How does private health insurance work in the UK?

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Private health insurance enables access to high-quality healthcare with no delay, making it a very popular choice for people from all walks of life. The market is more competitive than ever nowadays, so it’s relatively easy to find a great policy within most budgets.

To make sure you know what you’re paying for before securing a plan of your own, we’re here to explain exactly how private health insurance works in terms of charges, claims and more.

What is the purpose of private health insurance?

In the UK, private health insurance is designed to cover the cost of private medical treatment for acute conditions. These are short-term, curable health issues rather than long-term, chronic conditions people tend to live with their whole lives. Some benefits of having private medical insurance include:

  • To give you quick access to care at point of need rather than waiting for treatment or a diagnosis onan NHS waiting list, which are currently at the highest ever levels.
  • Control over where and when you are treated, and who by.
  • Access to a private room rather than being on a busy ward.
  • The option to receive specialist drugs and treatment unavailable on the NHS.

However, private health insurance can’t be used for everything. It’s up to you what level of cover you want, so you may prefer to choose a more basic option for the sake of a lower price (provided that the policy still adequately meets your needs). Insurers could also put exclusions on your plan. For example, covering pre-existing conditions can be difficult through some companies, though others may allow it in particular circumstances.

What are the different types of private health insurance?

The type of private health insurance depends on who you want to cover on the policy. The main kinds are:

You can also get international health insurance if you’re going to be overseas for a prolonged period. In addition, you may like to add extra cover so you can access private cancer, mental health and physiotherapy services.

How do you pay for private health insurance?

You normally pay a monthly premium but the cost of your private health insurance depends on many factors including age, lifestyle, medical history, and the cover you’re requesting. You may also be able to claim cashback — known as the NHS cash benefit — if you decide to receive healthcare in an NHS hospital rather than a private one.

How do private health insurance claims work?

Your insurer will pay out on your behalf if you need treatment while your policy is active. For them to do this, you will need to make a claim.

How to make a private health insurance claim

1.     Check your policy details

It’s important to check your policy to see whether you’re actually entitled to make a claim. There may be limits on how much you can claim per condition, for example, or how much you can claim per type of treatment. If you have added a six-week option to bring down the price of your policy, you will also be unable claim on your private health insurance if the NHS can see you within six weeks. Make sure you understand these details to avoid disappointment.

2.     Make your claim

Every provider has its own process, but most will need your GP to refer you to a specialist. You can then contact your insurer and provide the information you need to start the claims process. Some companies will refer you to a specialist without involving a GP. In these cases, you will be able to start the claims process online or over the phone.

3.     Receive your treatment

After your insurer agrees to cover your treatment, you can choose one of the approved healthcare providers outlined in the hospital list on your policy and book an appointment immediately. They will be paid directly by your insurer, which means you don’t need to claim any money back yourself.

How does medical underwriting impact how private health insurance works?

Choosing the right medical underwriting is hugely important, as it can impact the potential exclusions applied to your private health insurance. In a nutshell, underwriting determines how much of your medical history you’ll disclose to your insurer, and how it is used to select exclusions, so we cannot stress enough how crucial it is to get professional advice before you make a decision. We offer free, expert, independent advice here Healthcare Clarity. We’ll be totally transparent, but you have no obligation to follow our recommendations.

Do private health insurance premiums change?

Yes, private health insurance premiums often increase at the point of renewal for a number of reasons, whether due to medical inflation, or a change in your circumstances that means you will be more likely to make a claim. Prices may also rise if you’ve recently made a claim, or simply because you’ve aged into a higher bracket. However, you can ensure you aren’t paying over the odds by having your policy reviewed before you renew it, and potentially by switching providers for a more affordable plan. Get a quote from Healthcare Clarity now to explore the options available to you.