Private health insurance in the UK pays for private treatment of conditions that start after you take out the policy. It doesn't replace the NHS, and it isn't designed to pay for long-term illness. Understanding that one point avoids most of the disappointment people feel when they come to claim.
What private health insurance plans cover
Private health insurance plans generally pay for:
- Inpatient and day-patient treatment, including surgery
- Specialist consultations and diagnostic tests, with limits that vary by plan
- Cancer treatment, with the level of cover varying between insurers
- Optional extras such as mental health support and therapies
They usually don't pay for emergency care, which stays with the NHS and A&E, or for routine pregnancy and cosmetic treatment.
Individual health insurance plans: how underwriting decides what is covered
| Underwriting | How it works | Suits |
|---|---|---|
| Moratorium | No medical questions up front. Recent conditions are excluded and may become covered after a clear period, commonly two years. Your history is checked when you claim | A quick start when you have little history to declare |
| Full medical underwriting | You declare your history, and each condition is covered, excluded or covered on special terms from day one | Certainty about what is covered |
Chronic conditions, such as diabetes, asthma or high blood pressure, are commonly excluded under both routes, because standard policies are built for new, acute conditions that treatment can resolve.
Ways to cut the cost without gutting the cover
- A higher excess, set at a level you could pay
- A limit on outpatient cover, which keeps consultations and tests within a cap
- A restricted hospital list, in place of access to every private hospital
- A six-week option, where you use the NHS if it can treat you within six weeks and the policy steps in only if it can't
- Employer schemes, worth checking first, because workplace cover is often cheaper than an individual policy
Premiums generally rise as you get older, and insurers can reprice at renewal, so look at the likely cost in five years as well as this year.
Before you buy
- Check what the NHS can offer in your area, and whether faster access is worth paying for.
- List your must-haves: cancer cover, mental health, outpatient treatment, therapies.
- Choose the underwriting, and disclose your history honestly, because a misstatement can lead to a claim being refused.
- Ask what happens to cover for an ongoing condition after the first treatment ends.
- Compare plans with the same excess and the same limits, not just the headline price.
Alternatives
Health cash plans pay small fixed amounts towards everyday costs such as dental, optical and physiotherapy. They are cheaper than full private cover but don't pay for major treatment. Some people pay for a single private consultation or scan instead of holding a policy.
If your main worry is lost earnings rather than treatment, see our guide to income protection and disability insurance.