Private Medical Insurance – Is It Worth It?


Most UK residents are entitled to free healthcare from the NHS. With almost all conditions covered, it raises questions over why you would pay for private medical insurance (PMI). However, with reports of long waiting lists and funding cuts, many are turning to private policies to obtain their medical treatment.

Here we look at the pros and cons of taking out a health insurance policy.

What is it?

PMI covers all, or some, of the medical bills should you choose to be treated privately. It also gives you a choice in the level of care you receive and when it is delivered. PMI is quite often provided as part of an employee benefits package and, in some cases, may also cover your immediate family members.

What does it cover?

Like most other types of insurance, the level of cover will vary by the policy you buy. Basic cover will usually pick up the cost of in-patient treatments, such as surgery and tests, whilst more advanced cover will also include out-patient appointments, for example, consultations with specialists. They may also pay you a small fixed amount for any overnight stays in an NHS hospital.

Most policies will not cover you for pre-existing medical conditions, organ transplants, normal pregnancy and childbirth, cosmetic surgery, injuries sustained through dangerous sports and chronic illnesses such as HIV/AIDs, diabetes and epilepsy.

Do you need it?

PMI is very much a personal choice but it is usually driven by people’s desire to speed up the treatment process. If you have debts to repay, then it may be worthwhile prioritising those before taking out PMI as the premiums can be expensive.

If you are thinking about taking out PMI mainly for you children, then it is worth knowing that all children get priority on the NHS, so going privately may not be worthwhile, unless it is for something very specific or you would like to seek a second opinion.


  • Reduce waiting time – if your wait time is more than six weeks, you can use your insurance to be seen faster
  • Choose your location – in theory, you should be able to choose a surgeon and hospital to suit your location and schedule; you cannot do this on the NHS
  • Scans – if the NHS delays a scan or will not offer you one, you can use your cover to pay for it
  • Referrals – depending on the ailment, you can ask your GP to refer you to a specialist either for treatment or a second opinion
  • Specialist – you can access some drugs and treatments not available on the NHS as well as very specialist types of surgery, for example, for sports-related injuries
  • Your own space – private medical insurance can cover the cost of a private room, rather than staying in an open ward
  • Physiotherapy – this is almost always faster through private medical insurance than waiting for an appointment on the NHS


  • Private not always better – for some illnesses, such as cancer, heart disease or a stroke, the NHS treatment can be as good as or better than private hospitals. Also, many doctors who undertake private medical care also work for the NHS, so you could end up seeing the same doctor either way
  • Expensive – an average family of four policy can range from £700 to £1,800 per annum. Premiums will also rise as you get older so, by the time you are more likely to need medical treatment, the premiums may be unaffordable
  • Restrictions – as mentioned above, most policies will not cover you for chronic, incurable illnesses such as HIV/AIDs, diabetes and some forms of cancer
  • Check the small print – depending on the policy you choose, some may have an approved list of consultants and hospitals which might not include the location or expert you want to see

It is important to note that, even if you take out private medical insurance, you do not give up your right to use the NHS. You can also choose to pay for one-off private scans, consultations and treatments without committing to an annual policy.

If you would like to talk to an adviser about your health insurance policies, please contact Finura.

Articles on this website are offered only for general information and educational purposes. They are not offered as, and do not constitute, financial advice. You should not act or rely on any information contained in this website without first seeking advice from a professional.

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