to go private

-You can use savings to pay for all or part of your medical costs, as about 20% of private patients do. For example, hip and knee replacements typically cost around £10,000 each, and MRI scans can range from £500. You can compare prices for scans and ask your GP for help.

-You can also pay for a private consultation to get an expert opinion or second opinion, and if necessary, your consultant can refer you back to the NHS for treatment.

Other types of insurance to consider

-If you become sick or have an accident and cannot work, it may be difficult to make mortgage payments or pay bills, especially if you do not have enough savings or sick pay from your employer.

-In this case, it is important to prioritize insurance that will help you avoid financial hardship, such as income protection insurance.