What is private health insurance?
Private medical insurance (PMI) covers the cost of private medical treatment for acute conditions — illnesses that respond to treatment and from which you're expected to recover. It gives you faster access to diagnosis and treatment, greater choice of specialist and hospital, and private rooms rather than NHS wards.
It does not replace the NHS — it complements it, particularly for conditions where speed of treatment matters (cancer, heart conditions) or where NHS waiting times are long.
What does private health insurance typically cover?
- Inpatient treatment (operations, overnight stays)
- Day-patient procedures
- Outpatient consultations and diagnostics
- Cancer treatment (drugs, radiotherapy, chemotherapy)
- Mental health treatment (on many modern policies)
- Physiotherapy and therapies (on comprehensive plans)
⚠️ Private health insurance does NOT typically cover: GP visits (though some newer products do), A&E and emergency treatment, chronic conditions (pre-existing conditions are usually excluded), cosmetic surgery, or pregnancy and childbirth.
What it doesn't cover
Understanding exclusions is critical when choosing a policy. Most standard PMI excludes:
- Pre-existing conditions: Conditions you had before the policy started (there are different ways insurers handle this — moratorium or full medical underwriting)
- Chronic conditions: Ongoing conditions like diabetes, asthma, or arthritis — PMI is for acute conditions
- NHS-available treatment: Some policies won't pay for treatment available on the NHS within a set waiting time ("NHS redirect" clauses)
How much does private health insurance cost?
Premiums vary widely based on age, health, the level of cover, excess chosen, and the insurer. Rough monthly indicatives:
- Single person, age 30, standard cover: £40–80/month
- Single person, age 45, comprehensive cover: £100–180/month
- Family of 4, age 40s: £250–500/month
Adding a voluntary excess (e.g. £250–£500 per claim) significantly reduces premiums. Choosing a "six-week option" (where the insurer only pays if NHS waiting time exceeds 6 weeks) is another common way to reduce cost.
Individual vs company private health insurance
Many employers now offer PMI as a benefit. Company schemes often offer better value than individual policies due to group pricing. If it's available through your employer, this is usually the most cost-effective way to get cover.
💡 Even if you have employer PMI, a personal policy may be worth considering for continuity of cover between jobs and for conditions that develop while employed.
Is private health insurance worth it?
In the current NHS environment — with waiting times for specialist appointments and elective procedures running into months or years in many areas — the case for PMI has strengthened considerably. For people who can't afford to be out of action waiting for treatment, or who want peace of mind about speed of access to cancer and cardiac care, it represents genuine value.
The key is choosing the right policy for your circumstances and budget — which requires comparing the full market, not just the most-advertised brands.