Why do I Need Health Insurance ?

Private health insurance (also known just as health insurance) is supplementary to what is available on the NHS.

If you don’t already have it as part of your employee benefits package, and you can afford to pay the premiums, you may decide that it’s worth paying extra to have more choice over your care.

What is Health Insurance ?

Most residents in the UK have the right to NHS free health care. However, when you are treated privately, health care insurance covers all – or part – of your medical costs. This gives you a choice over the quality of treatment you receive and where you get it.

You don’t have to have private health insurance – but if you don’t want to use the NHS, you may find it tough to pay for non-insurance covered health-care services, particularly with severe illnesses.

Why Need Health Insurance

Why do you Need Health Insurance?

Health insurance, also known as private medical insurance, is intended to guarantee that you don’t have to think about hospital waiting queues or bills for the cost of treatments should you seek medical attention.

When you are personally covered, all or part of your bills will be paid by the health insurance cover.

A health insurance cover allows you to get promptly diagnosed and treated by a specialist at a reliable hospital whenever you need such medical care.

With such a cover, you’ll have a choice of a private hospital on your insurer’s approved list – most hospitals offer a private en-suite bed, television, and a variety of food that you wouldn’t normally receive as a regular patient.

What Does Health Insurance Cover?

The cover you get from private medical insurance, like any insurance, depends on the package you purchase.

Basic private medical insurance typically covers the risk of most in-patient procedures (tests and surgery) and day-care activities.

Some plans apply to out-patient services (such as specialists and consultants) and pay you a small fixed sum for each night you spend in an NHS hospital.

What Does Health Insurance not Cover?

Your health policy does not usually cover private care for:

  •         organ transplants
  •         pre-existing medical conditions
  •         normal pregnancy and childbirth costs
  •         cosmetic surgery to enhance the appearance
  •         war-related or extreme sports-related injuries
  •         chronic diseases such as HIV / AIDS, epilepsy, asthma, hypertension and other related diseases.

You may be able to select a package that includes mental health, depression, and injuries due to sports but they are not always covered.

Who Doesn’t Need Private Medical Insurance Cover? 

You don’t need private health insurance if:

  •         you’re able to rely on the NHS for your treatment
  •         you already have medical insurance through your work benefits plan
  •         you only have spare cash for basic insurance, such as car and home insurance (and life insurance if you have dependents)

·         you have debts to pay that require funds that should otherwise be used for health insurance

Pros and Cons of Health Insurance

There are a number of benefits to private health insurance. Usually, private cover allows you access to additional medical services, shortened waiting times in hospitals and a broader variety of specialised care, as well as a private space.

Other advantages include:

  •         Going down the private path ensures you’ll have access to treatment immediately, on demand. Relying on the NHS may mean waiting for treatment for a very long time, particularly for the rarer diseases which require specialist expertise.
  •         You will have access to a broader variety of services as well. Private clinics provide a broad variety of services from the most basic to the most advanced, which may provide you with ongoing rehabilitation therapies such as physiotherapy, much of which might not be readily accessible while dependent on the state.
  •         In certain cases, whether because it is too expensive or not available in state hospitals, you might be able to get the care that is not available at all through the NHS.
  • .     More flexibility and privacy. You can choose your own hospital and doctor yourself, and you can get your own private room.

Disadvantages include:

  •         The only drawback of private medical insurance is that all the flexibility and extra services it affords ultimately come at a premium.
  •         The price you pay depends on your coverage and whether or not you want to insure only yourself, or members of your family.
  • It is important to remember that not all things are protected by private insurance. This insurance cover may also exclude medical conditions such as diabetes, heart disease, high blood pressure and certain incurable cancers.       

Choosing the Right Health Insurance Policy and Cover

A robust package can cover a wide variety of services.

By selecting the cheapest insurance which covers all the care you think you would need, you might save money.

Many “pick and mix” policies require you to select precisely the cover that you need and set a price depending on your choice. That can be the best way to get a policy that covers all you need.

For example, you might select a package covering hospital visits, prescriptions and physiotherapy but not the expense of dental or homeopathic therapies.

To choose suitable health insurance, take time to find out:

  •         What illnesses and injuries you’d like to cover
  •         What treatment types you want to cover

You can then find coverage using health insurance comparisons online, which show a variety of providers and what their plans are providing.

You can also get offers from a broker for health insurance by either entering the details online or speaking with them by phone.

Then you can compare the quotes to find the right coverage by checking:

  •         That they give all the cover you need
  •         The premium cost (usually charged monthly)
  •         The excess you have to pay if you make a claim
  •         Any limitations to how much or how frequently you can make a claim
  •         Whether there is a waiting time (i.e. how long you have to wait before you can make a claim)
Typical Health Insurance Cover

What is Included in a Typical Health Insurance Cover?

Full Medical Underwriting

There are usually two main forms of cover. The first one is complete with medical underwriting. It ensures that when you apply for a policy you are expected to report your full medical history. You can contact your doctor to check this. Most insurers can only provide full medical underwriting to clients over 75 years old.

Moratorium Underwriting

The second form of cover is with underwriting of a moratorium. That means you are not initially compensated for any pre-existing medical conditions for a period of time specified by your insurer – typically 2 – 5 years.

You can then be compensated for such conditions as part of the terms of your policy for a specified period of time. If you have any pre-existing conditions, make sure that you contact your insurers to find out to what extent you will be protected.

Inpatient Treatment

The vast majority of health insurance policies cover inpatient treatment, which ensures you will be able to stay overnight for one night or more at a hospital until your cover has been arranged.

You can pick a private hospital room from a pre-approved list of hospitals that can be covered by your insurer. Your insurance must cover all treatments, examinations, medications and the expense of your stay.

Outpatient Treatment

Some plans cover outpatient care, which is when you would need to see a doctor or specialist that does not require a stay in a hospital overnight. Often this means smaller operations or therapies.

In certain health insurance plans, outpatient care is not always provided automatically, so if you want this, make sure you ask your insurer when you set up your policy.

Buying health insurance in the UK

Comprehensive insurance is considered to be the best private health insurance in the UK. This is considered the strongest because it covers a broader variety of procedures and conditions. However, is isn’t always the cheapest alternative.

Some insurance plans allow you to pick what they will cover and base the price on that. With a Health Insurance calculator, you can compare health insurance plans after you have determined what you want.

Compare quotes for health insurance by looking at the cover, the rate, the premium and any claim limit.

How Do Health Insurance Claims Work?

You are already beginning your insurance claim before you even make an appointment. The insurance carrier is only responsible for paying benefits that are provided by your contract, so before you agree to anything with your doctor or pharmacist, you should do some homework to avoid getting surprised.

Do not hesitate to ask for clarification from your insurance agent on something you don’t understand. Thoroughly read the agreement and know what’s covered. This is especially relevant when something such as an illness needing care not included in your policy comes up.

Your doctor will give the bill to an insurance claims collection centre after you have paid for your treatment. The collection centre gathers all necessary information from your doctor — the patient history sheet, admission forms and correct documentation for the services.

These are compared with an overview of benefits provided by the insurer to see if the policy covers the services. If so, the insurance carrier must make payment for the amount left. If not, you are responsible for any amount left after the payment.

Health Insurance Claims

Quick Facts About Health Insurance

  •         The total premium for British private health insurance is £1,435 a year
  •         More than half (53%) of the UK population agreed that they would pay for healthcare insurance if they could afford to

·         13% of UK households claim to subscribe to a private health insurance scheme


UK’s average private health insurance premium is £ 1,435 per annum. However, you could pay even less for health insurance, depending on the factors affecting the premium.

The NHS can handle treatments for conditions covered by private insurance. However, you may have to wait longer for services in the NHS where there is an increase in demand for healthcare.

This is entirely based on your personal preferences and circumstances. For example, health cover offers you just what you need if you want assured, quick access to medical care. But if you’ve recently purchased property or started a family, life insurance is a smart way to protect the financial security of your children, should anything ever happen to you.

There is more than one way to keep your health and life insurance costs under control. You have two primary choices with health insurance. Firstly, in the same manner as home or auto insurance, you can pick an excess – the higher the limit you choose, the lower the premium.

Secondly, by doing things to boost your insurance rating, you can save on your renewal premium which would limit any changes to the cover.

While most people would generally accept the NHS only as an alternative to a health insurance plan, there are also other alternatives.

Critical disease cover can be used to cover payments for treatment for particular serious health issues.

Healthcare cash plans which spread the cost of the healthcare expenses of your family or yourself into a monthly schedule are also available. They also come with other incentives such as routine check-ups, and dental care money back schemes.

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