Is private health insurance worth it?

Here in the UK, we know how lucky we are to have the NHS providing free healthcare for everyone who needs it. However, it’s no secret just how strained its services have become, which is why more and more people are turning their attention to private health insurance. Regardless of the cost, many simply want the peace of mind that they can access effective treatment as quickly as possible.

Our advisers frequently encounter customers who are very interested in the benefits of a private healthcare policy, but ultimately don’t know whether private health insurance is worth it. You probably have a lot of questions yourself, which is why we’ve put together this guide explaining everything you need to know about private health insurance.

What is covered by private health insurance?

Put simply, private health insurance covers medical treatment for acute conditions. Unlike chronic conditions like diabetes, epilepsy and heart disease — long-term illnesses that tend to be incurable — an acute condition occurs quickly and suddenly, with resolvable symptoms. Examples include broken bones, burns, flu, heart attacks and pneumonia.

However, the level of cover you receive will depend on the private health insurance you choose. Some will offer limited medical care, while others may give you access to specialists. Every policy falls into one of three categories:

  • Basic: Covers inpatient treatment, which is any medical care requiring a hospital bed or an overnight stay.
  • Mid-range: Covers both inpatient and outpatient treatment. Mid-range cover will often include what we call ‘limited outpatient cover’, which restricts the number of consultations you can claim per year. Some providers will then cover all diagnostic tests and scans in full, while others will only offer limited cover.
  • Comprehensive: The highest level of cover. Details depend on the provider, but the main difference between mid-range and comprehensive cover is comprehensive normally places no limits on outpatient care.

Many providers will also let you include additional health insurance cover options, such as mental health, cancer and private GP cover, if these aren’t already included in your policy.

What isn’t covered by private health insurance?

Private health insurance will not cover everything. For example, emergency treatment isn’t included, simply because most private hospitals are not set up to deal with emergencies . That’s why these services tend to be covered by the NHS. Other exclusions may include:

  • Pre-existing medical conditions (though there are exceptions to this)
  • Organ transplants
  • Pregnancy and childbirth
  • Cosmetic surgery
  • Drug and alcohol rehabilitation

However, we must stress that every provider is different so one may cover something you don’t expect. That’s why we encourage anyone considering private health insurance to call us for free, non-committal advice, and find out if there is a policy that meets all your needs.

What are the benefits of private health insurance?

People take out private health insurance for lots of different reasons, but the main benefits are:

  • Shorter waiting times: The target waiting time on the NHS is 18 weeks for “non-urgent” conditions, but since this is only a target, there still could be further delays. Private health insurance means you’ll be seen much more quickly.
  • Your condition will not be considered “non-urgent”: Many of us will have been in this situation: you are concerned about a symptom or condition but when you approach the NHS for help, you feel short-changed when your condition is described as “non-urgent” and you are placed on a waiting list. Having cover in place ensures that you’ll never feel this way.
  • Specialist treatment and referrals: You can receive a second opinion from a specialist and access diagnostics and treatment which has either been denied to you, or is simply unavailable on the NHS.
  • Choice of consultant and hospital: You can choose where to receive treatment from your hospital list, and may be able to pick a consultant depending on your policy.
  • Access to a private room: In most cases, you’ll be able to access private wards and rooms.
  • More healthcare options: Private health insurance doesn’t mean the NHS is off-limits. You’re welcome to continue using the NHS as much as you like, while still having the option to access private healthcare whenever you choose.

Is private health insurance worth the cost?

It’s commonly assumed that private health insurance is staggeringly expensive, but that doesn’t have to be the case. Of course, premiums will be higher if you require greater levels of cover, but there are also ways to reduce the costs.

For example, you can add excess to your policy, which means you pay a certain amount towards your medical bills in exchange for lower premiums, or you could include a six-week option, where you agree to use NHS services, as long as they’re offered within six weeks. This reduces the likelihood of you claiming on your policy, and therefore decreases your premium. However, it’s important to discuss this with a professional advisor to make sure you understand how such additions affect what you can claim on.

Whether you think private health insurance is good value for money is entirely personal. For many people, there’s no more worthwhile investment than their healthcare, while others are happy to exclusively rely on the NHS (though do remember you can still use the NHS when you’re insured). You need to decide how important the benefits are and what you’d be willing to pay for them. Learn more about the cost of private health insurance, and get a quote from Healthcare Clarity to see which providers offer policies in line with your budget.

Has the coronavirus affected private health insurance?

The coronavirus pandemic is the biggest health crisis the world has seen in decades and, perhaps unsurprisingly, more and more people are contemplating private health insurance as a result. No doubt the virus has emphasised just how useful the benefits can be. For example, it has become very difficult to see a GP on the NHS, but those with health insurance have taken advantage of quick, convenient private GP appointments online. And of course, we all know just how swamped the NHS is with Covid-19 cases, leading to delays across the board. As of January 2021, there were 4.5 million people on NHS waiting lists.

While the coronavirus has certainly highlighted the benefits of private health insurance, it’s also important to note that the pandemic is likely to impact the price. Due to the NHS backlog, we as a broker have seen an increase in claims activity. This means we expect that people who already have cover will be more likely to shop around at their next renewal due to prices increasing as a result of the claims. So, if you are interested in either taking out private health insurance for the first time or switching provider, make sure you use a comparison service like ours to avoid paying more than necessary. All previous medical history and claims are taken into account, and we compare every UK provider to find the best deal for your requirements.

Are there alternatives to private health insurance?

Although private health insurance is certainly the most popular alternative to the NHS, there are other options you may wish to consider:

Healthcare cash plans

Healthcare cash plans (HCPs) are not as well-known as private healthcare, but many employers offer this to their staff as a more affordable medical benefit. HCPs basically let you reclaim some of the costs of everyday treatments, like dental and optical care, though as with private health insurance, restrictions may apply if you have pre-existing conditions. It’s also worth mentioning that things like dental and optical cashback can be included as additional benefits to some health insurance policies.


Rather than paying an insurance provider, some people will make regular deposits to a savings account instead. They can then use this money to cover the costs of private medical care.

Paying for treatment

If you can afford to, you could pay for private medical treatment outright, though this could potentially cost tens of thousands of pounds. Therefore, you may need to be selective about when you go private. For example, you could pay for a private consultation if you want an expert or second opinion, but then be referred back to the NHS for treatment if need be.

Does everyone need private health insurance?

Private health insurance can benefit just about everybody. Even if you’ve never had any health issues in the past, it’s not a bad idea to take precautions in case that changes. However, it’s always worth checking whether your employer offers company health insurance as a workplace perk before opting for an individual policy that will probably be more expensive.

How do you get private health insurance?

If you have decided that private health insurance is worth it, it’s time to weigh up your options. You can start by looking at our health insurance provider reviews so you can see the pros and cons of different companies, then compare policies to find a suitable plan. We can do this on your behalf, and also offer free, expert advice every step of the way. You can be 100% confident that you’ve secured the best insurance for your needs, and will be covered if a health problem arises in the future.