What is health insurance? Everything you need to know

‍What is private healthcare?

Before we jump into the world of health insurance, it’s important that you understand what private healthcare is; the pros, cons, and how it works. Once you know all of this, you’ll be able to make a better decision about which policy is right for you.

So, what is private healthcare? It's a way to access high quality, fast treatment and is usually offered by businesses or taken up by an individual.

How to get private healthcare

Private healthcare can be accessed in a few different ways, and you have a lot of choices when it comes to the services you purchase. Here are the main ways people go about getting private healthcare:

Pay as you go private healthcare

Many providers offer a ‘pay as you go’ option, which means you’ll have access to all of their resources such as online booking and GPs, but your treatment won’t be covered by an insurance policy. You’ll only pay for the services you use, but this can often be higher than an annual insurance premium.

Health insurance

You’ll pay a monthly or annual premium for a policy that covers a set range of treatments. Not everything will be included, but by considering the options available, you can get an affordable private health insurance policy that best suits your needs.

Benefits of private healthcare

Private healthcare gives you a choice in many of the decisions that are otherwise made by the NHS. You can decide where, who and when you receive your treatment, and you’ll benefit from high-quality facilities. You’ll usually need a referral from a private or NHS GP before accessing private healthcare, but the option of using the NHS is always available to you, regardless of if you have health insurance or not.

What is health insurance?

Health insurance bridges the gap between using the NHS services and the cost of private treatment. Like other insurances you’re familiar with, you’ll pay a monthly or annual premium, and usually pay an excess in the event of a claim. Not every treatment is covered by every insurance policy, so it’s important that when shopping around, you consider your personal and family needs.

How does health insurance work?

Not every insurance provider works in the same way, but here’s the process you’ll usually have to go through.

1. After purchasing private health insurance, you’ll be given a policy start date. From this date until the final day of your policy, you’ll have access to your provider’s benefits.
2. When you’re worried about your health, and you need to see a doctor, the first step is usually to visit your private or NHS GP.
3. If treatment is required, you can ask your NHS GP to refer you to a private specialist or healthcare centre that accept payments from insurance providers. Your provider should have all of this information readily available for you.
4. Because you’re paying privately, you’ll be able to request when, where and who gives you treatment, subject to the insurers terms and conditions.
5. You’ll receive your treatment and pay any excess if opted. All other costs will be paid for by your provider, subject to the policy terms and conditions.

So, what is private medical insurance?

Private medical insurance is the perfect solution for anyone who’s health conscious and can see the benefit of private healthcare, but doesn’t want to pay the high costs of treatment. The NHS is still a fantastic service, but when it doesn’t fit into your lifestyle, private healthcare is the answer.

Private medical insurance is the cost-effective way to access the benefits of private healthcare

Benefits of private health insurance

The big question on everyone's mind; what are the benefits of private health insurance? Quite simply, there are many. But different benefits mean more to some people than to others. For example, a family of 5 may prefer a policy that covers them for a wider range of treatments than an individual. Here are the main benefits we know our customers consider important:

1. Choice of doctor, surgeon and specialist giving you treatment
2. Option for a private room with higher quality facilities
3. Shorter waiting list for treatments
4. Receive quick access to diagnosis privately
5. Access to treatments and drugs that might otherwise be unavailable on the NHS (usually because of their cost!)
6. You’ll still have access to every NHS service with a private healthcare plan
7. Peace of mind in the event of a health worry
8. Choice of which hospital or treatment centre you visit
9. More relaxed visiting hours for family and friends
10. You can choose the same doctor for every treatment, and build a relationship with them over the course of your life
11. Other benefits, such as money off eating out, gym memberships and leisure activities are often included with your health insurance plan
12. It relieves the pressure on the NHS

The NHS is a fantastic organisation, and you’ll receive high-quality care through their services.

Make sure to take your circumstances into account and consider all of the benefits and you will soon be able to decide on whether private health insurance is right for you and your family. Check out our post on is private health insurance worth it? if you'd like to learn more about how you can benefit and what you should bear in mind.

Which health insurance provider is right for you?

Contact any health insurance provider, and you’ll be offered a policy that you think is perfect for you. Ring up another, and you’ll be offered a completely different one that also sounds amazing. In both cases, there’s going to be a lot of technical speak and jargon thrown at you. Unless you’ve dealt with private health insurance before, you may not understand how the claims process works, what you’re covered for, or how payments work. Every provider will try and find you their best policy, but don’t be surprised if it starts to get confusing after the second phone call.

Equity Health work with all the major health insurance providers in the UK. We have no bias towards one over another, so we make it our mission to understand your needs. All of our advice is free, and we work with you to find your best possible provider and policy.

UK health insurance providers we work with

We don’t hide the providers we work with, and we actually encourage our customers to check them out before making a decision with us. We’ll give you all of the information you need, but you might find it useful to browse their websites to see if you’re particularly drawn to one. Here’s who we work with:

1. AXA PPP
2. BUPA
3. Aviva
4. Vitality Health
5. The Exeter
6. Freedom Health Insurance
7. PHC
8. WPA
9. CS Healthcare
10. Health-On-Line
11. Cigna

But, there’s more! We work with as many reputable providers as we can. Quite simply, it means that we have all the options available giving us more flexibility for our customers. There’s far too many to list in one blog post, so please get in contact if you’d like to learn about all of the providers we collaborate with.

What does private health insurance cover?

Each private health insurance policy will cover many treatments, but there may be some treatments that aren’t covered. This can change on a case-by-case basis, but pre-existing illnesses, illnesses associated with substance abuse, cosmetic surgery etc. won’t be included. If in doubt, pick up the phone, and we’ll answer your questions.

How much is private healthcare?

Private healthcare as an industry can be expensive. However, you will be getting access to superior facilities, specialist knowledge, expert treatment and a lot more. The only way they can afford to offer this is to charge a fair price for it.

To fully understand the value you can get from private health services, we recommend you look into the prices for individual treatments. Bear in mind that, depending on where you’re treated, the price may vary. These figures are purely a guideline*

1. Broken arm with surgery - £2900
2. Broken leg with surgery - £5120
3. Cardiac Pacemaker insertion - £4,925
4. Carpal tunnel release - £1,625
5. Cataract surgery - £2,375
6. Colonoscopy - £1,650
7. Coronary angiogram - £2,066
8. Fractures - £345
9. Gastroscopy - £1,030
10. Hernia repair - £2,730
11. Hip replacement - £8,320
12. Hysterectomy - £1,695
13. Knee replacement - £10,810
14. Skin lesion removal - £1,150
15. Sprains and minor wounds - £700
16. Vasectomy - £710
17. Vasectomy reversal £2,310
18. Varicose vein surgery £2,600
19. Wisdom tooth surgery £1,500

*The figures provided are taken from a variety of sources, and the averages have been given purely as indicative costs to the treatments listed. References: NHS, HCA, Aviva, AXA, Freedom, Money Advice Service, Net Doctor, New Victoria, Nuffield Health

The average health insurance policy cost for an individual is £1,435 per year

Source: Boughtbymany

Different providers use differing underwriting criteria when they assess their premium costs. This is why it’s so important to shop around between providers, not only could it save you money, but it’ll give you the best possible cover to suit your circumstances.

Just so you can start to build a picture of how the cost is calculated, here are the sort of things health insurance providers take into account.

1. Age
2. The area you live in
3. Smoking status (that includes vaping too!)
4. Treatments covered in your policy (e.g. do you want dental cover also?)
5. Treatments excluded in your policy (are you happy to go via the NHS for some services?)
6. How much excess you’re willing to pay
7. Access to ‘Complementary therapies’ such as physio treatment
8. Outpatient care (That’s when you visit a hospital for treatment, but you don’t require a hospital bed or overnight treatment)
9. Single or multi-person coverage
10. Family medical history
11. Profession
12. Insurance history
13. Marital status
14. Fraud in the industry (fraud claims put the average cost up for everyone else)

There’s a whole host of things which may be out of your control that dictate the price. Your circumstances may not look favourable to one provider, but you could be the perfect candidate for another - so you should compare health insurance to find the best policy for you.

Choosing a health insurance policy

Finding the right insurance policy for you can be a bit of a minefield. There are a lot of providers to contact, and really, the best policy depends on your personal situation.

No matter who you are, there are a few things you need to consider when shopping around:

1. How much excess you’re happy to pay
2. The maximum monthly premium you’re willing to pay for health insurance
3. Any specific treatments you’d like included/excluded
4. Whether you want outpatient services
5. Some policies will have a minimum and maximum age
6. Are there any treatments you’d be happy to have through the NHS, or do you want solely private healthcare?

Family medical insurance

As you enter family life, there’s no better time to start thinking about private health insurance. You’ll naturally become more conscious about looking after yourself and the people you care about. Family policies are a great way to pass on the benefits of private healthcare, without paying the price you would for insuring everyone priced individually.

Consider the following:

Family size: How many family members you have, and what treatments you’d like everyone covered for. The more members in your family, the wider coverage you’re going to need in your plan, and the more varied treatments you’ll need access to.

Special medical requirements: Does anyone in your family have allergies, pre-existing illnesses etc? You’ll need to declare this, and it will impact the options available to you.

Preparing for the future: If you set them up with a policy early, any future health issues and the renewal rates are likely to be more favourable.

Health insurance for retirees

Health insurance for retirees can be a bit more complicated. Due to your age, you might require regular treatments or check-ups. As such, you could be paying more than you may have been 10 years ago.

Consider the following:

Keep costs down: Opt for a policy that covers expensive treatments, and use the NHS or your own money for lesser ones.

Prepare for life after work: You may have had a healthcare plan included with your employment, so the sooner you start shopping around for plans, the better.

Get a fair and personal analysis of the market: Your policy could be more limited, which is just another reason why looking into the options available to you is so important.

Prepare and declare: Make sure you’ve got your medical history ready when looking into a policy, as it’ll impact the options available to you.

Your employment: If you’ve worked in an industry with associated health risks, even if they’re not present now, consider the treatments you might need in the future.

Self-employed health insurance

If you’re self-employed, what would happen if you needed medical treatment? You’d want treatment quickly and return back to work as soon as possible. Health complications for a self-employed individual pose a higher risk to their ability to work than they would to an employee in a corporate company who might continue to be paid their salary while off work.

The risk health complications pose on any self-employed individual is higher than an employee in a corporate company, so keep this in mind:

Future of your business: Are you thinking of expanding and taking on employees? A company-wide health insurance package is a great way to attract talent and keep employees in-work.

Your industry: Are you working in an industry with health risks associated? You’re better off getting insurance before something happens, as opposed to after.

You’re in control: You’ll have more fluidity over dates, location and your specialist. It’s not easy fitting life around work when you’re self-employed, but this extra bit of wiggle room can really help out.

Peace of mind: Do you worry about your business if you’re unable to work? This sort of worry is bad for emotional health. Even if it’s a basic plan, it might make you feel more at ease.

Individuals, working professionals and couples

Working professionals and couples tend to have really busy lives. You’re committed to your career, and you’re starting to think about your life in a long-term way. Here’s our advice to anyone falling under the ‘working professionals and couples’ category:

Current employment: If your current employer doesn’t offer health insurance, consider raising this in your next 1-to-1 meeting, they might already be considering the idea! Feel free to borrow the benefits we’ve listed to persuade them.

Future family: If you’re thinking about settling down and starting a family, there’s no better time to check out private healthcare benefits - you’ll find you relate to them much more with a baby on the way!

Couples policy: If you’re in a couple but not married, some providers may  offer you joint policies at a discounted premium - great for keeping the price per person down.

You’re at a busy stage in your life: Having access to faster treatment is just one less thing to slow down your momentum.

Family policy: Do your parents have a family policy? If you still live at home, you may be able to explore the option of adding yourself into their policy to keep the cost down.

Your own policy: Equally, if you’re already on your family policy, you’ll get more choice over what you’re covered for by starting an individual plan.

Business medical insurance

Staff retention is a big problem for businesses, and it only seems to be getting worse. While there’s a lot you can do by choosing the right candidates and creating a great working environment, these things aren’t going to help you should someone fall ill. Take this into account for company-wide corporate health insurance:

Back to work quicker: Access to quicker treatment will reduce the time your employees need to get back on their feet.

Attract talent: Offering health insurance as an employee benefit might be the deciding factor for candidates. There’s been a big shift in attitude towards health and wellbeing, so if you’re after the top talent in the world, this is the sort of thing that’ll help get them on board.

Save you money: The reduced absence, increased productivity and output of your workforce may actually end up saving your business more money than the cost of your policy.

Future expansion: If expansion is on the cards in the future, you can still benefit from taking a policy today as they are flexible and you can add new people in as and when you employ them.

What does a health insurance broker do? Where Equity Health comes in

We’ve thrown a lot of information at you in this blog, but if you’re still confused or you’ve got some questions - that’s a good thing. It means you understand that private health insurance isn’t black and white, and if you’re unprepared, it can be a bit of a headache.

This is where Equity Health comes in. As health insurance brokers, aside from publishing information for our clients, we’ve got a whole team that specialises in working with individuals, families and businesses to find them their best health insurance policy. We’re not biased towards a single provider, and we’ll work with your requirements to find you your best possible healthcare plan.

If you’re ready to start talking health insurance, or there are some points we’ve raised in this blog you’d like to talk over with one of the team, we’d be happy to help you out.