More patients using private medical insurance: what are the pros and cons?

Almost seven in 10 people would consider using private healthcare instead of the NHS, according to a new survey – and an increasing number of patients are using insurance to pay for it.

The report, commissioned by the Independent Healthcare Provider Network (IHPN), found of those respondents that went private for treatment, 58% paid using private medical insurance (PMI) compared with 49% in 2023.

Separate figures from the Private Healthcare Information Network (PHIN) also showed a rise in patients paying for treatment. Newly published data for the first three months of 2024 saw the highest level of private admissions in a quarter ever recorded by PHIN. It also found the number of admissions funded by PMI increased in every English region from January to March this year compared with the last quarter of 2023. 

While PMI can help pay for expensive private treatment, it isn't cheap and doesn't cover everything. Here, Which? takes a look at whether the perks of health insurance are worth paying for.

The cost of going private

Long NHS waiting lists mean many patients are choosing to pay private healthcare providers for diagnosis and treatment. 

IHPN's survey found over one third of people would go private in the next 12 months if they needed treatment. More than two in five people who have gone private before went straight to pay for care rather than trying the NHS first.

A surprising number of young people are also willing to pay for medical attention, with 44% of 25 to 34-year-olds expecting to use private healthcare in the coming year. While more than half of all 18 to 24-year-olds who have used private healthcare in the past, did so to access private GP appointments.

Our research found that the cost of a private GP appointment can cost between £29 to £90, which you might think is worth it to be seen quickly.

However, paying for private treatment can burn a sizable hole in your pocket. For example, the average price of a knee replacement costs £13,412, according to recent data from health insurance provider WPA. 

• Find out more: private GP appointments: what to know.

Is private medical insurance worth it?

Given the cost of going private, many people choose to take out a PMI policy. 

Customers pay a monthly or annual premium, but those payments can soon add up and, if you're young and healthy, you may find you never need to claim. 

We have weighed up the pros and cons of private medical insurance to help you decide if it is right for you.

Pros

• Jump the queue You can access treatment and diagnostic scans quickly.
• Wider access to some treatments Certain treatments that the NHS cannot afford to buy may be paid for by private medical insurers. For example, new cancer treatments that aren't yet approved by the NHS.
• Avoid big one-off costs If you don't have the funds, paying for private treatments with your own savings could be a struggle.
• Bills are usually settled by the insurer Private health insurance policies usually pay for your treatment directly with the provider, so you won't need to pay at the clinic and reclaim the costs later. 
• Extra support Some policies will offer mental health support or follow-up care that you might not otherwise get on the NHS. For example, extended physiotherapy to help you recover from an injury or surgery.
• Wellness perks Private health insurance often includes extra benefits aimed at promoting a healthy lifestyle, such as discounted gym memberships or free access to mindfulness apps. 
• Comfort Patients can also expect to be treated and recover in private rooms with access to home-comfort facilities, and a wider choice of food and family visits, that aren't available on the NHS. 

Cons

• Expensive The cost of PMI will depend on the level of coverage and your personal circumstances, such as age, medical history and where you live. Our research into private health insurance costs found that a 55-year-old living in the Midlands stands to pay more than £200 a month for comprehensive cover.
• Not everything is covered Chronic or incurable conditions are rarely covered and neither are injuries from some high-risk activities or pregnancy. Even people with certain jobs, such as oil rig workers aren't covered. Pre-existing medical conditions are also usually excluded.
• Some treatments may be extra Basic policies only cover treatment for patients who are required to stay in hospital for at least one night. If you haven't been admitted and are an outpatient, then cover is extra.
• The excess can be high Even if your insurance agrees to pay the cost of treatment, there is usually an excess to pay and it could still be hundreds of pounds depending on the level of cover you've chosen.
• Private doesn't mean better The quality of procedures and appointments are likely to be much the same as it would be using the NHS, largely as many private doctors also work for the NHS.

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