Is Private Medical Insurance Worth It?

As the name suggests, private medical insurance covers the cost of private medical care. In many cases, private health insurance lets you pay to avoid the queue — accessing diagnosis, treatment, and recovery support more quickly than might be possible through the NHS. 

Most private health insurance policies include inpatient treatment (i.e. stays in hospital) and day-patient care. They will often also cover outpatient consultations and diagnostic tests.

Typically, private health insurance will include:

• Specialist consultations and diagnostic tests like MRIs or X-rays
• Surgery and inpatient treatment
• Hospital accommodation and nursing care
• Physiotherapy and/or rehabilitation following surgery
• Cancer care (depending on the level of cover you have)

As with most things, you get more if you pay more. Higher-tier health insurance policies may also include mental health support, complementary therapies, and access to private GP appointments.

Ultimately, private health insurance providers are running businesses. They need to make a profit, which means they usually won’t cover conditions that have high-risk profiles. For example, policies are likely to exclude pre-existing conditions and emergency treatment. They might also exclude routine pregnancy care. So, for emergencies and general maternity care, you would still rely on the NHS.

Common exclusions include:

• Pre-existing medical conditions
• Chronic illnesses such as diabetes or asthma 
• Dental treatments
• Routine maternity care and childbirth
• Cosmetic or elective (non-prescribed) procedures
• Organ transplants
• Substance misuse treatment
• Experimental or unproven treatments

However, every insurer is different. Some insurers offer add-on options at extra cost for things like mental health and dental cover.

Private health insurance isn’t a necessity in most cases, but it does provide convenience, flexibility, and reassurance. It’s especially beneficial for people who don’t have the flexibility to follow NHS schedules, and for those who prefer to avoid NHS waiting lists.

For example, self-employed individuals may appreciate the extra control over appointment times as it helps to avoid long absences from work. Private treatment can also give an extra level of privacy and comfort that many patients find appealing.

The NHS is one of the best healthcare providers in the world, and gives outstanding care that’s free at the point of use. The aim of private medical insurers is not to compete with the NHS, but to offer a different experience focused on speed, choice, and comfort. Let’s take a look at some of the benefits of PMI compared to the NHS:

Faster access to treatment

Over 7.5 million people waited for more than three months for hospital treatment on the NHS in 2024.  This kind of delay is rare with private treatment. Private insurance allows you to schedule appointments, treatments, and even surgeries much faster than is often possible on the NHS.

Greater choice of specialists and hospitals

With the NHS, you may have some choice of specialists and hospitals depending on your location and circumstances. However, it’s more common for them to be assigned according to availability than patient choice.

There is much more choice in the private system. Private health insurance gives you a degree of control over who treats you and where the treatment takes place. This flexibility is useful for people who need specialised care or who find it difficult to reach some hospitals and treatment centres. 

Comfort and privacy

Private hospitals are typically more luxurious than their NHS counterparts. A private hospital room may offer an en-suite bathroom, a peaceful environment, greater privacy, and flexible visiting hours. While these facilities may not improve treatment outcomes directly, they do make for less stress and more comfort during recovery.

Access to treatments not always available on the NHS

Some drugs and treatments (such as newer cancer treatments and expensive diagnostic tests) are either not routinely available or hard to get through the NHS. Private cover can, in some cases, give access to these.

There is no ‘one-size-fits-all’ cost for private health insurance. What you pay depends on a variety of factors, including your age, your location, the insurer you pick, and the level of cover you want. 

As a very rough guide, a typical family premium (two adults in their 40s and two children under 10) can vary from £700 to £1800 a year. Younger, healthier people with basic cover will typically pay at the lower end of this range, while older people and people who choose more comprehensive policies will pay more. 

You can also expect costs to be higher if you add extras like mental health support to your policy.

There are plenty of ways to reduce the cost of private medical insurance without sacrificing quality of cover. Here are some of the most reliable:

Compare providers

Insurers have a variety of pricing structures, coverage options, and perks. Comparing multiple providers makes sure that you get the best value for your needs 

Choose a higher excess

Opting for a higher excess can significantly lower your monthly premiums. But do make sure the excess is affordable for you in case you need to make a claim.

Limit hospital networks

Many insurers allow you to choose from a network of approved hospitals. Larger networks can be more expensive, but opting for smaller networks can keep costs affordable. 

Consider family policies

If you are covering multiple people, a family policy may work out cheaper than individual plans. Some providers also offer child cover at no extra cost.

Review your cover regularly

Your healthcare needs are likely to change over time. Regularly reviewing your policy makes sure that you are not paying for cover you don’t need and gives you insight into new discounts or policy options that could benefit you.

PMI is not the only way to access private care. There are alternatives, which can offer greater flexibility and (sometimes) lower overall cost:

Self-pay for private treatment

You don’t necessarily need a private insurance contract to access private healthcare. If it's affordable for you, you can pay for private medical treatments out of pocket. Most private hospitals have transparent price lists for common procedures. So if you’re looking for something specific that you can’t get on the NHS, it may be worth looking into self-pay private treatment rather than taking out insurance.

NHS with supplementary health cash plans

You can use health care cash plans alongside your NHS treatments. For example, things like dental and optical treatments are hard to access on the NHS, but with a health cash plan, you can get these done privately and be reimbursed by your insurer. Health cash plans don’t give full private cover, but they can help manage routine expenses.

Critical illness cover and income protection

These types of plans don’t pay for medical treatment, but they do offer financial protection if you have health issues that affect your ability to earn. Critical illness protection will pay out a lump sum if you are diagnosed with something serious. Income protection provides regular payments if you can’t work.