News of King Charles and the Princess of Wales receiving hospital treatment for medical conditions came as a shock to the nation.
But the Royal pair did not have to wait in line for an NHS appointment.
For those who can afford to pay, gold-plated health insurance whisks you past any queue for the best care the nation can provide.
But is private health insurance just a luxury afforded by the affluent – or a benefit that anyone can enjoy?
WHAT EXACTLY IS PRIVATE HEALTH INSURANCE?
It is a policy paid monthly or annually to cover private health care outside the NHS, which includes services such as GP visits, testing and consultations, operations, physiotherapy, mental health care and dental and optician services.
Front of the queue: News of King Charles and the Princess of Wales receiving hospital treatment for medical conditions came as a shock to the nation
The more benefits a policyholder includes in their insurance, the more it will cost. Similar to car insurance, your no claims discount is affected. The more claims you make, the more expensive your renewal premiums will be. Inevitably, too, your premiums will rise as you get older.
HOW MANY PEOPLE HAVE THE COVER?
Around 6.9 million adults in the UK have private medical insurance, according to analysis of figures by City watchdog the Financial Conduct Authority (FCA) by employee benefit consultancy Broadstone. This number has risen by around one million people in the past five years.
Brett Hill, head of health & protection at Broadstone, says: ‘The pain of a condition, the cost to salary if a person has to leave the workforce, and the long wait for NHS treatment are driving people of all incomes to either self-fund urgent issues or take out private health insurance as a safety net.’
Dale Le Page, medical and life insurance expert at broker Howden, adds: ‘Health insurance used to be a benefit for the affluent to take out, but this has changed very much since the pandemic. And the average age has dropped from customers in their 50s to those in their late 30s.’
Employers have also expanded their benefits packages to include private health insurance to help the health and wellbeing of employees and to encourage loyalty and a fitter company.
WHICH COVER IS BEST… AND DO I NEED A BROKER?
There are around ten providers in the private health insurance market, although four firms dominate the industry: Bupa, AXA Health, Aviva and Vitality. Broadstone says smaller insurers such as WPA and The Exeter provide options for customers who want an alternative to the big brands.
Given the complexity of private health insurance and the number of clauses inserted into policies that, if not understood, could mean you are not insured for services, it’s advisable to use a broker. You will not need to pay the broker a fee, they receive commission from the provider. Or you can use a comparison website to compare premiums and read the terms and conditions on each provider’s website.
You may have to complete a lengthy application form if you are applying for what’s called full medical underwriting. This means that all your pre-existing medical conditions are fully investigated and your GP is consulted before you seek cover. Some pre-existing conditions such as high blood pressure and diabetes could be covered in your new policy if your condition has been stable.
Alternatively, you can go down a quicker route called moratorium underwriting. This gives you cover, but excludes all pre-existing conditions that have occurred in the last five years for the first two years of the policy. You can get this cover by filling in a short online form.
THE YOUNGER YOU ARE, THE CHEAPER THE COVER
THE younger you are when you take out a policy, the cheaper it is. A policyholder aged between 25 and 34 would pay on average £423 a year, while those aged between 55 to 64 would pay £738, according to figures from Howden. For a family of four where the oldest member is aged between 35 and 44, they would pay a premium of £1,485. This rises to £1,979 when the oldest family member is aged between 45 and 54 years old.
Options: Patients who go private can either pay a premium for cover or pay outright for their treatment
The policy premium is also affected by any pre-existing health conditions you have and the excess you choose. For example, if you agree to pay the first £500 of cover to keep the premium down.
The insurer checks the cost of hospitals in your area and the likelihood of you using them.
TREATMENT COVERED BY YOUR POLICY
Under most policies, a GP visit is not classed as a claim. You’ll be given access to a digital GP who will give you an appointment by video call. If the GP refers you to a consultant, you must call your insurer to get the appointment authorised before you attend. Whether it is approved depends on the level of cover. Any other treatment must also be pre-authorised. Once your treatment is complete, the hospital bills your insurer directly. You do not have to pay anything except your ongoing premiums.
IS EVERYONE ABLE TO BUY COVER?
Most people can access private health insurance, but some pre-existing health conditions could be excluded from cover.
You can get cover up to the age of 99, but it would be expensive and come with a lot of conditions.
HOW TO MAKE YOUR POLICY CHEAPER
Matt Howells, founder of medical insurance broker Vizion, says: ‘Insurers have put in place features to make health insurance more affordable.’
Each policy will come with core care which covers treatment in hospital. To keep your premium as low as possible, you can have a £500 excess, a cap on the value of consultations accepted under your policy or agree to self-fund your consultation which means you pay out of your own pocket.
An initial consultation can cost between £200 and £300, according to Vizion, while a follow-up appointment is between £150 to £250.
By cutting back the benefits, a policy with limited outpatient services, a cap on consultation fees and a restriction on which hospitals you can use could cost £70 a month for example for a 40-year-old woman living in Wales.
This could rise to around £190 if she moved to London. It would increase to £230 a month by including extra therapies and removing the restrictions on hospitals.
CAN I JUST PAY FOR MY OPERATION?
If you want to skip the NHS waiting list but don’t wish to get health insurance, you can pay privately for one-off operations.
According to figures from consumer website My Tribe Insurance, the cost of a knee replacement, if paid privately, would be £14,499. Bunion-removal costs £5,308 and a hysterectomy costs £8,014.
…AND WHAT WILL £50,000 A YEAR GET ME?
Matt Howells, who specialises in high net worth cover, says if you want the ‘Royal’ treatment, it could cost you up to £50,000 a year for a family of four.
For this price you would get international health insurance, designed to work in countries with no state-run medical services.
Policyholders can use any hospital they choose, in or outside the UK, as many times as they like. They do not have to wait for treatment, can have unlimited tests, consultations and operations without having to pre-authorise them with their insurer. They also have extra services such as on-demand maternity care, dental and eyecare and private GP access.
Strip back this policy and reduce the benefits and you are looking at a more affordable price. The average premium, according to Howden, has fallen from £1,500 a year in 2019 to £1,100 to date.
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