Your ultimate guide to private health care

Health care has, and always will be, in demand. And as the NHS is put under more and more pressure, the need for quality health care in the UK has risen exponentially.  

Individuals are increasingly exploring the option of private health care as an alternative to the public healthcare system. With rising concerns about the quality and accessibility of medical services, understanding how private health insurance works, its benefits, and costs is crucial. Read on for all you need to know about finding the right health insurance policy and provider for you.

How does private health insurance work?

With private healthcare, you pay for medical treatment and services out of your own pocket, rather than receiving funds from the government. 

An overview of private health insurance

Private health insurance, often referred to as private medical insurance (PMI), is a policy purchased by individuals or provided by employers to cover the costs of private healthcare services. 

Unlike public healthcare, where services are funded by the government and are often subject to long waiting times, private health insurance offers quicker access to medical care, a wider range of treatments, and enhanced facilities.

What’s the difference between health insurance and private health care?

Whilst this guide has familiarised you with a detailed knowledge of private health care, you might be unfamiliar with the difference between private health care and health insurance. 

Private health insurance is a financial arrangement where individuals or organisations pay premiums to cover potential medical expenses. It helps mitigate the cost of healthcare by reimbursing or directly paying for covered medical services. In contrast, private healthcare pertains to the provision of medical services by private healthcare providers, including hospitals, clinics, and physicians.

Coverage and benefits

Private health insurance policies vary in coverage and benefits, depending on the provider and the chosen plan. However, common benefits include:

Access to specialist care

Private health insurance allows policyholders to consult with specialists and receive specialised treatments without the need for referrals from primary care physicians.

Shorter waiting times

Private healthcare facilities typically offer shorter waiting times for consultations, diagnostics, and surgeries, ensuring faster access to necessary medical services.

Choice of hospitals and physicians

With a private policy, you have the flexibility to choose your preferred hospitals and healthcare providers, including renowned specialists.

Extensive treatment options

Private insurance often covers a broader range of treatments, including experimental therapies and medications not available through the public system.

Private rooms

Many private hospitals offer private rooms, for a more comfortable and peaceful stay. 

Optional extras

Depending on the plan, you may be able to add extras such as dental care, optical services, and mental health support.

Premiums and deductibles

It’s important to note that private health insurance is not free. You play regular premiums to maintain your coverage. Premiums vary based on factors such as age, health status, coverage level, and insurer.

Additionally, most policies come with a deductible — this is the amount you must pay out of pocket before the insurance coverage kicks in. Higher deductibles often result in lower premiums, while lower deductibles offer more immediate coverage but come at a higher cost.

How does the claims process work?

If you find yourself in need of medical care, you may be wondering how to make a claim. The exact claims process will vary depending on your insurance provider, however, you can usually expect the following steps:

Receiving medical services

Firstly, you’ll seek medical treatment from a covered healthcare provider or facility.

Billing and documentation

Throughout, it’s vital to ensure you accurately document any medical bills and details. 

Submission of claims

You’ll then need to submit the bills and documentation to your insurance company within the specified time frame.

Review and approval

The insurance company will review your claim and approve eligible expenses based on the policy terms and conditions.

Payment

Once the claim is approved, the insurer will pay out the approved amount, either directly to the healthcare provider or to you.

Is private health insurance worth it?

As NHS wait times get even longer, many people might be choosing to switch to private healthcare. But is it really worth it? 

Whether private health insurance is worth it depends on various factors, including your individual circumstances and preferences. Here are some key considerations:

Healthcare needs

Evaluate your healthcare needs —if you have pre-existing conditions or require frequent medical attention, private health insurance may provide quicker access to specialised care.

Income and budget

It’s also important to consider your financial situation. Private health insurance premiums can be costly, so assess whether you can comfortably afford the ongoing expenses.

Waiting times

Public healthcare often involves longer waitlists, while private insurance can offer quicker access to treatments. As such, think about whether you’re able to wait for treatment or want to fast-track the process.

Coverage preferences

Assess the coverage offered by private insurance and whether it aligns with your healthcare preferences. Some people prefer the additional options available through private healthcare.

Employer benefits

If your employer offers private health insurance as part of your benefits package, it may be more cost-effective to enrol.

Pros and cons of private health insurance

As you can see, there are some substantial pros to investing in private health care, including better access to the services that you need and enhanced privacy during hospital stays.

But there are also a few cons to be aware of before you take the leap. Bear the following points in mind.

• Premiums can be expensive.

• You’ll need to account for deductibles and out-of-pocket costs.

• You may find coverage is limited if you have pre-existing conditions. (These are medical conditions that existed before the policy's start date, and many private insurers have waiting periods during which they do not cover treatment related to those pre-existing conditions).

• Your health insurance may not cover certain elective or cosmetic procedures.

  
  

How much does private health care cost in the UK?

The price of private health care varies throughout the UK, but as a general rule of thumb, it’s best to take the following into account. 

Your age and health status

Younger, healthier individuals generally pay lower premiums than older individuals or those with pre-existing conditions.

Coverage level

The extent of coverage you choose greatly affects the cost. Comprehensive plans with a wide range of benefits typically have higher premiums.

Deductibles

Opting for a higher deductible can reduce your premiums but may increase your out-of-pocket expenses.

Location

The cost of private health insurance can also vary by region. In some areas, healthcare providers charge higher fees, which can impact insurance premiums.

Additional coverage

If you add extras like dental or optical coverage to your policy, this will increase your overall cost.

Provider and policy

Different insurance providers offer varying rates and policies, so it's crucial to compare quotes and coverage options.

Average premiums in the UK

According to ActiveQuote and BoughtByMany in October 2021, the average price for private health care for one person is £1,115 a year. However, this number can vary greatly depending on your age, your address, your smoking status, claim history, and whether you have any existing health conditions. 

It's important to note that healthcare costs and insurance premiums can change over time, so it's advisable to obtain current quotes and consult with insurance providers for accurate pricing information.

What to think about before investing in private healthcare

While private health insurance provides numerous benefits, it's essential to consider the costs and individual healthcare needs when deciding whether to invest in a policy. Policyholders should review policy terms, including coverage limits, waiting periods, and exclusions, to ensure they align with their expectations and requirements.

Compare private healthcare deals with SpotDif 

Private health care offers a compelling alternative to public healthcare systems, providing individuals with greater control over their healthcare journey.

If you’re considering choosing private medical health care, find the best deal with SpotDif. We’ll compare local health insurers and policies for you, so you can have peace of mind and know your medical needs are taken care of.

Get in touch with us today to find out more.