Private health insurance in the UK: is it worth it, and what affects the price?

In the UK, NHS treatment is free, and in an emergency it works very well. Planned appointments, tests and operations are a different story. The NHS standard is to start treatment within 18 weeks of referral, but many people wait much longer. That's why more and more Polish people in the UK ask whether private medical insurance is worth having. Below I explain what a policy gives you, what it doesn't cover and what the price depends on.

What does private health insurance give you?

The biggest benefit is time. Instead of waiting in a queue, you see a specialist quickly, get tests done and are treated in a private hospital. Cover depends on the policy, but it usually includes:

• Specialist consultationsA quick appointment with a specialist after a GP referral.
• DiagnosticsScans and tests such as MRI, CT and ultrasound.
• Hospital treatmentProcedures and operations as a day patient or with a hospital stay.
• Cancer treatmentFor many policies one of the most important parts of the cover.
• Physiotherapy and therapiesOften with a limit on the number of sessions.
• Online GPAppointments by phone or video, usually available around the clock.

Many policies also let you add mental health support, dental or optical cover.

What does a private policy usually not cover?

It's worth knowing the limits before you sign:

• Conditions you already haveHealth problems from before the policy starts are usually excluded, at least for a while.
• Chronic conditionsFor example diabetes or asthma; policies generally pay for treating acute problems, not the long-term management of a chronic condition.
• EmergenciesIf your life is at risk, you go to A&E in the NHS.
• Pregnancy and childbirthUsually not covered by standard policies.
• Cosmetic treatmentNot covered unless it's part of medical treatment.

How does the insurer assess your health?

When you take out a policy, you usually choose between two methods:

• MoratoriumYou don't fill in a detailed questionnaire, but conditions you've had treatment for in recent years are excluded. They can become covered if you have no problems with them for a set period after the policy starts.
• Full medical underwritingYou give your medical history and the insurer tells you from the start exactly what's excluded. That gives more certainty when you claim.

Which is better depends on your health history. It's one of the things worth talking through with an adviser.

What affects the price?

The premium is worked out individually. The main factors are:

• AgeThe older you are, the higher the premium.
• Where you liveTreatment in London is usually more expensive.
• Level of coverFor example whether the policy includes full diagnostics and outpatient appointments.
• ExcessThe amount you pay yourself when you claim.
• Hospital listA narrower list means a lower premium.
• Smoking and health historySmokers and people with past conditions pay more.

How can you lower the cost?

Private health insurance doesn't have to be expensive. The most common ways are:

• A higher excessYou pay less each month, and more only when you use treatment.
• An outpatient limitFor example a set amount for consultations and tests each year.
• The "6-week option"You use private treatment only when the NHS wait is longer than 6 weeks.
• A narrower hospital listLeaving out the most expensive hospitals in central London.

I have cover through my employer. Do I need my own?

If your employer provides private medical cover, check exactly what it includes and whether your family can join. Remember that it's a taxable benefit, and the cover usually ends when you change jobs. Many people take out their own policy so they're never left without cover.

Is it worth it?

Private health insurance doesn't replace the NHS, but it complements it well. It's especially worth considering if you're self-employed and every week off work means lost income, if a fast diagnosis matters to you, or if you want quick access to doctors for the whole family.

Want to know what a policy would cost in your situation? Get in touch. We'll talk in Polish or English, explain the terms step by step and prepare a free quote.