What is the difference between Inpatient and Outpatient cover?

Inpatient and outpatient cover are two common aspects of private medical insurance. Learn what these terms mean and how we find you the best healthcare plan.

Inpatient Cover

Inpatient cover applies to any treatment that requires a hospital bed overnight. This usually follows surgery but also includes day-patient cover for minor procedures requiring a hospital room, but you can be discharged on the same day.

Inpatient treatment is included as standard in most private health insurance policies.

What is usually included with inpatient cover?

  • Fees for the operation and any drugs required
  • Fees for medical staff like surgeons, anaesthetists and nurses
  • Pre-surgery checks
  • Private recovery room, other medical facilities and catering

Outpatient Cover

Outpatient cover pays for diagnostic tests and consultations that do not require a hospital bed overnight, such as blood tests, X-rays, MRI and CT scans. Many providers also cover minor procedures like wart removal or endoscopies under an outpatient option.

What are the different levels of outpatient cover?

  • Capped outpatient cover: Your provider will cover between £500 and £1,500 of outpatient benefits, so you may need to fund some diagnostics and tests yourself. MRI, CT and PET scans are usually fully covered.
  • Capped outpatient cover with full diagnostics:  Your insurer caps the number of consultations they pay for but covers ALL diagnostic tests in full. Strangely, this is a similar price to the previous option, and sometimes cheaper even though the cover is greater. However, it’s currently only offered by three providers: AXA PPP, The Exeter and Vitality
  • Full outpatient cover: There are no limits on consultations or diagnostic tests. This is the most expensive option as this is what most people claim for.

Should I add outpatient cover to my health insurance policy?

Many of our clients get private health insurance because they want quick access to consultations, tests and treatment. 

If this is important to you as well, then a reasonable level of inpatient and outpatient cover will let you skip NHS waiting lists. Contact our health insurance specialists to get advice on the best option for your requirements.

What is the best health insurance for inpatient and outpatient cover?

With the many options for health insurance plans and companies, it’s essential to know the most important factors to consider when making a decision. Here are some of them, as collated by our experts or experienced brokers and advisors:

Standard and Additional Coverage

Most insurers cover common acute conditions and tests, but you’ll find some that include other essentials in their standard coverage. One that’s starting to become a focus of the NHS and private health insurers is mental health. That’s all due to the COVID-19 pandemic, which further emphasised its importance.

You’ll find providers that include limited consultations and sessions with mental health professionals. You might think you won’t need this type of coverage, but unexpected life circumstances can negatively affect anyone’s mental and emotional health.

Insurers that cover or allow you to add (at a reasonable rate) alternative treatments and other therapy services like chiropractor, homoeopathy, and osteopathy are also some of the best. At some point in your life, you would need these services to enhance the positive effect of your current treatments or medications. Other important levels of cover to consider are dental and optical services.

Good Network of Healthcare Professionals, Hospitals, and Clinics

Remember that not all healthcare providers and facilities accept private health insurance plans or only accept particular private health insurance policies. If the insurance company’s providers list won’t include most of the nearest facilities and professionals in your area, it defeats the purpose of getting one. Also, if you’re more comfortable with your current GP, we highly recommend considering an insurer that they accept for payment.


Pre-existing conditions are the number one reason you’ll get rejected by a specific insurer, which is understandable. However, some will approve you for a policy at a higher premium rate. Although some can be dismayed by this, it will work in your favour in the future.

The additional cost every month or year will usually not be equivalent to your out-of-pocket expenses for your regular physician visits, medications, and tests. The same goes if your current health issues worsen.

Another way to evaluate cost-efficiency is the other perks or benefits you’ll get from the insurance provider, such as gym memberships. It might seem minor, but these will help you save on other wellness and lifestyle activities or items that usually take a toll on your budget.

From the information above, it’s clear that different health insurance providers offer varying levels of inpatient and outpatient cover, which is why we compare all UK companies to find you the best deal. Whether this is your first time seeking health insurance or you’re simply looking for a new provider, we will help you secure a policy that meets all your needs and offers excellent value for money.

Why is it important to seek advice on inpatient and outpaitent cover?

You’ll benefit from professional advice when choosing private health insurance. Talking to a specialist can help you decide what you require from your policy, prepare you for the long-term costs, and assess existing plans to see whether you can get a better deal elsewhere. At Healthcare Clarity, we’re here to provide all the guidance you need, so don’t hesitate to get in touch.

Inpatient and Outpatient FAQ's

All health insurance policies have different levels of cover, and providers take various factors into account when setting a price, like your age, location and lifestyle. We are here to answer all your questions, provide professional advice, and assess all your options to find the best plan for your budget.

Inpatient cover is typically included in any private health insurance policy automatically. However, the same isn’t true for outpatient care, although the majority of providers fully cover MRI, CT and PET scans. If you don’t have outpatient cover, you will need to rely on the NHS for diagnostic tests and scans, which could take significantly longer and, therefore, delay access to your inpatient treatment. However, if you have outpatient cover, you’ll be diagnosed and treated privately and receive quicker care overall.

Private health insurance cover options

Inpatient & Outpatient

Inpatient cover applies to treatment requiring an overnight hospital bed, while outpatient is for tests and consultations where a bed isn’t necessary.

Private GP

Avoid long NHS waiting lists, and instead see a private GP at your convenience.

Mental Health

Mental health insurance can cover a range of conditions, such as anxiety, depression, PTSD, and substance abuse.


Receive private physiotherapy treatment to get back on the move as quickly as possible.


Cancer cover lets you skip NHS waiting lists and even access drugs and procedures only available to private patients.


Learn about some of the additional benefits you can add to a private health insurance policy.

Types of health insurance

Whether you want to protect your family, your business or yourself, we can find the policy for you. Choose from any of the private health insurance options below:


Discover what the benefits are of having your own private health insurance policy.


Ensure your loved one's are protected and get the chance to receive quick treatment.


Private health insurance plans that are there to cover both you and your partner.


Find out more about private health insurance for your child or children.

Over 50s

Keep doing the things you love with health insurance that will allow quick treatment.


Keep your employees happy and healthy with a private medical insurance plan.