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What Does Private Health Insurance Cover

  • Feb 03, 2023
  • Health Insurance

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Private health insurance aims to provide a safety net against expensive private medical bills and long NHS waiting times and represents an alternative option for those who prefer to have more control over their health care and want to be treated in more comfortable facilities. Find out more about how health insurance works.

When buying health insurance, there often are multiple offers available, with different options and from different insurers, which can be overwhelming. Therefore, it can be useful to know what is usually covered by health insurance, so you can make an informed decision. In this article, we help you understand what’s typically covered and not covered by health insurance.

What does private health insurance usually cover?

Private health insurance is designed to cover the cost of treatment for acute medical conditions which first arise while your policy is active. This means that health insurance usually covers conditions that suddenly appear for the first time during your policy year and can be treated with short-term medical care which restores you to your previous state of health. Conversely, health insurance doesn’t cover conditions you’ve been suffering from before the start-date of your policy (usually referred to as ‘pre-existing medical conditions’), as well as chronic conditions which require long-term treatment and don’t have a known cure.

Understanding what acute, chronic, new and pre-existing conditions are, and being aware that health insurance is typically only for new acute conditions, is important because it helps you better understand your cover when taking out a health insurance policy. With this is mind, most health insurance policies can provide cover for:

  • Private treatment when admitted in a hospital as an inpatient or day patient.
  • Outpatient treatment.
  • Alternative therapies.
  • Dental surgery.
  • Mental health care.
  • Private GP benefit.
  • Cancer treatment.

However, health insurance cover can vary greatly between insurers and the different types of policy available. Many of the benefits mentioned above could be restricted to a maximum financial and some may only be available as additional benefits at an extra cost.

What does private health insurance usually not cover?

With health insurance, it’s common to be provided with a list of conditions and situations not covered, known as exclusions. This means if you make a claim for something on this list, your claim is likely to be unsuccessful. The exclusions vary with each policy and insurer but a typical health insurance policy doesn’t usually cover:

  • Pre-existing medical conditions.
  • Chronic conditions.
  • Emergency treatments.
  • Treatment – received outside the UK.
  • Cosmetic treatments.
  • Drug, alcohol or substance abuse.
  • Fertility treatment.
  • Maternity.

Does private health insurance cover you abroad?

Private health insurance doesn’t typically cover you when you’re abroad. You will usually be provided with a list of UK-wide hospitals that you can use. If you want to get treated abroad, for example in your home county, but you reside in the UK, you might consider a self-pay plan. If you are planning to live and work outside the UK for longer periods of time (more than twelve months), then an international health insurance plan can be helpful.

However, it’s important not to confuse international health insurance with travel insurance as they are different insurance products. International health insurance is specifically for people who plan to relocate outside the UK to live, study or work and wanting to cover their long-term healthcare needs. On the other hand, travel insurance is designed to cover unforeseen events while travelling for shorter periods (e.g. holidays) such as medical emergencies, lost baggage and cancellations. Read more about the difference between international health insurance and travel insurance.

Why get private health insurance?

Having private medical insurance means you get the benefits of using private healthcare but without having to pay expensive medical bills from your own pocket. Here are some of the advantages of health insurance:

  • Shorter waiting times for treatment.
  • More choice and control over where you’re being treated, when and by whom.
  • More comfort in private hospital rooms.
  • Access to treatments and drugs which might not be available on the NHS.
  • Read more about whether private medical insurance is worth buying.

How much does private health insurance cost?

The cost of private health insurance depends on several factors but the cover can usually be adjusted to fit your budget.

Your age has great influence over how much your premium is; as a result, you will find that the older you get, the more expensive your private health insurance is. Other factors that can impact your health insurance cost are excess, claims history, insurance premium tax and cost of private healthcare. Find out more about the cost of private health insurance.

What does Freedom Health Insurance cover?

Whether you are looking for individual, family or business health insurance, we have two products that can offer you a range of benefits to match your budget and medical requirements.

Freedom Elite is our comprehensive health insurance plan which provides cover for:

  • Specialist and hospital fees.
  • Dental surgery.
  • Home nursing.
  • Pregnancy complications.
  • Maternity cash benefit.
  • Private road ambulance.
  • MRI, CT, and PET scans.
  • NHS cash benefit.
  • Cancer cover.

On top of these standard benefits, you can opt for additional cover to suit your needs such as:

  • Extended hospital list.
  • Outpatient treatment.
  • Alternative therapies.
  • Mental health cover.
  • Dental, optical, and private GP benefit.

Please note that limitations and exclusions may apply to these benefits.

You can get a free and instant quote for Freedom Elite online in just a few steps.

Freedom Essentials is our affordable health insurance plan which covers:

  • Fixed cash benefit for inpatient and day patient treatment.
  • Cancer cash benefit.
  • MRI, CT, and PET scans.
  • Fixed cash benefit for pregnancy complications.
  • Fixed cash benefit for dental surgery.

On top of these standard benefits, you can opt for outpatient cover to enhance your policy. Please note that limitations and exclusions may apply to these benefits.

You can get a free and instant quote for Freedom Essentials online in just a few steps.