Figures from the British Medical Association (BMA) reveal that as of summer 2023, nearly 7.5 million patients were waiting for NHS treatment in England. Over three million have been waiting for over four months, and around 385,000 have waited over a year.
With that in mind, private medical insurance (PMI) can seem like a good option, but how accessible is it in terms of cost? Here, we look at the factors that influence your premium and what you could expect to pay.
- What does private health insurance cover?
- How much is private health insurance?
- What affects the cost of private healthcare?
- What’s the average cost of private healthcare per month?
- Is private health insurance worth it?
Policies typically include in-patient and day-patient treatment for acute conditions. This will mean that overnight stays are covered, as are minor operations where you can go home the same day. Acute conditions are illnesses that typically get better after surgery or a course of treatment, for example, hernias, cataracts, or joint pain.
Some policies include outpatient treatment as standard too, but this will depend on the benefits offered by the provider. If it’s not included as standard, you can normally add this cover for an additional cost. This option would mean diagnostic tests (such as scans) are also covered.
What else does private health insurance provide?
As well as standard covers, most private healthcare providers will offer an extensive range of additional features. This could include:
- Access to a GP 24/7 via video call
- Access to counselling
- Access to stress management helplines
- Therapies such as physiotherapy, acupuncture, osteopathy
- Chiropractic treatment
- Dental and optical treatment
Providers also work with a network of private hospitals, so you can select care and treatment that’s convenient to you. In some instances, you can keep costs down by limiting your choice of hospital, whereas pricier policies would give you access to a nationwide network.
What isn’t covered by private health insurance?
Private healthcare doesn’t cover emergency treatment which the NHS provides. As a general rule, private care policies also don’t cover chronic conditions either – these are long-term illnesses that are managed rather than cured. Examples of chronic conditions include asthma, diabetes, and arthritis.
Does private medical insurance cover cancer?
Yes, cancer care and treatment are often one of the key reasons why people take out PMI. However, cancer is classed as a chronic condition and the cover you get will depend on your chosen policy, and if it’s pre-existing.
Often, if cancer care is included, you may be able to access treatment and medication unavailable through the NHS.
Your age and where you live have a big impact on the cost of private health insurance. To give you an idea of what to expect, we looked at average costs based on age and location by level of cover.
Remember that the costs set out here are a guide only, and premiums will be determined by your individual circumstances. You can also cap the cost of certain treatments (for example, outpatient care) to keep premiums down.
|Age||Type of cover||Norwich monthly price||London monthly price||Central London monthly price|
|35||No outpatient cover with the hospital chosen by the insurer.||£32.37||£43.09||£53.36|
|35||£1,000 outpatient cover with countrywide hospital access, including therapies and mental health cover.||£65.53||£88.08||£109.64|
|35||Full outpatient cover with countrywide hospital access, including therapies and mental health cover.||£71.93||£96.75||£120.49|
|45||No outpatient cover with the hospital chosen by the insurer.||£43.84||£58.64||£73.80|
|45||£1,000 outpatient cover with countrywide hospital access, including therapies and mental health cover.||£87.15||£118.03||£151.30|
|45||Full outpatient cover with countrywide hospital access, including therapies and mental health cover.||£95.97||£129.99||£166.28|
|55||No outpatient cover with the hospital chosen by the insurer.||£57.56||£79.34||£102.89|
|55||£1,000 outpatient cover with countrywide hospital access, including therapies and mental health cover.||£113.30||£158.79||£202.32|
|55||Full outpatient cover with countrywide hospital access, including therapies and mental health cover.||£125.04||£174.71||£222.23|
*Figures accurate as at 30/06/2023 and are illustrative only.
Our research found that age and location had the greatest influence on cost, with a 35-year-old in Norwich paying 64% less for a basic policy than someone of the same age living in central London.
That gap increases with age, and we found that a basic policy for a 55-year-old living in central London would cost nearly 78% more than a 55-year-old in Norwich.
But while premiums are heavily influenced by age and region, they’re not the only factors that determine what you pay, and providers will also consider:
Previous medical conditions
If you’ve got a history of illness or poor health, this can increase what you pay. You should also bear in mind that most policies won’t cover pre-existing medical conditions.
Previous claims can increase what you pay as there’s a greater risk of you making further claims.
The level of cover you choose
The more comprehensive the policy, the more you’re likely to pay. For example, complete cancer care with access to the latest treatment will cost more than a policy without it.
We found the average cost of a basic policy for a 35-year-old was just under £43 per month. That figure rose to £96 per month for a policy providing full outpatient cover and access to nationwide hospitals.
Based on our figures, 55-year-olds looking for extensive cover would pay the highest average monthly premium (£174 per month). This would include nationwide hospital access, therapies, and mental health cover. However, policyholders based in central London could face monthly premiums of over £200 for the same comprehensive package.
What’s the average cost of private health insurance?
A true average is difficult to gauge as various factors determine premiums. As a result, annual costs can vary considerably, with policies ranging from several hundreds of pounds to thousands. Adding a partner or children can increase costs too. As with all insurance policies, the insurer will be basing your premium on the likelihood of you making a claim, and your age and where you live are the most influential factors.
Thanks to the NHS, private health insurance isn’t a necessity, but it does offer choice and convenience. Often, this means you’ll avoid lengthy NHS waiting lists – enabling you to get back on your feet faster.
If you want to find out more about private health insurance options and the specific benefits it could bring to you and your family, you can speak to a member of our team on 01603 967955. As an independent insurance broker, we can offer tailored advice to help you find a package that best fits your needs.