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Self-Pay vs Health Insurance - What’s the Difference?

  • Jan 05, 2024
  • Health Insurance

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In the UK, the NHS provides free healthcare (at the point of use) to all residents. Nonetheless, the number of patients choosing the private healthcare route has been growing in recent years due to increasing frustration with NHS waiting lists.

When it comes to private treatment, you might be wondering if it’s better to pay for it from your own pocket or purchase a health insurance policy to cover your hospital costs. In this article, we compare both options to help you make an informed decision regarding your private healthcare funding.

How does private healthcare work in the UK?

In the UK, private healthcare is provided by independent hospitals and clinics, separate from the NHS services, or NHS hospitals with private facilities and private wings. Anyone can access private healthcare in the UK by paying for their own treatment or consultation. However, it’s worth mentioning private healthcare in the UK functions alongside the NHS and is not meant to be a replacement. As an example, private healthcare facilities do not routinely offer all the different types of service found within the NHS such as A&E, ITU and maternity care. Read more about the different between the NHS and the private healthcare.

What are the benefits of private healthcare?

Faster access to treatment.

  • Choice of hospital and consultant.
  • Flexible appointment times.
  • Opportunity to use high-end healthcare facilities.

How can you access private healthcare in the UK?

Anyone can access private healthcare by paying for the services from their own pocket, also known as ‘self-pay’. As private healthcare in the UK tends to be quite expensive, individuals, families and companies also have the option to take out private health insurance to cover the costs of their private treatment for eligible claims in exchange for paying a monthly or annual premium to the insurance provider. Find out more about health insurance and how it works.

What is the difference between self-pay and private health insurance?

Self-pay and private health insurance are two ways to access private medical treatment in the UK. On a self-pay contract, you pay for the treatment yourself directly to the medical provider. On the other hand, if you have private health insurance cover, the health insurance company will pay the costs on your behalf in accordance with the terms and conditions of your policy.

Paying for medical treatment yourself under a self-pay contract

By self-paying for your private medical treatment, you cover the costs out of your own pocket at the point of use. However, some hospitals might offer flexible payment options.

Benefits of self-pay

Total freedom to choose any hospital and consultant

When you’re paying for your own private treatment, you can choose any hospital and consultant for your treatment as you are not limited by any hospital lists, as might be the case when you’re claiming on your health insurance.

Get any treatment available through a private hospital

Private health insurance usually excludes cover of certain treatments such as cosmetic treatments. On a self-pay contract, you can have treatment on the private healthcare system without being limited by policy exclusions.

Get treatment for any condition

With self-pay, you can be treated for conditions not normally covered by health insurance such as chronic conditions and pre-existing conditions. Find out more about chronic and pre-existing conditions.

Downsides of self-pay

The biggest downside of self-pay is the cost of treatment, which can get quite high depending on your condition and the facility the treatment takes place in and many people can’t afford to pay large amounts of money all at once. For example, for a hip replacement, the expected private costs are between £9,000 and £16,000.

Taking out health insurance

Taking out health insurance is a more affordable way if you want access to private healthcare in the UK. With health insurance (also known as private medical insurance) you receive cover for private medical bills for acute, short-term conditions which arise unexpectedly, and for the first time, after the start of your policy. A health insurance contract typically lasts 12 months with the option to renew at the end of the term and you can pay your premium monthly or annually. Find out more about health insurance.

Benefits of health insurance

More affordable way to access private healthcare

Private healthcare can be expensive on a self-pay contract. Health insurance gives you the option to fund your private healthcare gradually (partly or fully) and have peace of mind you won’t have to pay large amounts of money from your pocket when the unexpected happens. This means, you can take advantage of the benefits of private healthcare:

  • Shorter waiting times.
  • More choice regarding where you are treated and by whom.
  • Flexible appointment times.
  • More comfort and privacy in hospital rooms.

You can customise your cover

There are many different health insurance products available to buy and most providers will give you the option to customise your policy by adding optional benefits to enhance your cover. At a basic level, most health insurance policies will cover you for inpatient and day-patient cover. Other cover options can include:

  • Outpatient cover.
  • Dental cover.
  • Mental health cover.
  • Physiotherapy treatment.
  • Alternative therapies (chiropractor, osteopath, podiatrist or acupuncturist).

You can add your family to your cover

Usually, you will have the option to add your partner and/or your children to your health insurance cover. This means you will have peace of mind your loved ones can access private healthcare when needed.

Downsides of health insurance

When getting private health insurance, it’s important to know there will be limits to your cover, such as:

  • Some conditions will not be covered such as chronic conditions and pre-existing conditions.
  • Some treatments will not be covered such as cosmetic treatment, treatment for alcohol and drug abuse and addiction, and maternity and childbirth costs.
  • Monetary limits may apply to what your provider will pay towards your hospital bills, depending on your policy.
  • Hospital and consultant choice might be limited with some products or providers.

Self-pay vs health insurance – which one is better?

Accessing private healthcare on a self-pay basis gives you full control over your medical care, where and when you get treated and by whom, and can help you bypass NHS waiting lists. However, private medical costs can be very high.

Health insurance is a more affordable way to access private healthcare by helping you plan your finances in advance for any unexpected illness for which you might need private treatment. However, health insurance won’t cover you for absolutely every condition, and you might still need to pay some money from your own pocket or use the NHS for services which your health insurance policy won’t cover.

It’s also good to be aware that, no matter which route you take for accessing private healthcare, you may still need to use the NHS for services such as emergency treatment and GP visits.

Looking for a private medical insurance quote?

If you would like to find out more about the cost of UK private health insurance, head over to our simple, no-obligation online quote calculator.

Disclaimer: Freedom Health Insurance can’t offer advice on which cover could be best for you. To receive independent advice and compare different providers, you should seek the services of a health insurance broker.