Private Medical Insurance: Coverage, Costs, and Benefits Explained
Getting sick is not your hand. But getting what you need to stay healthy or recover from sickness is what you can do, and plan for. In the UK, if you get sick and you haven’t pre-planned for it, you can get in trouble because healthcare is expensive in the UK.
We usually plan for a whole month ahead of us for our family. We make a budget, we try to do everything wisely, and to make our budget go smoothly, without delaying utility bills, grocery, etc. And then, suddenly a family member gets sick, one visit to the hospital, bloodwork, and regular treatment, and you are way behind your budget, and it’s not even the middle of the month yet.
To avoid such uncertain emergencies, you need to work with private medical insurance that can save you from financial burden and mental stress at the same time. How does private medical care work in the UK? Keep reading to find out.
What Is Private Medical Insurance?
Private medical care is considered to be better but costly. In the UK, where healthcare services are too expensive to pay out-of-pocket, it is hard to go for private medical care if you don’t want a hit on your monthly budget. But if you have private medical insurance then things become easier for you.
Most citizens are entitled to free healthcare from NHS in the UK, but many people prefer to go private for the healthcare they need. Private health insurance or private medical insurance (PMI) is designed to cover you in case you prefer private medical care for the treatment of any health condition.Most citizens are entitled to free healthcare from NHS in the UK, but many people prefer to go private for the healthcare they need. Private health insurance or private medical insurance (PMI) is designed to cover you in case you prefer private medical care for the treatment of any health condition.
If you want to be facilitated privately for your treatment, without worrying about medical bills, then PMI is for you.
What Does It Do?
Private medical insurance is the type of insurance policy that pays your medical bills completely or partially if you want to take out private healthcare services in the UK.
Healthcare can be quite expensive for a UK citizen who doesn’t want to use NHS, so private medical insurance can kick and take the burden off of your shoulders when you need private care for any health condition, which can cost a lot in case of serious health conditions.
What Does Private Medical Cover?
Private medical insurance mostly covers acute health conditions, meaning injuries or sicknesses that can be treated quickly, so you can go back to your healthy life as soon as possible.
The long-term health conditions mostly fall outside the cover. These days, some policies also cover mental health problems and psychological issues.
Like all other insurance policies, what’s covered in your private medical cover depends on the type of coverage you buy and the insurer you buy it from. But here are the basics that are mostly covered by private medical insurance policies, such as most policies cover:
- In-patient costs, day-care surgery, tests, etc
- Diagnostic tests, x-rays, bloodwork etc
- Consultation charges
- Physiotherapy or any other aftercare that a doctor recommends for recovery
It is important to know that your pre-existing health conditions that you already know about, will be excluded from the cover. Or maybe, if you have any ongoing health condition, you can talk to your insurer and they may facilitate you with the customized policy.
What Isn’t Covered?
Private health insurance can privilege you a lot in the UK if you want to go for private treatment. But it is also important to know that private insurance doesn’t cover everything. Although it depends on the type of policy you purchase and the insurer you choose, here’s what’s not covered by most private health insurance companies:
- On-going or pre-existing medical conditions
- Organ transplant
- Healthy pregnancy and delivery costs
- Cosmetic/optional surgery
- Injuries from dangerous sports
- Chronic diseases such as diabetes, AIDS, Hypertension epilepsy, etc
All these conditions mentioned above aren’t completely restrained from the insurance policies, you can ask your insurer about your concerns with dangerous sports injuries or mental health, depression, etc, and they may customize your cover according to your needs.
How Do I Choose A Private Health Insurance Plan?
Whenever choosing private medical insurance in the UK, make sure that you have done a satisfactory survey in the market and got quotes from several insurers, so then you will be able to choose an insurance policy that fits your medical needs and your budget as well.
Mostly, you will get your private insurance as part of your employee benefit, if not, then you can purchase your insurance from:
- An insurer
- A broker
- Retailer
- Professional financial adviser
- Bank
- It is also recommended to shop around at different insurance websites for better understanding and comparison.
The Pros and Cons of Private Health Insurance
Almost all citizens of the UK have access to NHS healthcare but most people still prefer going private. Here are a few upsides and downsides of private health insurance:
Upsides:
- Specialist referrals: Your general physician can refer you to a specialist or expert so the referral specialist costs will be covered too.
- Scans you need: If NHS denies your scans due to some reason, you can have them done privately.
- Choose your hospital and surgeon: Unlike NHS, you have the option to choose your hospital and surgeon to make it compatible with your location and time.
- Private room: Open ward can be a bit uncomfortable as it is mostly for mixed-sex, so you can get your private room.
- Physiotherapy: Quicker access to physiotherapy that is recommended by your doctor, as compared to NHS, where you might have to wait.
- Special treatments: Some drugs and treatments aren’t available at NHS as they might be too expensive or are prohibited by NICE (National Institute of Health and Excellence in England and Wales) or SMC (Scottish Medicines Consortium).
Downsides:
- NHS is good at various things: If you are suffering from chronic illness such as cancer, stroke, or heart disease, then you might get even better care at NHS than private.
- PMI is expensive: PMI is expensive. It can vary between £700-£1800 per year for a regular family of two adults and two children under the age of 10. Premium prices keep going up every year so it might not be affordable for you later.
- Chronic and pre-existing illnesses are mostly not covered: Chronic illnesses with no cure like diabetes etc won’t be covered by PMI, and pre-existing conditions are usually not covered as well. If you tailor them to your cover, it will increase the price of the premium.
- Lack of local treatment options: You may not be allowed to choose the consultant you feel suitable if it’s not one of those covered by your insurance.
Difference Between Private Medical Insurance And Health Insurance:
A few key differences between private medical insurance and health insurance are:
Private Medical Insurance
Coverage: PMI can be extensive and provide immediate and effective treatment options.
Cost: PMI is expensive due to the wide range of facilities provided.
Care: PMI bypasses waiting time and provides quick treatment.
Health Insurance
Coverage: Health insurance provides basic financial assistance for specific or serious health conditions.
Cost: Health insurance is cheap but offers limited facilities.
Care: Health insurance can be complemented with NHS so you may have to wait for your turn.
Do You Need Private Health Insurance?
If you prefer going private for your healthcare then you should buy private medical insurance. Otherwise, purchasing PMI or not is totally up to you.
In the UK, most citizens get their free healthcare from the NHS, but if you need a wider range of facilities, specialists, and hospitals according to your comfort and convenience, then you should purchase PMI. It mostly depends on your health condition, financial situation, and personal preferences.
Conclusion
In the end, we conclude that Private Medical Insurance is not a necessity, but you can go for it if you prefer quick and effective healthcare with an extensive range of specialists, consultants, and an enhanced hospital experience.
If you find NHS useful, as you don’t have to go for specialist care frequently, then there is no need to spend extra money on PMI, as you may not be able to afford it as you grow older.
