Individual vs. company health insurance cover - Which is best?

Private medical insurance can be taken out by you as an individual, or through your employers company scheme. While you may think both options are equal, there are a number of differences between the two. Company schemes often have access to an exclusive range of benefits, which can boost your policy and give you much more for your money.

Benefits of company policies

  • Subsidised premiums – The reason employers take out private medical insurance is so if you’re unwell you can access the treatment you need quickly, ultimately minimising the time you have off from work. This means that many company schemes are either included for no extra price in your company benefits, or they’re heavily subsidised, so you pay drastically less than if you were taking out a policy individually.

  • Bespoke policies – Large company schemes are big business for medical insurance companies with huge contracts on offer of over £1 million. In order to encourage firms to sign up they offer a highly bespoke service, where your employer chooses the level of cover on the policy to suit the needs of it’s staff. Although individuals don’t get a final say in what the scheme includes, your HR department will be happy to take on board your suggestions.

  • Better underwriting – Companies have access to medical history disregarded underwriting. This is the best underwriting available as no previous conditions are excluded, and cannot be bought on an individual policy. However, just because they can access this product doesn’t mean your company will. Moratorium and fully medically underwritten schemes will be much cheaper, so they could choose to opt for one of these instead.

  • Faster access to treatment– Your company wants its employees to be able to access treatment as quickly as possible. Where individual policies generally always require a GP referral, company cover can side step this requirement in some circumstances. Often with back and neck pain your company cover will be able to send you straight to a physiotherapist rather than you having to wait for a GP appointment and then a referral.

  • Specialist fees – All insurers have fee guidelines that they use when paying specialists. This means they will cover up to a certain cost, which is fine for the majority of specialists. However, if you’re seeing a London specialist or one of the top consultants in the country, they may work outside these guidelines and charge substantially more. With individual cover you would need to meet any shortfalls out of your own pocket, however company schemes have the ability to opt out of these additional fees.

  • Increased discretionary cover – If you’re on a company scheme for a prestigious client, your insurance company could be more lenient. Before claims are denied for many of these policies the claims assessor will need to pass the details on to the account manager. They may opt to cover for treatments and procedures which are normally denied, to maintain goodwill with the company. In the past this has even gone so far as to include purely cosmetic surgery for the directors wife, so the level of discretion is quite considerable!

  • Family cover – For an additional fee you can often add family members onto the policy, this can be much cheaper than taking out individual policies for them.

  • No claims discount – Company schemes don’t offer a no claims discount, meaning you pay the same regardless how much you claim.


  • HR involvement – Some company schemes require you to submit your claim through the HR department first. This means the company gets access to your medical information which you may prefer to keep private. Although they will be bound by confidentiality laws, some employees can find this unsettling and would prefer to go to the insurer directly.

  • Lack of choice – If you take out an individual policy you can pick and choose the elements you want, and design the policy yourself. With a company scheme you have to accept the level of cover they have chosen. This could be great and offer a comprehensive level of cover with all the perks, or you could find yourself with a very limited policy or a high excess.

  • Leaving the company -If you leave the company your cover will end, even if this takes place during the middle of a claim. In some cases individuals are even taken off the policy by the company before they’ve been told their contract of employment has been terminated! This doesn’t happen often, but when it does it can be embarrassing for all concerned.

Generally company medical insurance policies offer better value for money and a more comprehensive policy than most individual policies. Of course, like anything this isn’t always the case, so it’s important to check the terms and conditions carefully to see exactly what your company scheme includes.

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