A Short Guide to Private Healthcare

Rather than wait to have routine investigations and procedures completed on the NHS, many of us are opting for private healthcare. This can help to cut waiting times, as well as relieving the pressure on the NHS.

How Does Private Healthcare Work?
Private healthcare operates as an insurance policy. You pay a monthly premium, and in exchange, the insurer will pay for certain medical treatments, tests, and therapies.

Many employers now offer private healthcare, which can be extremely cost-effective. Group plans are usually cheaper than individual policies, and the employer will benefit if their employees are treated, and able to return to work more quickly. If you receive private healthcare from your employer, you will need to pay tax on the cost of your premiums.

If your employer doesn’t offer this, or you want to buy a more comprehensive policy, you can set this up directly with the insurer. You can apply as an individual, or you can add your spouse or family members.

If you are a business owner, you can set up private healthcare through your company for yourself and your employees.

To claim on the policy, you would normally start by visiting your usual GP, although many healthcare policies now offer private GP consultations. Your GP would then refer you for the appropriate treatment.

Depending on the policy and the type of treatment, you may need to pay a contribution to the cost, known as an ‘excess.’ This could be up to a few hundred pounds. The higher the excess, the lower your monthly premiums will be.

What Will be Covered?
It’s important to check the coverage of your private healthcare plan, as they do not all work in the same way. The more comprehensive the plan, the more expensive it will be.

Typically, you can expect your policy to cover the following:

• Tests, diagnosis, and consultations with a specialist
• Hospital treatments, either as an in-patient or out-patient
• Physiotherapy and rehabilitation from injuries
• Mental health treatment

Many plans will also offer dental or optical cover. You may also find that if you opt for NHS treatment, your policy will offer a cash sum.

Policies are intended to work in tandem with NHS services, rather than as an end-to-end replacement.

Many insurance plans offer additional incentives with your cover. Free health checks and discounts on gym memberships or fitness equipment are widely available. These perks are, of course, built into the cost of the plan rather than genuinely free. It’s worth shopping around for the best premium and thinking carefully about which additional benefits you would actually use.

Exclusions
No private healthcare plan covers everything, and there are some situations where you may need to use the NHS or self-fund your treatment. For example:

• Emergencies such as accidents, heart attacks, or strokes
• Treating pre-existing conditions or chronic illnesses
• Normal pregnancy and childbirth
• Cosmetic surgery

Private healthcare is best suited to acute, or short-term conditions which require a specific treatment.

Why Should You Choose Private Healthcare?
If your employer offers private healthcare, or you can afford the premiums on an individual basis, it is definitely worth considering. The main benefits are:

• Reduced waiting times if you need to undergo tests or treatment.
• More choice over the hospital and doctor you use.
• You will usually be offered a private room for your stay in hospital, with a higher standard of accommodation than the NHS can provide.
• You can sometimes access treatments or medications that are not available on the NHS.
• Continuing support and policy benefits to help maintain your health.
• Opting for private treatment can help to reduce the strain on the NHS and free up resources.

What are the Downsides?
Like with any insurance contract, you need to weigh up the costs, benefits, and potential risks. If you are young and relatively healthy, there is a good chance that you won’t need to claim on your policy for many years. Older applicants with a history of medical issues may find that their premiums are more expensive, or their existing conditions are excluded entirely.

The potential disadvantages are:

• Your plan won’t cover every condition or situation. This includes many of the most common reasons for needing medical care, such as pregnancy, accidents needing immediate care, ageing, and chronic conditions requiring routine management.
• The premiums can be expensive, particularly if you opt for a comprehensive policy.
• The claims process can be complex and relies on smooth communication between your GP, treatment provider, and insurance company. Managing this process can be stressful, particularly when you are unwell.
• You need to read your policy conditions carefully before starting on a treatment plan. While the initial treatment may be covered, there may be limits or exclusions that apply later on. This can result in an expensive hospital bill.
• If more people opting for private healthcare creates spare capacity in the NHS, the result of this could be further funding cuts. This could create a two-tier system, which makes things even more difficult for those still relying on the NHS for treatment.

Private healthcare should be seen as a complement to NHS services, not a replacement. It can help you get back to work more quickly after an illness or injury, and ensure that you are more comfortable during your treatment.  If you use the plan effectively, you can also improve your overall health and access preventative support.

Most people will still need to use the NHS at some point in their lives, even if they have private healthcare. Despite its problems, the NHS should not be written off. It requires public pressure to be funded and managed adequately, but on an individual level, we can be mindful of how we use its resources.

Please don’t hesitate to contact a member of the team to find out more about private healthcare.