Over seven million people in the UK have private medical insurance (PMI) to cover all or part of the cost of private medical treatment if they fall ill. With constant headlines about waiting lists and problems in the NHS, it’s easy to see the appeal of private treatment, but is it worth the cost for you?

This article on private medical insurance (PMI) is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

The advantages

People may choose PMI for a wide variety of reasons, but for most the biggest advantage is the peace of mind knowing that you can get the treatment you need, when you need it, without the anxiety of waiting. With limited funds prioritised towards urgent cases, you could wait months for a non-urgent operation on the NHS. With private medical insurance, you could have the same operation within a few days of making the decision to operate. Other advantages include:

  • Convenience – with PMI you choose when and where you have your treatment, rather than fitting around a date given by the NHS.
  • Choice – with PMI you can choose where you’re seen and by whom.
  • Quality – most private patients enjoy a single room with high-quality features, such as en-suite bathroom and satellite TV.
  • Cleanliness – without the high turnover of patients, and with more staff, private hospitals have more time for cleaning, reducing the risks of super bugs.
  • Service - without the high pressures under which NHS hospitals operate private consultants, doctors, and nursing staff also tend to have more time to spend with each patient.

Modern private medical insurance also has the advantage of being affordable, offering a choice of cover levels to suit a wide range of budgets.  

The disadvantages

In an ideal world, your PMI policy would cover you for everything at a premium you could afford. In reality, the level of cover will vary according to the price you pay. As with anything, you get what you pay for. This means that you may find that your private medical insurance doesn’t cover you for everything you presumed and you may be let down when you need it most. Generally, PMI policies will only cover curable, short-term illness or injury, with more complex conditions, such as cancer only available as an added extra.

Private medical insurance is unlikely to cover you for existing conditions, even if they have not been fully diagnosed when you take out your policy. This means that it may not provide the treatment you need most. It’s important to be sure exactly what your PMI includes before you take out the policy.

Another disadvantage is that the cost of private medical insurance cover will increase with age, just as you’re more likely to need it. This can leave you in a ‘Catch 22’ situation since changing policy providers will exclude any pre-existing conditions once again, so you could find yourself trapped with ever increasing premiums.

Another consideration is the size and speciality of most private hospitals. Although you’re unlikely to be visited by a consultant with a group of student doctors in tow, you could miss out on the breadth of experience available in a large, multi-disciplinary teaching hospital. Furthermore, many private hospitals and clinics do not have intensive care support, so should anything go wrong you will have to be transferred to the local NHS unit.

How you can reduce your insurance costs

If, on balance, you decide to proceed with private medical insurance, there are many ways you can reduce your premium costs:

  • The less conditions that are covered, the less you will pay, so you may decide to limit your PMI to the conditions that concern you most. For example, BUPA provide a heart and cancer only cover.
  • Limit the range of hospitals available to you. By excluding the top hospitals, or those in places like London, you can cut the cost considerably.
  • Limit the extras your PMI includes. For example, you can pay to cover just consultations and in-patient treatment, and exclude extras such as physiotherapy and convalescent care.
  • Shop around. With more than a dozen leading PMI providers, and many more joining the market all the time, it’s worth comparing prices to get the best deal. Make sure you compare like for like to get an accurate picture of a policy’s value. As with all insurance, some of the best deals are available online.
  • Include an excess on your policy. Paying the first £500 or £1000 will cut the cost but can also reduce the policy’s effectiveness.

One of the best ways to cut the cost of private medical insurance is to get your employer to take out a group policy or to take a joint policy with other members of your family.

When considering the pros and cons of private medical insurance, it’s worth remembering that everything that’s covered by your policy is available to you free on the NHS. You need to decide how important the benefits are to you, and whether these benefits are worth the cost.

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