How Does Private Health Insurance Work in the UK?
Private health insurance in the UK is designed to give individuals, families, and businesses faster access to medical treatment, greater choice of specialists and hospitals, and added comfort throughout the care journey. But how exactly does it work alongside the NHS? And is it right for you or your company?
In this blog, we break down how private medical insurance (PMI) works in the UK, what it covers, and how to choose the right policy.
What Is Private Health Insurance?
Private health insurance (often called Private Medical Insurance, or PMI) is a policy that covers some or all of the costs of private healthcare. This can include consultations, diagnostics, surgery, and aftercare. Instead of relying solely on NHS services, private insurance gives you quicker access to treatment and often a more comfortable experience, such as private hospital rooms or access to certain drugs or treatments not available on the NHS.
PMI is offered by a range of insurers, including well-known names like Bupa, AXA Health, Vitality, Aviva, WPA, and Freedom Health Insurance.
What Does It Cover?
Policies can vary, but most include:
- Consultations with specialists
- Diagnostic tests (MRI scans, X-rays, blood tests)
- Surgical procedures in private hospitals
- Cancer treatment
- Mental health support
- Physiotherapy and other therapies
Note:
Some policies also include extras like dental cover, optical benefits, or private GP access.
Optical and dental cover often requires an additional payment to “attach” it to your policy.
More and more, private online GP access is included in basic policies, but this varies with the insurer.
However, most PMI policies don’t cover:
- Emergency care (you’ll still use the NHS A&E)
- Maternity and pregnancy care
- Pre-existing conditions and their related conditions (unless declared and covered)
- Chronic conditions (e.g., diabetes, asthma)
How Does It Work Alongside the NHS?
The NHS remains the backbone of healthcare in the UK, and private health insurance is there to complement it—not replace it. You’ll still rely on the NHS for emergency care, GPs (unless your policy includes private GP access), and treatment for chronic illnesses.
Having private health insurance doesn’t mean you sacrifice your right to rely on the NHS and most people mix and match which they use.
Private insurance steps in when you need:
- Faster diagnosis and treatment
- More choice in where and when you’re treated
- Access to specialists and procedures not widely available on the NHS
For example, rather than waiting 12+ weeks on an NHS waiting list for knee surgery, you could use your PMI to be treated privately within days or weeks.
Who Is It For?
PMI can benefit:
- Individuals who want peace of mind and faster access to care
- Families looking for comprehensive support for children or partners
- Self-employed professionals who can’t afford long periods off work
- Check out our blog on the Benefits of Health Insurance for Self-Employed Individuals here!
- Businesses wanting to offer a valuable employee benefit to attract and retain talent
Group health insurance policies are often more cost-effective than individual plans and can boost morale, reduce absenteeism, and demonstrate care for your team’s wellbeing.
What Affects the Cost?
Several factors influence your monthly or annual premium:
- Age – premiums generally increase as you get older
- Location – London and major cities may have higher hospital costs
- Level of cover – basic vs. comprehensive plans
- Excess amount – the more you agree to pay upfront, the lower your premium
- Underwriting type – moratorium or full medical underwriting
Working with an independent broker can help you compare plans across insurers and find the best deal for your needs and budget.
Check out our blog on Why Health Insurance Premiums Rise here!
How to Make a Claim
- See your GP (NHS or private, depending on your policy)
- Get a referral to a specialist
- Contact your insurer for authorisation
- Attend private treatment at an approved facility
Some policies also let you self-refer for certain treatments like physiotherapy or mental health support.
Why Use a Health Insurance Broker?
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Navigating health insurance can be overwhelming. An independent broker (like Lifepoint Healthcare) can:
- Explain the different types of cover
- Compare quotes across leading insurers
- Negotiate better rates
- Assist with claims and ongoing support
- Ensure the policy suits your unique needs
Best of all, this service is usually free to you—the broker is paid a commission by the insurer.
Final Thoughts
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Private health insurance in the UK offers speed, flexibility, and comfort—helping you or your employees access the right care, at the right time. It works alongside the NHS, not instead of it, and can be tailored to suit your circumstances and budget.
If you’re considering a plan for yourself, your family, or your business, we’re here to help.
Ready to explore your options? Get in touch with one of our expert advisers today.
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