What does family health insurance cover?
Family health insurance covers the cost of private medical care for all family members named on the policy, and many cover options may be available. Some examples include:
Private GP sessions
Many family health insurance policies include access to private General Practitioner (GP) consultations. This allows you to see a doctor quickly and conveniently, often without the long waiting times you may otherwise experience.
Virtual GP sessions
Some policies offer virtual GP consultations and other telemedicine services. This enables you to get medical advice from the comfort of your home, making it easier to manage health concerns without the need to travel.
Facility costs
Family health insurance covers expenses related to hospital stays and treatments, which may include room charges, nursing care and other related expenses.
Diagnostic tests
Coverage may include essential diagnostic tests such as MRI and CT scans. These tests are crucial for the early detection and treatment of various conditions, helping to ensure timely and accurate diagnoses.
Surgical costs
Family health insurance can cover the costs of minor or major surgeries subject to policy terms and cover amounts.
Inpatient cover
Inpatient cover typically includes treatments that require an overnight stay in a hospital. This covers room and board as well as medical treatments received during the stay, ensuring comprehensive care during hospital admissions.
Outpatient cover
Outpatient cover includes treatments and procedures that do not require an overnight stay. This can encompass consultations, diagnostic tests, and minor surgeries, providing flexibility and convenience for various medical needs.
Mental health
Many family health insurance policies provide coverage for mental health services. This may cover consultations with specialists, therapy sessions, and inpatient mental health care if needed, supporting the mental wellbeing of all family members.
Dental and optical
Some comprehensive policies may include cover for dental treatments and eye care. This can encompass routine check-ups, fillings, glasses, and contact lenses.
Health and wellness programmes
Many insurers provide access to health and wellness programmes, which may include fitness classes, nutritional advice, and lifestyle coaching.
Common family health insurance exclusions
While family health insurance provides extensive coverage, it's important to understand that there are certain exclusions you may find when comparing policies. Knowing what isn’t covered can help you make informed decisions and avoid unexpected expenses. Here are some exclusions you may find:
- Pre-existing conditions: Many family health insurance policies exclude pre-existing conditions, which are medical conditions that existed before the policy start date. This means that treatment for these conditions is not covered. Some insurers may offer coverage for pre-existing conditions after a specified waiting period, but this varies by provider.
- Cosmetic and elective procedures: Procedures that are purely cosmetic or elective are generally not covered. This includes surgeries for aesthetic purposes, such as facelifts, liposuction, and breast augmentation, as well as non-essential treatments that are not medically necessary.
- Fertility treatments: Most family health insurance policies do not cover fertility treatments, such as in vitro fertilisation (IVF), artificial insemination, and other assisted reproductive technologies. Some plans might offer limited coverage or discounts, but full coverage is rare.
- Experimental and unproven treatments: Treatments that are considered experimental or unproven are typically excluded from coverage. This includes therapies that have not been widely accepted as standard medical practice or lack sufficient evidence of their efficacy and safety.
- Chronic condition long-term care: While management of chronic conditions may be covered, long-term care and ongoing support for chronic conditions may be excluded. This means that long-term nursing care, home care, or residential care for chronic illnesses may not be covered.
- Alternative and complementary therapies: Although some policies cover certain complementary therapies, many exclude alternative treatments that are not supported by mainstream medical practice. This can include therapies such as homoeopathy, naturopathy, and certain holistic treatments unless the policy specifies otherwise.
- Mental health exclusions: While many policies provide mental health coverage, there may be exclusions for specific types of mental health treatments or conditions. For example, coverage might exclude long-term psychotherapy, treatment for behavioural disorders, or certain types of counselling.
- Self-inflicted injuries: Injuries or conditions resulting from self-harm, suicide attempts, or other self-inflicted actions are typically not covered by family health insurance policies.
- War and terrorism: Any injuries or illnesses that arise as a result of war, terrorism, or similar activities are generally excluded from coverage. This includes both active participation and incidental impacts of such events.
- Routine pregnancy and childbirth: Routine pregnancy and childbirth are often not covered, although complications during pregnancy and childbirth may be. Some policies offer maternity add-ons for an additional premium that cover these aspects, but they are not typically included as standard.
- Dental and optical care: Basic family health insurance policies often exclude dental and optical care, such as routine dental check-ups, fillings, eyeglasses, and contact lenses. These services may be included in more comprehensive plans or as optional add-ons.
- Substance abuse treatment: Treatment for alcohol and drug addiction is commonly excluded. Some policies might offer limited coverage for substance abuse treatment, but extensive rehabilitation and long-term support are generally not covered.
- Vaccinations and immunisations: While some policies might cover routine vaccinations, others exclude them, especially travel-related vaccines or those not deemed essential by the NHS.
- Travel and overseas treatment: Treatment received outside the UK is typically excluded unless your policy includes travel insurance benefits. Even then, coverage may be limited and subject to different terms and conditions.
Would you benefit from family health insurance?
Family health insurance provides a range of benefits designed to meet the needs of families. These policies may offer cost savings, easy management, peace of mind, and access to high-quality care, providing comprehensive protection for all family members. Some benefits you may encounter include:
Cost-effectiveness
- Economical: Family policies may be more affordable than purchasing individual policies for each family member.
- Family discounts: Some insurers offer discounts for family policies, reducing overall costs.
- Free cover for newborns: Some policies automatically cover newborns at no additional cost for a certain period.
Simplified management
- Single policy: One policy covers the entire family, making it easier to manage and renew.
- Unified premium payment: Only one premium payment to handle, simplifying financial planning.
- Flexible additions: Easily add new family members, such as newborns, to the policy.
Comprehensive coverage for the entire family
- Equal coverage: All family members receive the same level of coverage and benefits.
- Inclusion of dependents: Policies may be extended to cover older children.
Enhanced peace of mind
- Security for all members: Knowing the entire family is covered in case of illness or injury may provide peace of mind.
- Reduced stress: Handling health issues may be less stressful when access to care concerns are minimised for the entire family.
Quick access to healthcare
- Private GP sessions: Fast access to private GP consultations, diagnosis and treatment.
- Virtual GP consultations: Convenient virtual appointments from anywhere using a connected smart device.
High-quality care
- Choice of specialists and hospitals: Access to a broad network of private hospitals and specialists, subject to the terms of the chosen policy.
- Advanced treatments: Health insurance may provide availability to cutting-edge treatments and medications that may otherwise be inaccessible.
Comprehensive coverage
- Wide range of services: Includes GP consultations, hospital stays, surgeries, and more.
Mental health support
- Comprehensive mental health services: Your policy may cover you for therapy sessions, specialist consultations, inpatient care and other mental health treatments.
Access to complementary therapies
- Alternative treatments: Coverage may include therapies such as physiotherapy.
Dental and optical cover
- Comprehensive plans: Some policies include dental and optical treatments, covering routine check-ups, glasses, and contact lenses.
Additional perks and rewards
- Health and fitness discounts: Discounts at health and fitness clubs.
- Rewards programs: Access to exclusive deals and discounts for family activities and outings.
Support services
- 24/7 health helplines: Round-the-clock access to medical advice and support.
- Specialist consultations: Direct access to specialists for specific health concerns.
Which providers offer family health insurance?
Many UK health insurance providers offer private health cover for families, and in some instances, they will offer additional benefits such as cost-savings for family policies. Some examples of providers include:
- Bupa
- Vitality
- AXA Health
- Aviva
- WPA
- The Exeter
- Freedom Health Insurance
For a comparison of the differences between each provider’s family health insurance offering, please contact us.
How much does family health insurance cost?
The cost of family health insurance will vary from family to family. To get an accurate cost, we recommend you compare your options, but otherwise, here’s what may have an impact on the price you pay:
- Age of family members: Insurance premiums generally increase with age. Covering older family members may result in higher costs.
- Young children: Including young children in the policy may also affect the premium, although typically to a lesser extent than older adults.
- Pre-existing conditions: Family members with pre-existing medical conditions can lead to higher premiums due to the increased risk of needing medical care.
- Chronic conditions: Conditions such as diabetes or asthma may also result in higher costs.
- Comprehensive plans: Policies that offer extensive coverage, including advanced treatments, mental health support, and wellbeing services, tend to be more expensive.
- Additional benefits: Adding optional extras like dental care, overseas emergency treatment, or premium hospital access can increase the premium.
- Regional differences: The cost of healthcare can vary by region, so where you live may impact your insurance premiums. Premiums may be higher in areas where insurers experience higher claims costs.
- Health and fitness: Lifestyle factors such as smoking, alcohol consumption, and overall fitness levels can affect the cost of insurance. Healthier lifestyles may result in lower premiums.
- Excesses and co-payments: Higher deductibles or co-payments can reduce the monthly premium but may increase out-of-pocket expenses when making a claim.
- No claims discount: Some insurers offer discounts for not making claims, which can lower the cost over time.
- Family discounts: Some insurers, like Bupa and Aviva, offer to cover additional children at no extra cost or only charge for the oldest child, reducing overall premiums.
- Newborn coverage: Free cover for newborns for a specified period, typically up to three months, can reduce initial costs.
- Cashback and bonuses: Some insurers provide cashback for routine healthcare expenses or bonuses for events like the birth or adoption of a child.
- Wellbeing services: Participation in health and wellness programs offered by the insurer can sometimes lead to premium reductions.
How is family health insurance different to other policies?
When considering health insurance, it's essential to understand the differences between various types of policies. Here's a look at how family health insurance differs from individual (personal), couples, and business health insurance.
Individual (Personal) health insurance
Individual health insurance policies are designed to cover a single person. These policies are tailored to the specific healthcare needs and medical history of that individual and offer the following benefits:
- Personalised coverage: Coverage is customised based on the individual's medical history and current health needs.
- Specific benefits: The benefits and coverage limits are specific to one person, making it easier to tailor around their wants and needs.
- Premium costs: Premiums are based on the risk profile of the individual, including age, lifestyle, and pre-existing conditions.
Couples health insurance
Couples health insurance is designed to cover two people, such as a married couple or partners living together. This type of insurance has its own unique features:
- Shared benefits: Both individuals receive the same level of coverage and access to healthcare services under one policy.
- Cost-effective: It can be more cost-effective than purchasing two individual policies, as insurers may provide discounts for couples.
- Joint underwriting: The policy is underwritten based on the health profiles of both individuals, which can affect the overall premium and coverage options.
Business Health Insurance
Business health insurance, also known as group health insurance, is provided by employers to their employees. This type of insurance has distinct characteristics:
- Group coverage: Coverage is extended to a group of employees, and often their families, under one plan.
- Employer-sponsored: Premiums may be covered in full or part by employers (subject to the insurers terms), which may make it a more cost-effective option for employees compared to the cost they would pay for an individual policy.
- Standardised benefits: Benefits and coverage levels are standardised across all employees, although some plans may offer options for additional coverage at extra cost.
- Tax-benefits: The cost of health insurance may be tax deductible from your expenses while providing an employee benefit that may offer many advantages to your business.
Recap: 6 things to think about with family health insurance
We’ve covered some of the core information surrounding family health insurance, such as your cover options, providers, benefits and how it differs from other health insurance types. To help recap, here are some of the key points to remember:
1. Coverage options and flexibility
Different health insurance providers offer various coverage options, from comprehensive plans that include a wide range of medical services to more focused plans that cover essential treatments. Consider your family’s specific healthcare needs and choose a plan that offers the right balance of coverage and flexibility. Look for options that allow you to customise the policy with add-ons like dental care, mental health support, and outpatient treatment.
2. Cost and affordability
The cost of family health insurance can vary significantly based on factors such as age, location, and the level of coverage. Evaluate the premiums, deductibles, and any additional costs associated with the policy. Some insurers offer discounts for covering multiple family members or for adding a spouse to the policy. It’s also worth considering plans that include free cover for newborns or offer cashback for routine healthcare expenses.
3. Access to specialists and hospitals
Check the policy provides the type of access to hospitals and specialists you require. You can choose an extensive list that covers most UK hospitals including those in central London, a comprehensive list for hospitals in your local area or even allow the insurer to provide a list of hospitals and specialists at the time of claiming which can provide cost savings.
5. Comprehensive benefits
Family health insurance should cover a wide range of medical services to address various health concerns. Look for policies that include benefits such as hospital admissions, diagnostic tests, mental health support, outpatient treatment, and comprehensive cancer care. Additional benefits like wellbeing services, discounted gym memberships, and stress counselling helplines can also be valuable for maintaining overall health.
5. Exclusions and limitations
All health insurance policies have exclusions and limitations. Common exclusions include pre-existing conditions, chronic conditions, cosmetic treatments, and treatments related to pregnancy and childbirth. It’s essential to read the fine print and understand what is not covered by the policy to avoid any surprises when you need to make a claim.
6. Convenience and support services
Consider the convenience and support services offered by the insurer. Features like 24/7 health helplines, digital GP services, and online portals for managing your policy can significantly enhance your experience.
Compare family health insurance policies
We offer a free comparison service to help you navigate through the various family health insurance policies available. Our expert team is here to assist you with any questions, compare different insurance plans, and negotiate terms on your behalf. You are under no obligation to purchase a policy through us, but we are dedicated to finding the best possible coverage for your family’s unique needs. To get started, just complete the form below.
