The Full Guide to Private Medical Insurance

You may not feel the need to get private medical insurance. However, it is best to have one due to the benefits you get and the help that you are provided with when you are in need.

This article will explain everything to you about private medical insurance – what it is, what all it includes and why should you buy it.

Understanding Private Medical Insurance

Private medical insurance is a cover that offsets the costs of medical treatment in a private clinic or hospital. Acute conditions that start after the beginning of the policy are the only diseases that are covered under this kind of insurance.

From basic to comprehensive, the different amount of premiums provide different kinds of facilities to the individual. The cost of premiums depends on the requirements of the customers. One can choose the following things:

  • Location of their treatment
  • The contribution that they are willing to make for the treatments’ costs
  • Types of treatments covered

Why Buy Private Medical Insurance?

By purchasing private medical insurance, we cut down the future unexpected costs of illnesses and injuries. This cover helps in paying for access to private treatment and care, complementing the services of the NHS (National Health Services). Moreover, an individual is provided with some services through private medical insurance that one may not get at the NHS. Thus, opting for private medical insurance would be the best idea.

The following are the benefits of private medical insurance that would encourage you to buy it:

  1.     Healthcare choices
  2.   You can get direct care from a consultant
  3.   While advanced options of treatment like some types of cancer drugs cannot be obtained from the NHS, private hospitals provide access to these
  4.     Well-timed facilities
  5.     You can be admitted to a private hospital or clinic very fast
  6.     You can get a timely referral to the consultant
  7.     You can get treated whenever it is appropriate for you
  8.     First-class accommodation facilities
  9.     You are provided with home amenities like television
  10.     You get to experience the privacy of the en suite room
  11.   The comfort and cleanliness of a private hospital are more than that of the NHS

In addition to the above-mentioned points, you must consider the fact that there is no waiting time or less waiting time in the case of private hospitals. When you are required to be treated at the earliest, you can get the kind of care you need in private hospitals and clinics.

In the case of the NHS, due to long waiting times, your disease is also likely to worsen. Moreover, it is not good for a person to wait outside a clinic for consultation instead of taking rest.

What Things Does the Insurance Cover?

Every cover includes different things based on the cost of its premiums. However, the covers generally include the following:

  •     Diagnostic tests and scans
  •     Costs of hospitalising
  •     Surgery
  •     Visiting a consultant
  •     Nursing care
  •     Clinic and hospital accommodation
  •     Cancer drugs

In addition to these, individuals can add the following in their cover:

  •     Acupuncture
  •     Complimentary therapies
  •     Chiropody
  •     Optician costs
  •     Osteopathy
  •     Psychiatric treatment
  •     Dental treatment
  •     Outpatient consultations
  •     Physiotherapy
  •     Choices for mental health treatment

Private medical insurance is designed only for acute conditions, diseases that long for a short while and can be cured easily. Chronic illnesses are not included. It is best to understand the differences between these two before opting for a cover.

Acute illnesses may include conditions like cataracts, fractures, joint replacement, etc.

The chronic illnesses are the diseases that have one or more of the given features:

  •     Continues indefinitely
  •     Requires rehabilitation
  •     Likely to repeat in the future
  •     Does not have a cure
  •     Requires long-term control, relief, or monitoring of the symptoms

Other than these, the private medical insurance does not include any illnesses or injuries that the individual has suffered from earlier. However, they may be able to get the insurance for particular pre-existing conditions by making a payment for a supplementary premium. The person may also meet certain criteria that would result in his pre-existing medical condition getting covered in private medical insurance.

Based on the cost of premiums, the things that the insurance covers are decided. The different kinds of insurances, in the order of increasing premiums, are:

  • Basic- This insurance covers the costs of the treatment and any related costs while the person is an inpatient at the clinic or hospital/
  • Medium- This type of insurance includes both inpatient support and outpatient care.
  • Comprehensive- This kind of insurance includes inpatient support, outpatient care and other relative treatments like physiotherapy.

Some insurers even provide private medical insurance for people aged more than 50 years old. The policies for these people are divided into three categories:

  1.     People over the age of 50
  2.     People aged more than 65
  3.     People who are older than 70 years

What does Private Medical Insurance not Cover?

The cost of premiums decide the things covered in the policy. However, there are certain things that the cover does not include at all. These are:

  •     Chronic illnesses, as mentioned earlier
  •     Emergency treatments
  •     Elective treatment
  •     Organ transplants
  •     Injuries resulting from dangerous sports
  •     Childbirth and pregnancy
  •     Pre-existing medical conditions
  •     Treatment abroad
  •     Cosmetic surgery
  •     Treatment for drug abuse

Causes of an Augmentation in Premiums

Now that you have understood everything about private medical insurance, let us understand the factors that are likely to increase the costs of premiums.

  •     What you choose to include in your policy
  •     Your medical history
  •     Your family’s medical history
  •     Lifestyle
  •     Age


Although private medical insurance covers chronic illnesses only, having this may turn out to be very beneficial for you and your family. Not only are the waiting times eliminated but also the level of comfort and privacy are high. Before opting for a policy, comprehend it properly.