Do you need private medical insurance – and can you afford it?

Most of us are entitled to free healthcare from the NHS. We may see private medical insurance, or more familiarly health insurance as something of a luxury.

But the NHS is struggling to treat a growing population with inadequate funding. It remains the best solution for accident or emergency, but for many types of illness, it can mean long waiting lists and overcrowded wards.

Private medical care provides an alternative. You can get a private room rather than a bed on a mixed ward, and you can choose your surgeon and hospital. It can mean quicker access to scans of all kinds, and it can mean getting back to full health faster.

However, like all insurance, the cover you get from private medical insurance depends on the policy you choose.

The most basic private medical insurance usually only covers in-patient treatments and day-care surgery in an approved list of hospitals. More comprehensive policies cover out-patient care, including visits to consultants.

All will come with a list of exclusions. Any pre-existing medical condition will not be covered, normal pregnancy and childbirth will be excluded, and so will organ transplants.

So do you need it?

You only really need private medical insurance if you believe you will get better treatment privately. It will mean saving time, meaning that you are out of action for less time and it could mean access to treatments and drugs that the NHS can’t afford.

If you are at particular risk for sporting injuries, or if your business or career means that you can’t afford to wait for treatment, you can make a sound business case for the cost of private medical insurance.

If you can’t, you may still decide it is worthwhile. It can’t stop you becoming unwell, but it might make a stay in hospital a great deal more comfortable.

Can you afford it?

Many people get their private medical cover as part of their salary package. If you don’t, it can be expensive, especially if you want to cover the whole family.

A young family, two adults in their 30s and two children might get basic cover for around £1000 a year. This cost will rise with age, and the likelihood that you will need medical attention. The cost for a 55-year-old, with no excess and no outpatient cover would be around £1,000 a year. This might rise to around £1,400 at 65 and more than £2,000 at 74. Premiums will usually rise every year, and with age – so by the time you’re older, and more likely to need hospital treatment, you might find it much more difficult to afford it.

This is for a basic cover, and costs can be considerably higher than this if you have pre-existing conditions.

There are ways of accessing private medical care without private medical insurance. Around one in five private patients are self-funded, dipping into savings for treatment as they need it.

This is costly. Hip and knee replacements cost an average of £10,000 each, while a routine MRI scan can cost upwards of £500. You can also pay for a private consultation if you feel you need an expert or second opinion, and have your consultant refer you back into the NHS for treatment.

If you would like to find out more about private medical insurance and with fitting it in to an all-round protection plan, the best prescription is to talk to the Continuum team.