Private Medical Insurance – Is it worth it?

The latest health statistics in 2016 show that more and more people choose to pay for private healthcare rather than taking out a private medical insurance.

Ageing and the continuous growth of population together with rapid advances in medicine and medical technologies have lead to increased public expectations of the way they look after their health or their healthcare is provided. As a consequence more and more people decide to access private healthcare on an ad-hoc or ongoing basis.

Although the Internet provides a large amount of information for the patient in search of private healthcare, essentially, the family doctor should become the trusted friend, the advocate who stands fully prepared to help the patient navigate the complex healthcare system.

Generally speaking, UK based health insurances (versus expat health insurances) shall cover an individual for a range of specialist consultations and treatments but not for seeing a GP. Some insurance covers may provide telephone access to a GP but not for you to see a family doctor that you are comfortable with.

A private medical insurance is primarily designed to cover the cost of private medical treatment for short-term curable illnesses or injuries. A more comprehensive policy may include specialist therapies, although has exclusions on certain pre-existing conditions. And if so, will you not be better off paying directly for your health?

Insurances come with exclusions

• Pre-existing medical conditions
• Chronic illnesses such as HIV/AIDs-related illnesses, diabetes, epilepsy, hypertension and related illnesses
• Normal pregnancy and childbirth costs
• Organ transplants
• Injuries relating to dangerous sports or arising from war or war-like hostilities
• Cosmetic surgery to improve your appearance

are amongst the most common exclusions. Mental Health is also not always covered.

Will you get the best treatment privately?

Most certainly if you are in need of emergency care, the UK private sector is not the place for you. If you suffer a stroke or a heart attack for example, NHS will provide you with the best treatment available in UK. The NHS is geared to manage these conditions in optimal timeframes whilst the private sector is not.

For cancer care equally you will receive priority treatment on the NHS. Depending on the type of cancer one may wish to have treatments that are not available on the NHS although these are unlikely to be covered by a private health insurance.
For some chronic illnesses the private sector is not adequately geared up to deal with conditions such as Ankylosis Spondilitis, as I recently found out. The multidisciplinary teams just not exist or work efficiently.

One other matter to consider is your location. We often find that people that attend our clinic in Scotland wish to see a specialist privately. The issue is that such specialists may not be available locally and a patient may have to travel hours away. So a private insurance may seem like a good idea, but if there aren’t the specialists or there is no availability locally, is it worth it?

I have a private health insurance via my employer

Many companies offer a private health insurance as part of the employee benefits package. But who is actually paying for it?

Employer-paid private medical insurance is a benefit in kind, so employees pay tax and national insurance on premiums.
Within the last few years, due to an increase in premiums, employers are looking at cutting down their costs resulting in reduced cover and increased excess payments.

Private Health Insurance versus Self-paying

Our Tips:

• BEST: look after yourself, prevention is key to a health life
• Shop around: a good GP saves you monies. He/she will be able to advice on best and most cost effective medical center for your needs
• Ask for fixed price treatments from hospitals