Insurance

Private Health Insurance Guide UK — Costs, Benefits + Is It Worth It?

How private health insurance works in the UK, what it costs, what it covers, and whether it is worth the money alongside the NHS.

With NHS waiting lists at record levels, private health insurance is increasingly popular in the UK. Around 4 million people have individual private medical insurance, with millions more covered through employer schemes. Here is what it offers and whether it makes sense for you.

What Private Health Insurance Covers

Standard Cover

Cover Detail
Inpatient treatment Surgery, hospital stays, procedures
Day-case treatment Procedures not requiring overnight stay
Diagnostic tests MRI, CT scans, blood tests
Specialist consultations Referrals to specialists
Cancer treatment Chemotherapy, radiotherapy, surgery

Enhanced Cover (Often Optional)

Cover Detail
Outpatient treatment GP referrals, follow-up appointments
Mental health Therapy, psychiatry (often limited)
Physiotherapy Sessions with a physiotherapist
Dental Check-ups, treatment, hygiene
Optical Eye tests, glasses, contact lenses
Maternity Pregnancy and birth (usually moratorium)

What Is NOT Covered

Excluded Detail
GP services Most policies require NHS GP referral
Emergency treatment Use A&E/NHS
Pre-existing conditions Usually excluded (see underwriting)
Cosmetic surgery Unless medically necessary
Chronic condition management Long-term conditions (diabetes, arthritis)
Pregnancy (standard plans) Often excluded or limited
Organ transplants Usually excluded

Typical Costs

Individual Plans

Age Basic Mid-Range Comprehensive
25–30 £30–£50/month £50–£80/month £80–£120/month
30–40 £40–£65/month £65–£100/month £100–£150/month
40–50 £55–£90/month £90–£140/month £140–£200/month
50–60 £80–£130/month £130–£200/month £200–£300/month
60–70 £120–£200/month £200–£300/month £300–£450/month

Family Plans

Family Size Basic Comprehensive
Couple £80–£150/month £200–£350/month
Couple + 1 child £100–£180/month £250–£400/month
Couple + 2 children £120–£200/month £280–£450/month

Types of Underwriting

Type How It Works Pros Cons
Moratorium No medical questions; pre-existing conditions from last 5 years excluded Quick, easy setup Less comprehensive
Full medical Detailed health questionnaire; insurer decides what to cover Clearer about what’s covered Time-consuming; may exclude more
Continued personal medical exclusions (CPME) Switching from another insurer; maintains existing cover Keeps previous cover Must have existing insurance

NHS vs Private

Feature NHS Private
Cost Free £30–£300+/month
GP access Through NHS GP Usually need NHS GP referral
Waiting times Can be 18+ weeks for elective treatment Days to weeks
Choice of consultant Limited Full choice
Choice of hospital Limited Private hospitals, private NHS rooms
Accommodation Shared ward Private room
Emergency care Excellent (and free) Use NHS A&E
Continuity of care Variable Consistent named consultant

Reducing Costs

Strategy Saving
Higher excess £100–£500 excess reduces premiums significantly
Six-week wait option Only use private if NHS wait exceeds 6 weeks
Guided/guided option Insurer helps choose consultants (lower cost)
Hospital list Choose a limited list of hospitals
No outpatient cover Reduces premium but limits cover
Employer scheme Often cheaper than individual (group rates)
Pay annually 5–10% discount vs monthly

Is It Worth It?

Consider Private Insurance If:

  • NHS waiting times concern you for non-emergency treatment
  • You want choice of specialist and hospital
  • Your employer offers it as a benefit
  • You need regular specialist care
  • You value private rooms and flexible appointment times
  • Mental health support with faster access

The NHS May Be Sufficient If:

  • You are generally healthy
  • Emergency/urgent care is your main concern (NHS excels here)
  • Budget is tight
  • You can accept NHS waiting times
  • You use NHS dental and optical services

Alternative Approaches

Approach Cost Benefit
Self-fund Pay as needed No premiums; full control
Health cash plan £5–£30/month Cashback on dental, optical, physio
NHS + savings fund Premium in savings account Builds fund for private treatment

For broader insurance planning, see our life insurance guide and critical illness cover guide.