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There’s a great deal of misunderstanding surrounding what private medical insurance (PMI) actually is, and the benefits it can provide to customers. Making an informed decision now will ultimately spare you disappointment in the future. PMI isn’t the right choice for everyone, so it’s important to know the facts upfront before committing yourself to an expensive policy.

What is private medical insurance?

Private medical insurance is designed to pay your medical bills if you’re treated privately. Individuals can choose to take out a policy directly, or it can be included within an employee benefit package, where it’s administered through a company scheme. The big four UK insurance companies are bupa healthcare, aviva health insurance, vitality health and axa ppp healthcare.

What does medical insurance include?

  • Treatment for acute medical conditions – Private medical insurance is designed to cover acute conditions. These are illnesses and injuries which are relatively sudden in onset, whereby after treatment you make a full recovery to your previous state of health. Some examples of acute conditions are broken bones, haemorrhoids and cancer.

  • Specialist fees – Your insurance is designed to cover all your specialist bills. These are surprisingly expensive, with just a short consultation costing up to £250 or more in the case of some London specialists.

  • Hospital fees – Your policy will pay for your treatment at a private hospital. This will include procedure costs, nursing care, your own private room and any drugs and dressings you need while you’re in hospital. When you take out your policy you will be asked to opt for your preferred hospital list, consider this carefully as although some lists are cheaper than others they may not include the facilities you want to use.

  • Secondary care – Medical insurance policies are designed to cover you from the point you’re referred onwards by your GP to a hospital specialist, this is known as secondary care.

  • Emergency admissions – If you’re admitted to an NHS hospital in an emergency situation, your policy will cover you to be transferred to private hospital via a private ambulance when you’re well enough to be moved.

  • Planned procedures – These are procedures you’ll know in advance that you will need, such as a scheduled knee operation or planned heart surgery.

  • Diagnostic scans – Your insurance will cover the scans your specialist needs to diagnose your condition. These include ultrasound, X-ray, MRI, CT and PET scans.

  • Planned treatment regimes – Sometimes you need regular treatment to get better, your insurance will generally cover this if it’s recommended by your specialist. This can include courses of chemotherapy, or a block of physiotherapy sessions.

5 Benefits of private medical insurance

  • Speedy access to the treatment you need, without the inconvenience of NHS waiting lists.
  • Increased choice, including the ability to decide which specialist will treat you and the hospital you want to use.
  • Comfortable facilities such as your own private room with an excellent range of food choices.
  • The added convenience of being able to fit your medical appointments and procedures around your lifestyle.
  • Access to expensive drugs that are not yet covered on the NHS.

4 Drawbacks

  • Cost – If you’re struggling to afford private medical insurance then you should be aware that the costs will increase year on year. For the elderly and many others this can prove to be prohibitively expensive.

  • Not all treatments covered – Your insurance is only designed to cover you for acute conditions so if you have an ongoing chronic condition you may not be able to obtain any benefit under your policy.

  • No private GP cover – You will still need to use your NHS GP to obtain a referral to a specialist.

  • Policy restrictions – Some policies are better than others and it’s vital to read the small print so you know what you’re signing up for. Outpatient limits and large excesses can mean that some policies will only provide a minimal benefit.

Do you really need private medical insurance quote?

Private medical insurance offers people increased choice surrounding their medical care and can provide a valuable supplement to the services of the NHS. However, it doesn’t suit everyone and some people prefer to save their money and just pay for private treatments when the need arises.

On average you can expect to be seen on the NHS in 7 weeks, with only 1 in 10 patients waiting longer than 18 weeks for treatment.

Although NHS waiting lists can be long the extent of this has been hyped by the media. On average you can expect to be seen on the NHS in 7 weeks, with only 1 in 10 patients waiting longer than 18 weeks for treatment.

Whether you need private medical insurance is largely down to personal choice and your individual circumstances. If you can afford it then you’ll benefit from increased convenience and flexibility, but the same quality of specialists are available on the NHS so you won’t be getting any preferable treatment. Our national health service is internationally regarded as one of the best in the world, so whether you opt for private cover or not you can be secure in the knowledge that you’re in safe hands.

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