Can I use NHS Hospitals if I have health insurance?

Jan 17, 2018
NHS hospitals

The short and simple answer is yes you can – the NHS provides free, universal access to anyone who is “ordinarily resident” in the UK (and even visitors to the UK are entitled to free emergency treatment, treatment for certain infectious diseases, whenever psychiatric treatment is ordered and to family planning).

If your immigration status allows you to live in the UK, therefore, you are entitled to receive the full range of NHS services – and the fact that you have private health insurance does nothing to detract from that right.

But that simple and straightforward answer rather begs another question – if the NHS is free and universal, why have private medical insurance?

Private medical insurance and NHS services working together

Typically, private medical insurance is designed to supplement NHS services, and not to replace them. Even if you have such insurance, you may still see your consultant on a private basis and use NHS hospitals for the treatment you need.

Indeed, there are some medical health services which your insurance is unlikely to cover – these might include:

  • treatment in accident and emergency departments;
  • visits to your GP;
  • the treatment of pre-existing conditions that may have been excluded by your private medical insurance policy;
  • infertility, pregnancy and childbirth;
  • organ transplants;
  • treatment of chronic conditions and illnesses, such as asthma or diabetes;
  • cosmetic surgery (including laser eye surgery); and
  • most forms of dental surgery.

Some people consider it to be unfair that those who are able to afford private medical insurance continue to use NHS services provided in NHS hospitals – an opinion published in the Guardian newspaper on the 11th of September 2017, for instance.

It might just as easily be argued, however, that the close working relationships between private medicine and publicly-funded NHS hospitals work to the benefits of both:

The combination of providers and sharing of facilities prevents an unnecessary duplication of scarce medical resources, in terms of qualified, professional talent and the infrastructure of buildings and facilities maintained and shared by NHS hospitals and private hospitals (whether independent or shared with the NHS);

The existence of private medical providers allows the NHS to out-source services and patient demands which it might not otherwise have the capacity to meet – as described in a report in the Financial Times on the 26th of March 2017;

Medical research funded by the private sector increases knowledge and helps to develop techniques and treatments which are ultimately to the benefit of all patients, whether treated by the NHS or private medicine; and

NHS guidelines enforce as clear a demarcation and separation as possible between treatment on the NHS and private treatment – so avoiding any blurring of the two systems to the potential detriment of NHS patients.

Private medical insurance

The nature, scope and level of private medical insurance you buy help to determine the balance between your use of NHS and private healthcare. The more elaborate your insurance plan – and the more you pay for it – the more comprehensive your choice of private facilities rather than the NHS.

Thanks to the considerable number of different plans, your choice is extensive. That is what makes a thorough and carefully informed health insurance comparison so essential.To help you make that comparison, by comparing the relative cost of one plan over another, you might want to refer to the health insurance quotes available through our partnership with Assured Futures.

Although this reveals a wide choice, the general benefit of private medical insurance is that it gives you:

  • the possibility of avoiding NHS waiting lists – a report in the Financial Times on the 30th of November 2017, revealed that these have already reached their longest in a decade and this winter’s increased demand on NHS services has only exacerbated the problem;
  • access to leading consultants of your choice – and the retention of that same consultant throughout your treatment, rather than the different ones to whom you might be referred during the course of NHS treatment;
  • your own private, en-suite room in private hospitals or the private facilities of NHS hospitals;
  • care by a higher ratio of medical and nursing staff than you might receive in NHS hospitals; and
  • your choice of higher quality meals.

As previously mentioned, health insurance is a supplement to services provided by the NHS and is typically designed to kick into action for treatment (including tests, examinations and surgery) for essential medical conditions – referred to as “acute” conditions – which are likely to respond well to prescribed courses of action.

This includes cover for treatment you receive when you need to stay in hospital for a night or more (inpatient treatment) and the consultations and tests you need before and during admission.

This may also include treatment you receive on an outpatient basis – although some health insurance plans may cap the cost of such services or offer a more limited range of possible treatments.

Depending on the plan you choose, you may also have access to drugs and procedures which are currently not available through NHS services – although all medication you are prescribed has still been approved by the National Institute for Health and Care Excellence (NICE).

More comprehensive – and expensive – health insurance plans may include additional benefits, such as access to private ambulances, nursing in your own home, complementary therapies, accommodation for you when your child is in hospital and a 24-hour telephone line for help and advice.

A careful comparison of the many different types of health insurance plans available is essential for discovering the nature and scope of benefits provided, together with the costs of each policy. But you must also take into account your current state of health and whether you have any pre-existing medical conditions.

As a guiding principle, health insurers look to cover conditions and illnesses which are newly diagnosed and likely to respond quickly and successfully to treatment. As a result, you may find that many pre-existing conditions are specifically excluded from your health insurance or make it more difficult to obtain the protection you want. Once again, a careful comparison of competing plans may help to identify those insurers more likely to provide the cover you need.

NHS or Private Healthcare?

Why not take a look at what you get with health insurance

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