News of King Charles and the Princess of Wales receiving hospital treatment for medical conditions came as a shock. 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.
Is private health insurance just a luxury afforded by the affluent or a benefit that anyone can enjoy?
Here we explain exactly what private health insurance can offer you, how much it will cost and advice on how to get it for the cheapest rate possible.
What is private health insurance?
Private health insurance is a policy paid monthly or annually to cover you for private health care outside the NHS. It includes GP visits, testing and consultations, operations, physiotherapy, mental health care and dental and optician services. The more benefits a policy holder includes in their insurance, the greater the cost.
King Charles will undergo medical treatment for an enlarged prostate next week. Pictured: Charles, Camilla and other members of the Royal Family attending the Christmas morning church service at Sandringham last year
The Princess of Wales is recovering in hospital after undergoing abdominal surgery earlier this week
As with car insurance, your no claims discount is affected. The more claims you make the more expensive your renewal premiums will be. Your premiums will rise throughout your policy term as you get older.
How many people have private health insurance?
In the UK there are 6.9million adults who have private medical insurance, according to analysis of Financial Conduct Authority figures by consultancy Broadstone. This number has risen by one million people in the five years since the FCA first started its research.
Experts say there are a number of reasons behind the rise. Brett Hill, head of health & protection at Broadstone, said: ‘The pain of 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 incredibly affluent to take out but this has changed very much since the pandemic. Now the average age has dropped from customers in their fifties to those in their high thirties.’
Employers have also expanded their benefits packages to include private health insurance to ensure employees stay healthy.
Which insurer is best for you… and always use a broker
There are ten providers in the private health insurance market, although four firms dominate the industry: Bupa, AXA Health, Aviva and Vitality.
Broadstone said 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 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 policy if your condition has been stable.
Prince William said Kate is ‘doing well’ in hospital following her surgery
Moratorium underwriting
Alternatively, you can go down a quicker route called moratorium underwriting. This process will give 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 a short form online. Your provider only contacts your GP when you come to make a claim.
Under most policies, a GP visit is not classed as a claim.
The younger you are the cheaper the policy
The younger you are when you take out a policy, the cheaper it is. A policy holder between 25-to-34 years-old would pay £423 a year compared to those aged 55-to-64 who would pay £738, according to figures from Howden.
For a family of four where the oldest member is aged between 35-and-44-years-old they would pay a premium of £1,485. This rises to £1,979 when the oldest family member is aged between 45-and-54.
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.
What your policy allows for
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 you have. 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 eligible?
The majority of people can access private health insurance but some pre-existing health conditions could be excluded from cover.
A spokesman from Vitality said: ‘Where someone has a pre-existing condition, it’s worth talking to the provider or your financial adviser who can take you through what would and wouldn’t be included. You shouldn’t assume that everything would be excluded.’
Some providers also impose age limits. Vitality, for example, covers policy holders aged between 18-and-79-years-old. You can get cover up to the age of 99 but it is expensive and comes with many conditions.
How to make your policy cheaper
Mr Howells said: ‘Insurers have put in place affordable 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 to £300, according to broker Vizion, while a follow up appointment costs between £150 to £250.
By cutting back the benefits, a policy with limited out-patient services, a cap on consultation fees and a restriction on which hospitals you can use could cost £70 a month.
Can I self-pay for operations?
If you want to skip the NHS waiting list but don’t want 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 you paid privately would be £14,499. Bunion removal costs £5,308 and a hysterectomy costs £8,014.
The London Clinic, where the Princess of Wales had her operation
What if a treatment goes wrong?
Your first port of call is to complain to your insurer. All private health insurers are regulated by the FCA so have a formal complaints policy. If the customer cannot resolve their complaint with the insurer they can take their complaint to the Financial Ombudsman Service for independent adjudication.
…and what do I get for the super-rich cover of £50,000?
High net work medical insurance broker Matt Howells, founder of Vizion 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.
Policy holders 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 eye care 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.
Some links in this article may be affiliate links. If you click on them we may earn a small commission. That helps us fund This Is Money, and keep it free to use. We do not write articles to promote products. We do not allow any commercial relationship to affect our editorial independence.
