How does medical insurance work?

In the UK, it is the National Health Service (NHS) which is the primary provider of healthcare to residents. The NHS covers everything from consulting a doctor to emergency care.

So, if you are a resident in the UK there’s a good chance that you are eligible to gain medical support from the NHS. Even though various medical treatments, drugs, and services can be availed through the NHS. Often, the waiting lists for these services are long. Such delays compel individuals to opt for Private Medical Insurance.

Private Medical Insurance plans and policies offer better access to resources. Such as specialised drugs and treatments, better facilities and shorter waiting times.

Private medical insurance plans provide better facilities, shorter waiting times, and more specialised treatments.

National Health Service

The majority of the UK population rely on the NHS for their treatments when they cannot afford Private Health Insurance because it provides healthcare free at the point of use.

If you move to the UK. You will have to obtain the immigration status of ‘indefinite leave to remain’ to be eligible for NHS treatment. This ‘ordinary residential status’ will allow you to gain access to medical care for free.

In case you do not get the indefinite leave to remain in the country. You would do better by obtaining private medical insurance. Though private services will cost you more. They will save you a whopping 150% charge on the NHS tariff.

The government has imposed this tariff to curb “medical tourism”. Whereby people from across the world visit the UK to take advantage of free medical services.

What does the NHS cover?

Usually, the services provided by a General Practitioner (GP) such as blood tests, consultations, and emergency and non-emergency treatments in an NHS hospital are covered by the NHS.

Here are some services which are provided for free by institutions established by the NHS:

  • NHS pharmacies not only help you with the supply of medicines, but you can also consult your pharmacist for advice on minor ailments.
  • Access to free mental health services in the UK have helped many in overcoming their mental health issues. All thanks to the comprehensive mental health network established by the NHS.
  • With the NHS sexual health services. Either at a GP or sexual health specialists’ clinic.
  • If your ophthalmologist decides that an eye-sight check-up is necessary for the well-being of your vision, it is done for free. Otherwise, you are required to pay for it.

Private Medical Insurance

Even though free medical services provided by the NHS are great. They often come with long waiting lists.

Some services have waiting lists as long as 6 months. Therefore, private medical insurance can provide the quick access to specialist services, hospitals and drugs that people require. Without barring your access to NHS benefits.

Everyone from outpatients and inpatients can access private health insurance for their treatment.

There are various types of private medical insurance schemes in the UK.

The types of health insurance plans are:

  • Individual health insurance
  • Joint health insurance
  • Family health insurance
  • Child health insurance

While an individual insurance plan is perfect for someone who is looking for immediate care when in need. Joint plans can come in handy for couples without children who are looking for better healthcare opportunities.

For couples with children, family health insurance plans are the right choice.

If you opt for a child health insurance plan, the diseases which are more specific to children will be covered.

In order to access the benefits of private insurance, you need to pay a premium on an annual or monthly basis to the insurance company. The premium depends upon the number of members it covers, length of coverage, age, lifestyle and any pre-existing medical conditions.

If you are employed or retired, it is possible that your employment or retirement benefits package covers the premium already.

What treatments does private health insurance cover?

Private Health Insurance covers all kinds of diseases which are curable and acute.

It covers the treatment of inpatients, patients who are required to stay in the hospital for many days for the treatment. Outpatients, patients who visit the hospital for diagnosis, consultations, and tests without having to stay overnight. Or day patients, patients who visit doctors for regular appointments.

The coverage you get depends upon the clauses of the medical insurance policy that you opt for. The lower the premium, the lesser the pay-out.

Your policy might ask you to choose from any of the following treatments which you would like to have covered.

  • Physiotherapy
  • Psychiatric treatment
  • Dental treatment
  • Medical treatment and nursing at home
  • Optical treatment
  • Treatment of more specific diseases like cancer

What will your Private Medical Insurance not cover?

While every policy comes with its own terms and conditions. Many are not likely to cover the following:

  • The ongoing treatments for long term diseases. Such as HIV and more, especially if they are incurable as yet.
  • Treatments such as cosmetic surgeries and fertility treatments. Which are not crucial for your well-being, but you choose to undergo.
  • Emergency treatments are always referred to the NHS because it runs Ambulance and A&E departments in hospitals.
  • Treatment for drug abuse. Such as going to rehab for recovery.
  • Overseas treatment. Which is usually covered by your travel insurance.
  • Care and treatment during pregnancy. Only if there are no health-related complications.
  • Pre-existing medical conditions. Conditions you have had treatment for before buying the policy.

In a nutshell. Free healthcare in the UK is, in fact, free for the people who are either residents, or have a status similar to that of ‘ordinary residents’, and not for those coming in as tourists.

Those who are not able to obtain treatment on the NHS. Or do not want to wait for their turn to receive medical aid. Can purchase private medical insurance plans. They provide better facilities, shorter waiting times, and more specialised treatments.

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