Is private health insurance affordable?

Is private health insurance affordable? main image

You can tell it’s winter time – that’s when National Health Service (NHS) hospitals are typically packed to the rafters, nursing shortages are more evident than usual, and even doctors complain about the NHS operating under “third world conditions”, while waiting times for treatment continue to lengthen.

Further evidence comes from the British Medical Association (BMA) itself, which declared in a statement on the 22nd of January 2018 that the NHS is not just under pressure but at “breaking point”.

In response to long waiting times on the NHS, many people turn to private health insurance – but, is it affordable health insurance?


Affordability is extremely difficult to manage of course – it all depends on your personal means and circumstances. What may be affordable to one person, may strike another as expensive.

Another fundamental principle to keep in mind when considering affordability is that, in the UK, private healthcare is a supplement to and not an alternative to the services provided by the NHS.

In countries such as the United States, where public spending on healthcare provision is much lower, private medical insurance premiums need to finance a much greater proportion of services provided – and insurance premiums need to be correspondingly higher.

In the UK, therefore, the principal advantages of private medical insurance include:

  • the ability to avoid – or substantially reduce – time spent on NHS waiting lists;
  • your choice of consultant and, in many cases, choice of private hospital for treatment;
  • higher standards of inpatient care, including private, ensuite rooms, private telephones, TV and quality menus;
  • access to drugs and treatments which might not be available through the NHS; and
  • more flexible or unrestricted visiting times for family and friends.

The amount you pay for your health insurance determines for many and how readily you may access these benefits. But health plans vary enormously, and it is essential to compare health insurance quotes from multiple providers to match your needs and circumstances to the benefits available.

If you are looking for cheap health insurance, for example, your choices are inevitably more restricted.

Since the best health insurance is the health plan that most suits your individual needs and circumstances, it may be helpful to take a closer look at some of your options when comparing health insurance quotes.

“Self-pay” health cover

Amongst the more affordable or budget options are so-called self-pay health schemes – which are not health insurance policies in their strictest sense, but health cash plans.

Healthcare cash plans typically cover the day-to-day costs of staying fit and healthy (such as dentist and opticians’ appointments plus prescriptions for spectacles), plus some complementary treatments including physiotherapy.

With self-pay health insurance, you may opt for private health consultations and treatment as and when you need it, with the scheme providing reimbursement of a percentage of the costs you have met.

Do note, however, that the amount you can receive every year will be limited and will not cover the costs of any surgery required.

“Stop-loss” health insurance

Another potentially affordable health insurance option is what research by the King’s Fund describes as “stop-loss” health insurance – where you meet, say, the first £1,000 or £2,000 of the cost of private medical treatment.

In other words, this has the same effect of choosing a high excess on any claim you make under your health insurance policy.

Insurance to avoid long waiting lists

Some of the more affordable health insurance plans may also kick in only when NHS waiting times exceed a given limit – if the NHS is expecting you to wait longer than a specified time, only then does your health insurance come into action to provide private consultations and treatment.

Selective coverage

You may also find that some cheap health insurance plans are restricted to cover for specified illnesses and conditions only – such as cancer treatment or heart diseases.

Comprehensive health insurance

What you might consider to be the less affordable health insurance options are the various schemes that offer some form of comprehensive cover. It may be interesting to note the King’s Fund’s comments, however, that although an estimated 11% of the population has some form of private medical insurance, by no means all have comprehensive cover.

Amongst these more comprehensive forms of private medical insurance, there are broadly two distinct types:

Moratorium underwriting

  • such policies typically require a generally less detailed medical declaration, but any pre-existing medical conditions or those from which you have suffered in the past few years are likely to be excluded from cover – although that cover may be reinstated once you have been symptom-free for a prescribed period;

Full medical underwriting

  • although some people may regard this as the best health insurance in terms of its comprehensive cover, it requires the completion of a detailed medical questionnaire, which may also need input (with your permission) from your GP;
  • with the more comprehensive cover it offers, full medical underwriting also tends to be the most expensive type of private medical insurance.

In sum, private medical insurance is designed to meet individual health needs and circumstances. Affordable options are available, and this helps to account for the fact that by no means all health insurance offers entirely comprehensive cover.

Affordable health insurance?

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